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Wednesday, July 25, 2018

DRUGS for infectious agents / other agents /

Nitazoxanide covers broadly !!
rota, amoeba giardia, clostridium dificile and parvum , blastocystic hominis(protozoal)

Campylobactor jejuni (supportive)(in severe cases give azithro or quinolone)

Botulism (supportive+ botulism antitoxin if given early in disease)

shigella (supportive)(severe cases: CIPRO  }}}  ampicillin/TMP-SMX/,ceftriaxone,azithromycin)

Vibrio cholera (azithromycin first line )(doxy 2nd line)

B.cereus ,
staph aureus (supportive / preformed toxins)

yersinia (supportive }}   if septic treat with amikacin, / TMP SMX / doxy / cipro)

amoeba (sympto ? :intestinal/hepatic abscess:  metronidazole/tinidazole followed by
                                                                           paromomycin/iodoquinol )
              (asympto? :  paromomycin/iodoquinol)


Giardia (nitazoxanide/ metronidazole/tinidazole)
         

Toxoplasma gondii (serology/ PCR |||||  )   (asympto? :: no t/m necessary)
                         sympto?::: child pyrimethamine+sulfadiazine   (e folic acid)
                        same for pregnant and immuno compromised .
          If eye involvement , add steroids.
    do not forget folic acid addition because of both drugs pyri and sulfadia


Trichinella ( mebendazole/ albendazole )   add steroids in severe disease

Amanita mushroom ( supportive care for hepatic and renal functions)

Tetrodotoxin ( puffer fish)  rapid ascending paralysis with death in 4 hrs ( give resp support)

campylobactor jejuni can cause:
GBS, glomerulonephritis, igA nephropathy , erythema nodosum, hemolytic anemia (not HUS) , reactive arthritis , UTI, hepatitis, pneumonia , meningtitis.
                       t/m:   erythromycin //azithromycin )

LACTOBACILLUS GG (reduces severity and duration of ROTA virus diarrhoea)
(for a minimum period of 7 days or untill diarrhoea resolved)

Saccharomyces boulardii ( for A/B diarrhoea, and clostridium difficile diarrhoea)
(for a minimum period of 7 days or untill diarrhoea resolved)



Clostridium difficle ( hold offending AB, start metronidazole.... 2nd line is vanco./ // NT TOX //
                        s. boulardii )


ETEC, EPEC, EIEC (ceftrizaone, azithro , TMP-SMX , ampicillin , cipro)
never give A/B for EHEC


Amoeba ,, metronidazole follwed by iodoquinol or paromomycin

shigella :opd ::cipro, tmp x, azithro
inpatient ,ceftriaxone

clost difficile
metronodazol oral or iv
2nd line vanco oral


salmonella diarrhea to be treated in <3mo, immunocompromised,malginancy,or systemic disease ot with ceftriaxone.
otherwise observe this diarrhea.


campylobactor jejuni : erythro ,azithro