The CDC is the best place to check for updated STI guidelines and resistance patterns. Chlamydia: Doxycycline 100 mg orally 2 times/day for 7 days (preferred) Azithromycin 1g 1 time dose (can use in pregnancy) Levofloxacin 500 mg orally once daily for 7 days Alt in preg: Amoxicillin 500 mg orally 3 times/day for 7 days […]
Infectious Disease
Urinary Tract Infections
When presented with a urinary tract infection, you have to ask: Cystitis or pyelonephritis? Lower UTI – cystitis: dysuria, frequent urination, urgency, suprapubic pain, hematuria Upper UTI – pyelonephritis: same as above plus systemic symptoms like fever chills, flank pain, CVA tenderness, nausea and vomiting Complicated or Uncomplicated Complicated: associated with a structural or functional abnormality […]
Pneumonia
Community Acqired Pneumonia (CAP) CAP is defined as pneumonia with an onset outside of the hospital setting or < 48 hours after hospital admission. Mortality ranges from < 1% to 50% depending on severity of illness. It is one of the leading infectious causes of hospitalization anddeath. Bacterial CAP is usually caused by S. pneumonia, […]
Endocarditis Guideline Review
Causes: Bacterial infection is the most common cause of endocarditis, specifically viridans group strep, Staphylococcus aureus, HAECK group organisms (Haemophilus species, Aggregatibacter actinomycetemcomitans, Cardiobacterium hominis, Eikenella corrodens, and Kingella kingae), or Enterococcus. Endocarditis can also be caused by fungi, such as Candida. Some weird fastidious bacteria show up too, like Bartonella, Brucella, Coxiella burnetii (causes […]
Sinus Troubles: When Should I See My Doctor
We’ve all had sinus troubles before and it’s sometimes hard to tell if it’s a bacterial infection, a virus, or allergies. Your physician probably even has a hard time. Here are some tips on when to see your physician, and when you should visit your local pharmacy for some home remedies. Viral Sinusitis If you’ve […]
COVID-19 mRNA EUA Vaccine FAQs
There have been a lot of questions about the COVID-19 mRNA vaccines. I thought I would put together an easy FAQ with some referenced answers. I’ll keep adding to it as I get more questions. I have a FAQ about the Johnson and Johnson vaccine too. Is it Going to Alter my DNA? If you […]
Clostridium/Clostridiodes Difficile
Clostridiodes difficile is a pretty big problem, causing quite a bit of morbidity and mortality every year, and it’s becoming more and more common. It can be pretty tricky to treat. C. diff is an anaerobic, spore-forming rod and it makes a toxin that contributes to the severity of the disease. It causes diarrhea and […]
Sinusitis
Sinusitis is usually viral. Only use antibiotics if signs and symptoms are greater than 10 days or purulent discharge with a fever greater than 102 degrees. Viral is quick, usually lasting less than a week. Bacterial often has double sickening and purulent discharge. Do not do imaging unless immunocompromised or orbital cranial involvement. Only symptomatic relief for […]
Respiratory Syncytial Virus
Treatment: Mostly supportive care Ribavirin – only in select patients (complicated congenital heart disease, chronic lung disease, bronchopulmonary dysplasia, immunocompromised patients) Beta-agonists or race epinephrine – not usually used Corticosteroids, hypertonic saline or antibiotics are also not usually used. Prophylaxis: Palivizumab: 15 mg/kg/dose; prophylaxis is not recommended if > 29 weeks gestation (risk factors not considered) Neonates […]
Meningitis
Signs and Symptoms: Brudzinski sign and Kernig Sign Fever, altered mental status, neck, stiffness, seizures, neurological deficits Treatment: <1-month-old – ampicillin (listeria coverage) and cefotaxime or gentCommon pathogens: Group B Strep, E. coli, K. pneumoniae, Enterobacter, Listeria monocytogenes 1-23 months old – vancomycin and ceftriaxone or cefotaximeCommon pathogens: S. pneumoniae, N. meningitidis, H. influenzae 18-50 years – vancomycin […]