Topics to review before an ID elective

[somethingdeep]

---

Members don't see this ad.

Can anyone recommend what resources or topics would be useful to review before doing an inpatient elective in infectious disease?

 

[Kalydeco]

1. Infections.
2. Disease.

 

[masaraksh]

The 2 fundamental steps of the incision & drainage procedure

 

[Kalydeco]

The 2 fundamental steps of the incision & drainage procedure

1. Incise.
2. Drain.

 

[Doctor Strange]

Antibiotics Simplified by Gallagher is gold.

 

[andrek82]

I would get familiar with the classes of anti infectives, especially 3rd/4th line. I finished mine up a few weeks ago, and we never saw anyone who hasn't been through 2 or more drugs already. So, it's important to know what could be next, and whether or not it will oral or iv. We got quizzed on side effects quite a bit, and knowing how to read a sensitivities report is also important. When it comes down to it though, there are so many tissues and likely organisms based on risk factor that you'll look most things up, just like the fellow and attending. I carried around a copy of the Sanford Guide (http://www.amazon.com/gp/aw/d/19308...erapy+2015&dpPl=1&dpID=41wGLKOAWJL&ref=plSrch). The 2014 version is a couple bucks cheaper and just as good. It is a tiny book that fits in any pocket and will be a great resource on intern year too.

 

[swoopyswoop]

know your abx coverage. know the mcc organisms for common infections. these 2 combined --> you can come up with the rx.

 

[J ROD]

drugs and bugs..........

 

[DNAdude120]

I liked the antibiotic video from onlinemeded to get a BASIC overview of abx. Specific things that I remember coming up a lot included hardware infections and complicated bacteremias.

 

[HelpPleaseMD]

review basic treatment of CAP, HCAP, their differentiation
categories of C. DIFF and their associated treatment
osteomyelitis treatment, should get bone biopsy before starting abx

When to consider line infections
Duke's criteria and endocarditis workup
Fever of unknown origin

Treatment of sepsis
Cholangitis treatment

That would be a good starting point and should cover 90% of what you will see

 

[typhoonegator]

Get a copy of your hospital's antibiogram. It should give you information on the relative resistances seen in the hospital in addition to the formulary anti-infectives. That will give you a leg up when you're trying to decide whether to add a cephalosporin or a quinolone for VAP, and which one to pick.

If your hospital has a lot of oncology, make sure you brush up on neutropenic fever coverage.

Also when you need to double cover gram negatives. And how to treat C. diff. A lot of ID, particularly in the ICU, is the same questions over and over. Two days of fever with elevated WBC and no source? RUQ u/s, CXR, LENIs, blood cultures, screen for drug fever culprits, consider central fever...

And review the infectious hepatitides. Which antibodies to order to screen.

And if it's encephalitis, always consider Powassan. And if it's cholangitis, always consider the Chinese liver fluke.

 

[somethingdeep]

Antibiotics Simplified by Gallagher is gold.

I would get familiar with the classes of anti infectives, especially 3rd/4th line. I finished mine up a few weeks ago, and we never saw anyone who hasn't been through 2 or more drugs already. So, it's important to know what could be next, and whether or not it will oral or iv. We got quizzed on side effects quite a bit, and knowing how to read a sensitivities report is also important. When it comes down to it though, there are so many tissues and likely organisms based on risk factor that you'll look most things up, just like the fellow and attending. I carried around a copy of the Sanford Guide (http://www.amazon.com/gp/aw/d/19308...erapy+2015&dpPl=1&dpID=41wGLKOAWJL&ref=plSrch). The 2014 version is a couple bucks cheaper and just as good. It is a tiny book that fits in any pocket and will be a great resource on intern year too.

know your abx coverage. know the mcc organisms for common infections. these 2 combined --> you can come up with the rx.

I liked the antibiotic video from onlinemeded to get a BASIC overview of abx. Specific things that I remember coming up a lot included hardware infections and complicated bacteremias.

review basic treatment of CAP, HCAP, their differentiation
categories of C. DIFF and their associated treatment
osteomyelitis treatment, should get bone biopsy before starting abx

When to consider line infections
Duke's criteria and endocarditis workup
Fever of unknown origin

Treatment of sepsis
Cholangitis treatment

That would be a good starting point and should cover 90% of what you will see

Get a copy of your hospital's antibiogram. It should give you information on the relative resistances seen in the hospital in addition to the formulary anti-infectives. That will give you a leg up when you're trying to decide whether to add a cephalosporin or a quinolone for VAP, and which one to pick.

If your hospital has a lot of oncology, make sure you brush up on neutropenic fever coverage.

Also when you need to double cover gram negatives. And how to treat C. diff. A lot of ID, particularly in the ICU, is the same questions over and over. Two days of fever with elevated WBC and no source? RUQ u/s, CXR, LENIs, blood cultures, screen for drug fever culprits, consider central fever...

And review the infectious hepatitides. Which antibodies to order to screen.

And if it's encephalitis, always consider Powassan. And if it's cholangitis, always consider the Chinese liver fluke.

Super helpful, thank you everyone! Just ordered myself a copy of Sanford's guide 🙂

 

[Shipping News]

Know how long to treat the common bacterial infections. ID is often asked to not only pick the antibiotic but to also decide the duration of treatment. Especially important in patients going home on IV antibiotics. It's helpful to also know how often the drugs are dosed for practical considerations. There are guidelines for this stuff, like in IDSA.

Your bread & butter is going to MRSA bacteremia, the various pneumonias, endocarditis, osteo & diabetic infections, etc

 

[masaraksh]

IV KCN works wonders.