Antibiotic Essentials (PAPERBACK) | Released: 30 Jun 2015

About the Book

Antibiotic Essentials provides an overview of antimicrobial therapy, followed by guidance on therapy for over 550 clinical syndromes, including cardiovascular infections, sexually transmitted diseases, sepsis, and transplant infections.
The Subsequent chapters cover antibiotic susceptibility profiles, parasites, fungi and other organisms, HIV infections and prophylaxis.
A separate chapter covers infectious diseases and antimicrobial agents in paediatrics.
A chest x-ray atlas and a list of antibiotic pearls and pitfalls are also provided.
Encompasses over 170 antimicrobial drug summaries in its concluding chapter, including six recently approved antimicrobials, new to this edition.
Each antimicrobial drug summary includes pharmacokinetic data, antibiotic resistance potential, adverse effects, drug interactions, and dosing recommendations.

About the Author

Burke A. Cunha MD MACP

Table of Contents:
TABLE OF CONTENTS 1. OVERVIEW OF ANTIMICROBIAL THERAPY 1 Factors in Antibiotic Selection...................................2 Spectrum............................................................................2 Tissue Penetration........................................................2 Antibiotic Resistance ..................................................2 Safety Profile.....................................................................4 Cost........................................................................................4 Factors in Antibiotic Dosing........................................4 Dosing in Renal/Hepatic Insufficiency.............5 Routes of Elimination (Renal and Hepatic)....5 Microbiology and Susceptibility Testing.............6 In Vitro vs. In Vivo Susceptibility...........................7 PK/PD and Other Considerations in Antimicrobial Therapy....................................................9 Bactericidal vs. Bacteriostatic Therapy.............9 Monotherapy vs. Combination Therapy.........9 Intravenous vs. Oral Switch Therapy..............10 Bioavailability of Oral Antibiotics......................11 OPAT ...................................................................................11 Duration of Therapy .................................................11 Empiric vs. Specific Antibiotic Therapy ............12 Positive Blood Cultures vs. Bacteremia (MSSA, MRSA, CoNS)................................................13 Drug Fever...........................................................................13 Relative Bradycardia ......................................................14 Antibiotic Failure .............................................................14 Pitfalls in Antibiotic Prescribing..............................15 2. EMPIRIC THERAPY BASED ON CLINICAL SYNDROME 17 CNS Infections Acute Bacterial Meningitis.........................................18 Acute Nonbacterial/Chronic Meningitis...........21 Encephalitis.........................................................................25 Brain Abscess/Subdural Empyema/ Cavernous Vein Thrombosis/Intracranial Suppurative Thrombophlebitis.........................27 HEENT Infections Facial/Periorbital Cellulitis..........................................29 Bacterial Sinusitis.............................................................30 Keratitis..................................................................................31 Conjunctivitis.....................................................................32 Chorioretinitis....................................................................34 Endophthalmitis..............................................................35 External Otitis....................................................................37 Acute Otitis Media..........................................................38 Mastoiditis...........................................................................39 Suppurative Parotitis.....................................................40 Pharyngitis...........................................................................40 Thrush (Oropharyngeal Candidiasis) ..................43 Mouth Ulcers/Vesicles..................................................44 Deep Neck Infections, Lemierre’s Syndrome, Severe Dental Infections.............46 Epiglottitis............................................................................47 Lower Respiratory Tract Infections Acute Bacterial Exacerbation of Chronic Bronchitis.......................................................48 Mediastinitis.......................................................................49 Community-Acquired Pneumonia ......................49 Zoonotic Atypical Pneumonia................................60 Lung Abscess/Empyema ...........................................67 Nursing Home-Acquired Pneumonia ................68 Nosocomial Pneumonia.............................................68 Cardiovascular Infections Subacute Bacterial Endocarditis............................70 Acute Bacterial Endocarditis....................................74 Prosthetic Valve Endocarditis...................................76 Pericarditis/Myocarditis...............................................78 Central IV Line/Pacemaker Infections................79 Vascular Graft Infections.............................................82 Gastrointestinal Tract Infections Esophagitis..........................................................................84 Peptic Ulcer Disease......................................................85 Gastric Perforation..........................................................85 Diarrhea/Typhoid (Enteric) Fever.............................86 Cholecystitis.......................................................................92 Cholangitis..........................................................................93 Gallbladder Wall Abscess/Perforation................93 Acute Pancreatitis...........................................................94 Pancreatic Abscess/Infected Pancreatic Pseudocyst.....................................................................95 Liver Abscess......................................................................95 Hepatosplenic Candidiasis........................................96 Granulomatous Hepatitis...........................................96 Viral Hepatitis.....................................................................97 Intraabdominal or Pelvic Peritonitis/ Abscess (Colitis, Appendicitis, Diverticulitis, Septic Pelvic Thrombophlebitis, Spontaneous Bacterial Peritonitis, CAPD-Associated Peritonitis, TB Peritonitis).................................... 