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coal
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250886
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thera URI
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2013-12-05 00:37:02
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  1. causative organism of sinusitis
    • S. pneumoniae
    • H. influenza
    • M. catarrhalis
  2. 7 S & S of sinusitus
    • mucopurulent discharge
    • congestion
    • periorbital swelling
    • facial pain
    • maxillary toothache
    • fever
    • nonproductive cough
  3. 4 goals of Tx of sinusitis
    • symptomatic relief
    • restore & improve sinus function
    • prevent complications
    • eradiate pathogens
  4. sinusitis first line therapy in peds w/no PCN allergy
    amox 80-90 mg/kg/day in 2-3 doses
  5. sinusitis first line therapy in peds w/ PCN allergy non-type 1
    cefdinir 14 mg/kg/day in 1-2 doses
  6. sinusitis first line therapy in peds w/ PC allergy type 1
    azithromycin 10 mg/kg day 1 then 5 mg/kg/day on days 2-5
  7. sinusitis first line therapy in adults w/no PCN allergy
    amox 1 g PO TID
  8. sinusitis first line therapy in adults w/ PCN allergy non-type 1
    cefdinir 600 mg PO QD 1-2 doses
  9. sinusitis first line therapy in adults w/ PCN allergy type 1
    azithromycin 500 mg on day 1 then 250 mg on days 2-5
  10. Tx of acute sinusitis > 7 days or > 101 and no previous Tx in past month
    • high dose amoxicillin 
    •            or
    • macrolide for 10-14 days
  11. Tx of acute sinusits > 7 days or > 101 and previous Tx in past month
    • augmentin
    •       or
    • oral cephalosporin for 10 - 14 days
  12. causative organisms of otitis media
    • up to 75% of cases are viral
    • S. pneumonia 49%
    • H. influenzae 29%
    • M. catarrhalis 28%
  13. 6 S&S of otitis media
    • rapid onset
    • otalgia
    • fever
    • irritability
    • ear tugging
    • hearing loss
  14. 5 goals of Tx of otitis media
    • control pain
    • eradicate infection
    • prevent complications
    • avoid unnecessary antibiotics
    • minimize adverse effects of Tx
  15. symptomatic Tx of otitis media
    • analgesics
    • antipyretics
    • local heat
    • tympanostomy tubes for recurrent episodes
  16. Tx of otitis media in peds w/no PCN allergy
    amox 80-90 mg/kg/day in 2-3 doses
  17. Tx of otitis media in peds w/ PCN allergy non-type 1
    cefdinir 14 mg/kg/day in 1-2 doses
  18. Tx of otitis media in peds w/ PCN allergy type 1
    azithromycin 10 mg/kg day 1 then 5 mg/kg/day on days 2-5
  19. Tx of otitis media in peds w/no PCN allergy and a severe illness
    augment 90 mg/kg/day in 2 doses
  20. Tx of otitis media in peds w/ PCN allergy non-type 1 and a severe illness
    clindamycin 30-40 mg/kg/day in 3 doses
  21. Tx of otitis media in adults w/no PCN allergy
    amox 1 g PO TID
  22. Tx of otitis media in adults w/ PCN allergy non-type 1
    cefdinir 600 mg PO QD 1-2 doses
  23. Tx of otitis media in adults w/ PCN allergy type 1
    azithromycin 500 mg on day 1 then 250 mg on days 2-5
  24. Tx of acute otitis media in kids w/no antibiotic in past month
    amoxicillin 80-90 mg/kg/day
  25. Tx of acute otitis media in adults w/no antibiotics in past month
    amoxicillin 1000mg TID
  26. Tx of acute otitis media 3 days later and responding vs no response
    • continue
    • stop amoxicillin and start augmentin
  27. causative organisms of pharyngitis
    • group A strepotoccus - most common
    • viruses
  28. 5 S&S of pharyngitis
    • sore throat
    • fever
    • dysphagia
    • red,swollen tonsil
    • malaise, HA, abdominal pain, vomiting
  29. 3 goals of Tx of pharyngitis
    • resolve symptoms
    • limit spread
    • prevent complications
  30. Tx of symptomatic pharyngitis
    • analgesics
    • antipyretics
  31. Tx of pharyngitis Group A strep
    • PCN is drug of choice, tx for 10 days (can use amoxicillin)
    • alternates
    •   macrolides
    •   1st gen cephalosporins
    •   clindamycin
  32. acute otitis media < 6 mo with a certain diagnosis
    antibacterial therapy
  33. acute otitis media < 6 mo w/ an uncertain diagnosis
    antibacterial therapy
  34. acute otitis media 6 mo - 2 yo w/ certain diagnosis
    antibacterial therapy
  35. acute otitis media 6 mo - 2 yo w/ an uncertain diagnosis
    • antibacterial therapy if severe illness
    • observation if non-severe illness, 48-72 hours prior to starting antibiotics
  36. acute otitis media > 2 yo w/ certain diagnosis
    • antibacterial therapy if severe illness
    • observation if non-severe illness, 48-72 hours prior to starting antibiotics
  37. acute otitis media > 2 yo w/ uncertain diagnosis
    observation option, 48-72 hours prior to starting antibiotics

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