[Os 213] Lec 05.2 Drugs for Rti
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Transcript of [Os 213] Lec 05.2 Drugs for Rti
Mark, Cristina, Kevin UPCM 2016 B: XVI, Walang Kapantay! 1 of 1
OS 213: Circulation and Respiration LEC 05.2: ANTIBACTERIALS FOR RESPIRATORY TRACT INFECTIONS
Exam 2 | Cecilia C. Maramba-‐Lazarte, MD| August 23, 2012
OUTLINE I. Antibacterials for RTI
A. Viral Respiratory Infections B. Choice of Antibiotics for
Bacterial Infections C. Recommended Antibiotics for
Pedia CAP
II. Review of Antibiotics A. Penicillin B. Cephalosporins C. Macrolides D. Quinolones
This trans was based on the print-‐out of slides of Dr. Maramba.
I. ANTIBACTERIALS FOR RTI
A. VIRAL RESPIRATORY INFECTIONS • Many respiratory diseases may be viral in origin and does not require antibiotics o Rhinovirus, Adenovirus, Rubella, Corona Virus, Parainfluenza
• Consider Efficacy, Safety and Cost o Efficacy: based on target pathogens and prevailing resistance in locality
o Local epidemiology, Age, Severity of Illness, Co-‐morbidities, Hospital-‐Acquired
B. CHOICE OF ANTIBIOTICS FOR BACTERIAL INFECTIONS
Table 1. BACTERIAL ETIOLOGY OF RESPIRATORY TRACT INFECTIONS Pharyngitis Group A Streptococcus Otitis media S. pneumoniae, H. influenzae Epiglottitis H. influenzae Bronchitis Sinusitis
Pneumonia S. pneumoniae, H. influenzae Lung Abscess Anaerobes
Table 2. ANTIMICROBIAL RESISTANCE (%) by Disc Diffusion DOH
antimicrobial resistance surveillance Jan-‐Dec 2010 Pathogen Ampi Chloro Coamox Cotri Pen Erythro Cefu Strep. pneumo
0 5.9 0 21.1 0 3.3 0
H. influenza
16.5 12 0 34.5 0
M. catarrhalis
24.2 17.1 47.6 45.9 0
S. aureus 95.3 6.3 5.8 54 8.7 0
C. RECOMMENDED ANTIBIOTICS FOR PEDIA CAP
Table 3. ANTIBIOTIC THERAPY FOR PEDIA CAP
Age Suspected Organism Empiric Therapy
Alternative Therapy
0-‐2 months
Gram (-‐) Bacilli Ampicillin + Aminogly
3rd gen Ceph + Aminoglycoside
Mild Amoxicillin Severe Pen G
2nd or 3rd gen Cephalosporin
3 mos – 5 years
H. influenza, S. pneumonia, S. aureus
Very Severe
Chloramphen. 3rd gen Cephalosporin
>5 yrs S. pneumoniae Pen G 2nd or 3rd gen Cephalosporin
Hospital Acquired
S. aureus, Gram (-‐) bacilli Ceftazidime Piperacillin-‐ Tazobactam
ACCORDING TO RISK STRATIFICATION & LIKELY ETIOLOGY
• CAP Low risk • CAP Moderate risk • CAP High risk • HAP • Other etiologies
Table 4. LOW RISK CAP Likely Pathogens Empiric Therapy
Previously healthy: Amoxicillin or extended macrolide
S pneumonia H influenzae C pneumoniae M pneumoniae M catarrhalis
With stable comorbid illness: Coamoxyclav OR 2nd gen cephalosporin OR extended macrolides
Table 5. MODERATE RISK CAP
Likely Pathogens Empiric Therapy Previously healthy: Amoxicillin or extended macrolide
S pneumonia H influenzae C pneumoniae M pneumoniae M catarrhalis
With stable comorbid illness: Coamoxyclav OR 2nd gen cephalosporin OR extended macrolides
Table 5. HIGH RISK CAP
Likely Pathogens Empiric Therapy Previously healthy: Amoxicillin or extended macrolide
S pneumonia H influenzae C pneumoniae M pneumoniae M catarrhalis
With stable comorbid illness: Coamoxyclav OR 2nd gen cephalosporin OR extended macrolides