100 iv Antibiotic Essentials Genitourinary Tract Infections Dysuria-Pyuria Syndrome....................................... 103 Cystitis................................................................................. 103 Catheter-Associated Bacteriuria/Candiduria.......104 Epididymitis..................................................................... 106 Acute Pyelonephritis.................................................. 107 Chronic Pyelonephritis............................................. 108 Renal TB.............................................................................. 108 Renal Abscess (Intrarenal/Perinephric).......... 109 Prostatitis/Prostatic Abscess.................................. 110 Urosepsis........................................................................... 111 Pelvic Inflammatory Disease, Salpingitis, Tuboovarian Abscess, Endometritis/ Endomyometritis, Septic Abortion.............. 113 Sexually Transmitted Diseases Urethritis/Cervicitis.......................................................114 Vaginitis/Balanitis...........................................................115 Genital Vesicles................................................................116 Genital Ulcers...................................................................117 Suppurating Inguinal Adenopathy ....................118 Genital/Perianal Warts................................................118 Syphilis..................................................................................119 Bone and Joint Infections Septic Arthritis/Bursitis...............................................121 Lyme Disease/Lyme Arthritis..................................127 Infected Joint Prosthesis...........................................128 Osteomyelitis....................................................................129 Skin and Soft Tissue Infections Cellulitis, Erysipelas, Mastitis....................................132 Complicated Skin/Skin Structure Infections (cSSSIs).....................................................134 Skin Ulcers..........................................................................137 Skin Abscesses/Infected Cysts (Skin Pustules/Boils, Furunculosis).............................140 Skin Vesicles (Non-Genital)......................................142 Wound Infections..........................................................144 Superficial Fungal Infections Skin/Nail.............147 Skin Infestations..............................................................150 Ischiorectal/Perirectal Abscess..............................151 Sepsis/Septic Shock 151 Febrile Neutropenia 158 Transplant Infections Bacteremia .........................................................................160 Candidemia.......................................................................161 CMV/HHV-6/BK Virus....................................................162 EVB/PTLD............................................................................163 RSV ..........................................................................................163 Adenovirus.........................................................................163 Encephalitis/Meningitis.............................................164 Brain Abscess/Mass Lesions....................................164 Focal/Segmental Pulmonary Infiltrates........................................................................165 Diffuse Pulmonary Infiltrates..................................165 Viral Hepatitis....................................................................166 Toxin-Mediated Infectious Diseases Toxic Shock Syndrome...............................................169 Botulism...............................................................................170 Tetanus.................................................................................170 Diphtheria...........................................................................170 Bioterrorist Agents Anthrax.................................................................................173 Tularemia Pneumonia.................................................173 Pneumonic Plague........................................................174 Botulism...............................................................................174 Smallpox..............................................................................174 Ebola......................................................................................174 3. ANTIBIOTIC SUSCEPTIBILITY PROFILES  AND INITIAL THERAPY OF ISOLATES PENDING SUSCEPTIBILITY RESULTS 185 Antibiotic Susceptibility Profiles (Penicillins, Macrolides, Tetracyclines, and Others)........186 Antibiotic Susceptibility Profiles (Cephalosporins).......................................................191 Antibiotic Susceptibility Profiles (Aminoglycosides, Fluoroquinolones, Carbapenems, and Others)................................198 Gram Stain Characteristics of Isolates (by Morphology Arrangement, Oxygen Requirements).........................................203 Alphabetical Index of Isolates................................205 Key Factors in Antibiotic Selection (Isolate Known)............................................................................207 Antibiotic Resistance Potential..............................207 Aerobic Isolates...............................................................208 