ABP Pediatric Infectious Diseases flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

First-line treatment for GAS pharyngitis

Penicillin V or amoxicillin for 10 full days. The prolonged course eradicates group A Streptococcus and prevents acute rheumatic fever; shorter courses have not reliably shown that protection.

Latent tuberculosis treatment regimens

Options include 4 months of daily rifampin, 12 weeks of weekly isoniazid plus rifapentine in children 2 years and older, or 6 to 9 months of daily isoniazid.

Cat-scratch disease antibiotic

Azithromycin for 5 days is first line for Bartonella henselae lymphadenitis with nodes 2 to 3 cm or larger; most cases resolve spontaneously, but treatment shortens the illness.

Pertussis treatment and prophylaxis

Azithromycin for 5 days is preferred for treatment and for household postexposure prophylaxis. It reduces transmission but does not shorten the paroxysmal cough once it has developed.

Influenza antiviral treatment window

Oseltamivir is most effective when started within 48 hours of onset, but hospitalized or high-risk children should be treated regardless of how long symptoms have been present.

HSV encephalitis treatment

Intravenous acyclovir 20 mg/kg every 8 hours for 21 days in neonates and children. Treatment is started empirically before CSF HSV PCR results return because delay worsens outcome.

Congenital CMV treatment indication

Valganciclovir for 6 months is used for symptomatic congenital CMV with central nervous system involvement, such as chorioretinitis, sensorineural hearing loss, or microcephaly.

Measles postexposure prophylaxis

MMR within 72 hours of exposure for eligible contacts; immune globulin within 6 days for infants under 12 months, pregnant women, and severely immunocompromised children who cannot receive live vaccine.

Candidemia first-line therapy

An echinocandin such as caspofungin or micafungin is first line. Remove central venous catheters, obtain a dilated eye examination, and repeat blood cultures until sterile.

Pneumocystis pneumonia treatment

High-dose trimethoprim-sulfamethoxazole for 21 days. Add adjunctive corticosteroids when hypoxemia is present, defined as PaO2 under 70 mmHg or an alveolar-arterial gradient over 35.

Severe malaria treatment

Intravenous artesunate is preferred for severe pediatric malaria. Quinidine plus doxycycline or clindamycin is an alternative when artesunate is unavailable, with cardiac monitoring during infusion.

Intrapartum GBS prophylaxis

Intravenous penicillin G is preferred. Cefazolin is used for non-anaphylactic penicillin allergy, and clindamycin or vancomycin only when susceptibility testing confirms activity against the isolate.

Empiric therapy for early-onset neonatal sepsis

Ampicillin plus gentamicin. Add cefotaxime or another third-generation cephalosporin when meningitis is suspected, because gentamicin penetration into cerebrospinal fluid is inadequate.

Neonatal HSV treatment duration

Acyclovir 20 mg/kg every 8 hours for 14 days in skin-eye-mouth disease and 21 days in disseminated or CNS disease, with repeat CSF PCR near the end of therapy.

Minimum age for MMR

Twelve months for routine administration. A dose given at 6 to 11 months before international travel does not count toward the routine two-dose series.

Rotavirus vaccine timing limits

First dose by 14 weeks 6 days of age and the final dose by 8 months 0 days. Doses given after these limits are not recommended because of intussusception risk.

Hepatitis B birth dose

Give within 24 hours of birth to all infants. For infants of hepatitis B surface antigen-positive mothers, also give hepatitis B immune globulin within 12 hours at a separate site.

Contraindications to live vaccines

Severe immunocompromise including SCID and high-dose corticosteroid therapy, pregnancy, and anaphylaxis to a vaccine component. Inactivated vaccines are used instead in these situations.

Febrile neutropenia empiric therapy

Start an anti-pseudomonal beta-lactam such as cefepime, piperacillin-tazobactam, or meropenem within 60 minutes. Add vancomycin for hypotension, suspected catheter infection, or MRSA colonization.

Asplenia infection risks

Encapsulated organisms-Streptococcus pneumoniae, Haemophilus influenzae type b, and Neisseria meningitidis-cause overwhelming sepsis. Provide penicillin prophylaxis, complete vaccination, and ceftriaxone for any fever.

Chronic granulomatous disease organisms

Catalase-positive organisms, including Staphylococcus aureus, Aspergillus, Serratia, Burkholderia, Nocardia, and Chromobacterium. Prophylaxis uses trimethoprim-sulfamethoxazole plus itraconazole, sometimes with interferon gamma.

Vancomycin monitoring target

Aim for an AUC24/MIC of 400 to 600 mg·h/L for serious infections. Trough-only monitoring of 15 to 20 mcg/mL is an alternative when AUC cannot be measured.

Beta-lactam allergy cross-reactivity

Cross-reactivity between penicillins and later-generation cephalosporins is about 1 to 2 percent. Avoid a cephalosporin only when the prior reaction was anaphylaxis to a drug with an identical side chain.

Clostridioides difficile first-line treatment

Oral vancomycin or fidaxomicin for 10 days. Metronidazole is reserved for when preferred agents are unavailable because it produces lower rates of initial cure.

Blood culture volume in children

Optimal yield requires 1 to 3 mL per bottle in infants and up to 10 mL in older children. Inadequate volume is the most common reason for a falsely negative culture.

CSF glucose ratio in bacterial meningitis

A CSF-to-serum glucose ratio below 0.4, together with elevated protein and neutrophilic pleocytosis, supports bacterial rather than viral meningitis and warrants empiric antibiotics.

Urine culture in young infants

Collect by catheterization or suprapubic aspiration. Bag specimens frequently grow contaminants, and a positive bag result requires confirmation by a properly collected specimen before treatment.

Airborne precautions indications

Pulmonary tuberculosis, measles, varicella, and smallpox require a negative-pressure room and an N95 respirator because these pathogens travel on small droplet nuclei over long distances.

Hand hygiene for C. difficile

Wash with soap and water, because alcohol-based rubs do not kill spores. Use contact precautions with gown and gloves for the duration of diarrhea.

CLABSI prevention bundle

Hand hygiene, maximal sterile barrier during insertion, chlorhexidine skin antisepsis, optimal catheter site selection, and daily review of line necessity reduce central line-associated bloodstream infections.

Kawasaki disease diagnostic criteria

Fever for at least 5 days plus 4 of 5 features: rash, conjunctivitis, oral changes, extremity changes, and cervical lymphadenopathy. Treat with IVIG and aspirin.

Febrile infant under 3 months

A rectal temperature of 38.0 degrees Celsius or higher warrants a full sepsis evaluation with blood, urine, and CSF cultures and empiric intravenous antibiotics pending results.