4th Year ID elective help

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bbtbay

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Hi I am a 4th year who will be doing an ID elective in August. I was wondering if anyone who is in ID or did an ID elective could share any thoughts on a book I could use to prepare for my ID elective (or use during elective).

Any input would be greatly appreciated.

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I don't have a book to recommend, but here were my observatiosn from my 4th year elective in ID. Basically, your primary consults will be to help the team rule out an infectious etiology for a patient who's started having fevers. The usual suspects to keep in mind are pneumonias, UTI, bacteremias, C. Diff colitis, line or other hardware infections, routine physical actions (like pulmonary toilet or bed turning or something similar), and any new medication added which may be causing a drug fever. As such, a de novo fever workup will consist of pan culturing (Blood, Urine, and sputum), CXR, C. Diff titers, and changing lines (if they have central lines, they should be moved to a different location and not just changed over a wire). When in doubt, CT the head looking for sinusitis, espically if they have an NG tube or something. Always be wary of lines used for TPN because they grow candida like crazy. For C. Diff, a neat pearl is that oral vanco is the only FDA approved treatment (even though flagyl is the typical first line treatment). If you want to look like a stud, the infectious disease society of america has practice guidelines for the major infections etiologies, so it's a good thing to site on rounds. It's also helpful because a bunch of your consults will be along the lines of "How many weeks of antibiotics does this patient need for his osteo/bacteremia/viral meningitis/whatever". The site is

http://www.idsociety.org/Content.aspx?id=9088

As such, just review your major antibiotics and their typical spectrum and resistances and you'll have a good start to things. The antibiotics I'd recomend knowing everything about are:

vancomycin
nafcillin
ceftriaxone
cefpodixime
cefepime
gentamycin
piperacillin/tazobactam (Zosyn)
flagyl
clindamycin
bactrim
augmentin
ampicillin/sulbactam
ciprofloxacin
levofloxacin
doxycycline
imipenem
fluconazole
caspofungin
acyclovir (CBC needs to be followed closely with people on IV acyclovir, and they need to be prophylactically hydrated to prevent serum saturation and crystal deposition in the kidneys)
 
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