Capnophilic Isolates.....................................................235 Anaerobic Isolates.........................................................236 Yeast/Fungi........................................................................242 Gram Stain/Giemsa Stain Technique.................246 CSF Gram Stain................................................................246 Sputum Gram Stain......................................................248 Urine Gram Stain............................................................248 Fecal Gram Stain.............................................................249 4. PARASITES, FUNGI, UNUSUAL ORGANISMS 253 Blood Pathogens Microfilaria in Blood......................................................254 Trypanosomes in Blood.............................................255 Spirochetes in Blood....................................................257 Intracellular Inclusion Bodies in Blood .............258 Table of Contents v CSF/Brain Pathogens Cysts/Mass Lesions in CSF/Brain...........................261 Lung Pathogens Pulmonary Cystic Lesions/Masses.......................265 Pulmonary Coin Lesions............................................266 Pulmonary Infiltrates/Mass Lesions....................267 Heart Pathogens Chagas’ Disease...............................................................273 Liver Pathogens Liver Flukes.........................................................................273 Cystic Masses in Liver..................................................274 Hepatomegaly.................................................................275 Stool/Intestines Pathogens Intestinal Protozoa.........................................................276 Intestinal Nematodes (Roundworms)...............278 Intestinal Cestodes (Tapeworms) ........................281 Intestinal Trematodes (Flukes/Flatworms)..................................................282 Other Intestinal Infections........................................282 Skin/Muscle Pathogens Infiltrative Skin/Subcutaneous Lesions.......... 283 Infiltrative Skin Lesions ± Ulcers/Sinus Tracts/Abscesses..................................................... 284 Skin Vesicles/Bullae..................................................... 288 Subcutaneous Serpiginous Lesions................. 288 Skin Papules/Nodules/Abscesses...................... 289 Rickettsia (Fever/Petechial Skin Rash)............. 294 Other Skin Lesions....................................................... 297 Myositis.............................................................................. 298 5. HIV INFECTION 301 Overview .......................................................................... 302 Stages of HIV Infection ............................................. 303 Acute (Primary) HIV Infection............................... 304 Approach to HIV Testing.......................................... 305 Initial Assessment of HIV Patients..............................308 Indications for Treatment of HIV Infection....................................................................... 312 Antiretroviral Treatment........................................... 313 Antiretroviral Treatment Failure........................... 316 Opportunistic Infections in HIV Disease........ 319 Treatment of Opportunistic Infections........... 323 Treatment of Other Opportunistic Infections in HIV....................................................... 338 HIV Coinfections (HBV/HCV)................................. 344 6. PROPHYLAXIS AND IMMUNIZATIONS 353 Surgical Prophylaxis.................................................... 354 Post-Exposure Prophylaxis...................................... 358 Chronic Medical Prophylaxis/Suppression.........364 HIV Pre-Exposure Prophylaxis (PrEP)........................365 HIV Post-Exposure Prophylaxis (PEP).......................366 HIV Opportunistic Infections.........................................366 Transplant Prophylaxis........................................................367 Endocarditis Prophylaxis.......................................... 369 Travel Prophylaxis......................................................... 371 Malaria Prophylaxis..................................................... 375 Tetanus Prophylaxis.................................................... 377 Immunizations............................................................... 378 7. PEDIATRIC INFECTIOUS DISEASES AND PEDIATRIC DRUG SUMMARIES 386 CNS Infections.............................................................. 387 HEENT Infections........................................................ 391 Lower Respiratory Tract Infections................... 396 Vascular Infections..................................................... 402 Gastrointestinal Infections.................................... 403 Bone and Joint Infections..................................... 407 Skin and Soft Tissue Infections........................... 411 Common Pediatric Antimicrobial Drugs.......414 8. CHEST X-RAY ATLAS 425 Unilateral Focal Segmental/Lobar Infiltrate Without Effusion....................................................................426 Unilateral Focal Segmental/Lobar Infiltrate With Effusion ....................................... 431 Unilateral Ill-Defined Infiltrates Without Effusion ...................................................................... 436 Unilateral Ill-Defined Infiltrates With Effusion .................................................................................443 Bilateral Infiltrates Without Effusion ............... 448 Bilateral Infiltrates With Effusion ...................... 458 Cavitary Infiltrates (Thick-Walled) .................... 463 Cavitary Infiltrates (Thin-Walled) ...................... 470 9. INFECTIOUS DISEASE DIFFERENTIAL DIAGNOSIS 474 10. ANTIBIOTIC PEARLS & PITFALLS 507 11. ANTIMICROBIAL DRUG SUMMARIES 521 APPENDIX 720 INDEX 731 COLOR ATLAS OF CSF, SPUTUM, AND URINE GRAM STAINS & FUNGAL STAINS (see center of book) vi Antibiotic Essentials