4th year with a micro/bugs&drugs Question

[Sparkymd]

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It has been a long time since micro in second year. To be honest, I don't think I ever had "when to use what antibiotic" down. Now looking ahead to intern year, I want to prepare a little bit. I know some say don't read in preparation, but this is a serious area of weakness that I want to improve and I have time. Any thoughts on great resources? Websites, books, anything. Thank you in advance.

 

[smq123]

It has been a long time since micro in second year. To be honest, I don't think I ever had "when to use what antibiotic" down. Now looking ahead to intern year, I want to prepare a little bit. I know some say don't read in preparation, but this is a serious area of weakness that I want to improve and I have time. Any thoughts on great resources? Websites, books, anything. Thank you in advance.

- Sanford guide. Although you probably already knew that.

- The Hopkins Antibiotic Guide. This is available online, and is a great resource. You have to register to use it, but registration is free. My main gripe with it is that they don't include pediatric dosing, but if you're doing something like IM which is pretty much all adults, it's not a big deal. Otherwise, it's easy to read, easy to use, and very informative.

- Practice. As you see more and more patients, you will become comfortable with which abx are generally used for which conditions. It will become second nature to you.

Trust me, some residents are very bad at this too. Which is how you end up with, for instance, residents treating uncomplicated UTIs with clinda, of all things.

 

[Droopy Snoopy]

- Sanford guide. Although you probably already knew that.

- The Hopkins Antibiotic Guide. This is available online, and is a great resource. You have to register to use it, but registration is free. My main gripe with it is that they don't include pediatric dosing, but if you're doing something like IM which is pretty much all adults, it's not a big deal. Otherwise, it's easy to read, easy to use, and very informative.

- Practice. As you see more and more patients, you will become comfortable with which abx are generally used for which conditions. It will become second nature to you.

Trust me, some residents are very bad at this too. Which is how you end up with, for instance, residents treating uncomplicated UTIs with clinda, of all things.

And when in doubt just give levaquin

 

[Dirt]

I just use epocrates. After you treat something like three times you remember what to use.

The hopkins guide is great. It is annoying, however, that a native iphone version costs you $25.

 

[cabinbuilder]

And when in doubt just give levaquin

Z-Pak cures everything and most patients can afford it.

 

[Requiem]

I just use epocrates. After you treat something like three times you remember what to use.

The hopkins guide is great. It is annoying, however, that a native iphone version costs you $25.

Epocrates, if you're referring to the epocrates app for itouch, is absolutely garbage.

Sanford can be cumbersome to use, but it has good information in it. Use it enough and it'll get easier.

Bugs and drugs was a decent resource (stopped being published in 2006) but a free copy is available online now. www.bugsanddrugs.ca i think, just google it.

Lexi-comp has decent information regarding indication dosing, but nothing regarding spectrum. It also has decent information regarding renal impairment dosing. Lexi is available through uptodate, which you should have access to.

Infectious disease society of america (IDSA) has good guidelines published, available on their website.

In summation:

Spectrums are hard to learn and almost impossible to learn on the fly. This is why most attendings and almost all residents have trouble with abx dosing and don't know alternatives. I'd recommend you spend some solid time trying to get coverages of major abx groups down, and then it'll become easier. These are great references, but there needs to be a core knowledge.

Guidelines : IDSA
Dosing: Lexi
Spectrum: Sanford/bugsanddrugs
Renal impairment : lexi / product monograph / renal dosing handbooks.

gl!

 

[Sparkymd]

Thank you so much! Any thoughts on the actual bug stuff? I could stand to learn some of the actual micro stuff. I guess maybe just Micro made ridiculously simple?