🎖️PharmaRx Insights✨

32-year-old HIV-positive man who presents to the clinic with,a cough productive of sputum. He is receiving darunavir/ritonavir, tenofovir. A sputum sample is positive for AFB Which is Best treatment ?

Important note about drug and dose adjusted in HIV patient who have TB

TB treatment Regimen in HIV ( special caution due to drug interaction ⚠️)

Diagnosis of TB 📍

Summary of Latent TB treatment 🔖

Summary of Active TB treatment 🔖

Active Vs Latent TB 💢

TB screen test 💢

Topic : TUBERCULOSIS⚠️🫁 Tuberculosis (TB) is LUNG infection caused by Mycobacterium tuberculosis (an aerobic, non-spore forming bacillus). The disease has two phases: latent and active. Diagnosis: ^Active TB; By symptoms : cough/hemoptysis (coughing up blood), purulent sputum, fever, night sweats and unintentional weight loss.And chest X-ray ^Latent disease can be diagnosed using the tuberculin skin test (TST), also called a purified protein derivative (PPP) test, or an interferon-gamma release assay (IGRA) blood test. Treatment depend on the phase (Active or latent ) : #Active TB : Active TB treatment is divided into two phases (intensive and continuation); Intensive : ( four drugs: rifampin, isoniazid, pyrazinamide and ethambutol for two months (this regimen is known as " RIPE” therapy). Continuation : (four months) treatment use two drugs (commonly rifampin and isoniazid) depending on the drug susceptibility of the isolate. ———————————————————————————————— #Latent TB treatment : Regimen options choose one depend on the patient case and other factor : ■ INH and rifapentine once weekly for 12 weeks via directly observed therapy (DOT) or self-administered. Do not use this regimen in pregnant patients. ■ INH with rifampin daily for 3 months. ■ Rifampin 600 mg daily for 4 months. ■ INH 300 mg daily for 6 or 9 months.( this is preferred in HIV-positive patients taking antiretroviral therapy (due to the risk for drug interactions). Note : shorter regimens (e.g., 3 or 4 months) are preferred in most adults due to higher completion rates and less risk of hepatotoxicity compared to longer courses of isoniazid (INH).

Explanation of this Q : #Ceftriaxone plus gentamicin plus linezolid is not good empiric therapy because cetriaxone has no activity against P. aeruginosa. Because the patient has been in a hospital for 5 days or more (8 days at this point), she is at increased risk of MDR organisms, specifically P. aeru-ginosa and MRSA(Answer A is incorrect). #Although piperacillin/tazobactam has good activity against most common causes of nosocomial pneumonia (including P. aeruginosa), the most recent guidelines recommend two antibiotics with activity against P. aeruginosa for patients with risk factors for MDR organisms She also needs an antibiotic with MRSA activity (Answer B is incorrect). #Levofloxacin has activity against P. aeruginosa, but two drugs should be used (Answer C is incorrect). #Cefepime plus tobramycin plus vancomycin is the best empiric therapy because it includes two antibiotics with activity against P. aeruginosa and another agent for MRSA (Answer D is correct).

a 66-vear-old woman who underwent a two-vessel coronary artery bypass graft 8 days ago and has been on a ventilator in the surgical ICU,Her temperature rising and new infiltrate in the right lower lobes, MH COPD Which is the best empiric therapy?

68-year-old man who presents to the emergency department with coughing His MH congestive heart failure.A chest radiograph reveals infiltrates. If He were hospitalized, which the best empiric therapy ?

Risk factor of MDR 🔖

Treatment of HAP and VAP SUMMARY ⏺️

Risk factor of HAP 📍