Tags: Cephalexin

Actinomyces

Disease occurs when mechanical insult disrupts the mucosal barrier or organisms gain access to privileged sites. For example, actinomycosis commonly occurs after dental procedures, trauma, surgery, or aspiration. Actinomyces israelii causes the majority of human disease owing to this genus, but other species, including Actinomyces naeslundii, Actinomyces viscosus, Actinomyces enksonii, Actinomyces odontolyticus, and Actinomyces meyeri have also been implicated. Actinomycosis is threefold more common in men than women.

Bordetella Species: Clinical Syndrome

The catarrhal stage is characterized by nonspecific upper respiratory symptoms, including rhinorrhea, mild cough, and low-grade fever. During this stage, which typically lasts 1-2 weeks, the disease is highly communicable. The paroxysmal stage is marked by sudden attacks or paroxysms of severe, repetitive coughing, often culminating with the characteristic whoop and frequently followed by vomiting.

Staphylococci

Staphylococcus aureus colonizes the human skin, vagina, nasopharynx, and gastrointestinal tract. Colonization occurs shortly after birth and may be either transient or persistent. Published studies differ widely in estimates of the prevalence of S aureus carriage.

Intravascular Catheter-Related Infections

Can be life-threatening. Often prolong hospital stay, and can be complicated by metastatic lesions and bacterial endocarditis. A 53-year-old white woman was admitted to the hospital with complaints of severe shaking during infusion of her hyperalimentation solution. She had been receiving intravenous hyperalimentation for 16years for a severe dumping syndrome that prevented eating by mouth.

Anti-Infective Agent Dosing

The characteristics that need to be considered when administering antibiotics include absorption (when dealing with oral antibiotics), volume of distribution, metabolism, and excretion. These factors determine the dose of each drug and the time interval of administration. To effectively clear a bacterial infection, serum levels of the antibiotic need to be maintained above the minimum inhibitory concentration for a significant period. For each pathogen, the minimum inhibitory concentration is determined by serially diluting the antibiotic into liquid medium containing 104 bacteria per millihter.

Specific Anti-Infective Agents

Clinicians should be familiar with the general classes of antibiotics, their mechanisms of action, and their major toxicities. The differences between the specific antibiotics in each class can be subtle, often requiring the expertise of an infectious disease specialist to design the optimal anti-infective regimen. The general internist or physician-in-training should not attempt to memorize all the facts outlined here, but rather should read the pages that follow as an overview of anti-infectives. The chemistry, mechanisms of action, major toxicities, spectrum of activity, treatment indications, pharmacokinetics, dosing regimens, and cost are reviewed.

Urinary Tract Infections and Prostatitis

A urinary tract infection is defined as the presence of microorganisms in the urine that cannot be accounted for by contamination. The organisms have the potential to invade the tissues of the urinary tract and adjacent structures.

Skin and Soft Tissue Infections

Impetigo is a superficial skin infection that is seen most commonly in children. It is highly communicable and spreads through close contact. Most cases are caused by S. pyogenes, but S. aureus either alone or in combination with S. pyogenes has emerged as a principal cause of impetigo.

Respiratory Tract Infections, Upper

The goals of treatment include reduction in signs and symptoms, eradication of infection, and prevention of complications. Avoidance of unnecessary antibiotic use is another goal in view of S. pneumonia. dClindamycin is only recommended in cases of documented S. pneumoniae. It is not effective against H. influenzae or M. catarrhalis.

Respiratory Tract Infections, Lower

Bronchitis, bronchiolitis, pneumonia clinical presentation and treatment.