ID:IOTS - Infectious Disease Insight Of Two Specialists 34. Arguing about atypicals
Nov 14, 2022
Dive into the quirky world of pneumonia as the hosts tackle the challenges of treating atypical pathogens. Discover why standard antibiotics often miss the mark and what alternatives exist. They dissect the nuances of antibiotic prescribing, especially in relation to guidelines. The difference between viral and atypical bacterial infections is explored, revealing critical treatment strategies. Plus, learn how doxycycline can be a game-changer for less severe cases. It’s a fun yet informative journey through infectious disease dilemmas!
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Why Beta-Lactams Fail Atypicals
- 'Atypical' pneumonias are mainly Legionella, Mycoplasma, and Chlamydophila and often require non–beta-lactam drugs.
- These organisms evade beta-lactams because of absent cell walls or intracellular location.
Choose Atypical Cover Thoughtfully
- Use macrolides, tetracyclines (doxycycline), or quinolones to cover atypical organisms when indicated.
- Prefer doxycycline locally due to clarithromycin cardiac risks and stewardship concerns about quinolones.
Wrong Extra Atypical Added In Hospital
- Callum describes a case where a patient with penicillin allergy was placed on vancomycin and ciprofloxacin and then had clarithromycin inappropriately added.
- He felt concerned that clinicians followed guidelines without understanding that ciprofloxacin already covers atypicals.