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Gram-positive bacteria: Staphylococci
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Staphylococcus aureus
Staphylococcus aureus causes a variety of suppurative (pus-forming) infections and toxinoses in humans. It causes superficial skin lesions such as boils, styes and furunculosis; more serious infections such as pneumonia, mastitis, phlebitis, meningitis, and urinary tract infections; and deep-seated infections, such as osteomyelitis and endocarditis. S. aureus is a major cause of hospital acquired (nosocomial) infection of surgical wounds and infections associated with indwelling medical devices. S. aureus causes food poisoning by releasing enterotoxins into food, and toxic shock syndrome by release of superantigens into the blood stream.
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Staphylococcus aureus
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Superantigens
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Treatment of Infections Caused by Staphylococcus aureus
Antistaphylococcal penicillins: Nafcillin, oxacillin First Generation cephalosporins: Cefazolin Second Generation Cephalosporins: Cefurxime Third-generation cephalosporins: Ceftriaxone, cefotaxime, ceftizoxime B-Lactam/b-lactamase inhibitor combinations: Ampicillin-sulbactam, piperacillin-tazobactam, ticarcillin-clavulanate Carbapenems: Imipenem, meropenem
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Treatment of Methicillin-resistant Staphylococcus aureus
Vancomycin Linezolid Streptogramins (Quinupristin-dalfopristin) Daptomycin Tigecycline
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Gram-positive pathogens: Streptococcus pneumoniae
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Streptococcus pneumoniae
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Treatment of Streptococcus pneumoniae
Penicillin G Aminopenicillins: Ampicillin
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Treatment of Penicillin-resistant Streptococcus pneumoniae
Second Generation Cephalosoporins: Cefuroxime Third Generation Cephalosporins: Cefotaxime, Ceftriaxone Quinolones: Moxifloxacin, Levofloxacin Vancomycin Macrolides/ketolines: Telithromycin
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Streptococcus pyogenes
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Streptococcus pyogenes
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Treatment of Streptococcus pyogenes
Penicillin G Aminopenicillins: Ampicillin Aminoglycosides are sometimes added for synergy: Gentamicin Clindamycin is added for severe invasive Streptococcus pyogenes infections
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Treatment for Penicillin-resistant Streptococcus pyogenes (and other penicillin resistant Streptococcus) Vancomycin Second-generation cephalosporins: Cefuroxime Third-generation cephalosporins: cefotaxime, ceftriaxone
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Enterococci
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Enterococcus
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Enterococcus Resistance Mechanisms
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Treatment of Infections Caused by Enterococcus
Penicillin G Aminopenicillins: Ampicillin Extended-spectrum Penicillins: Piperacillin Carbapenems: Imipenem, meropenem For serious infections, add an aminoglycoside for synergy: Gentamicin
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Treatment for Infections Caused by Penicillin-resistant Enterococci
Vancomycin
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Treatment for Vancomycin Resistant Enterococci (VRE)
Linezolid Tetracycline-like: Tigecycline Sometimes also active: Daptomycin Quinupristin/dalfopristin
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Gram-positive Bacteria: Listeria Monocytogenes
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Listeria monocytogenes
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Treatment of Infections Caused by Listeria monocytogenes
Ampicillin + Gentamicin If penicillin allergic: Trimethoprim-sulfamethoxazole
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Bacillus anthracis
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Bacillus anthracis
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Bacillus anthracis
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Treatment of Infections Caused by Bacillus anthracis
Quinolones: Ciprofloxacin Tetracycline: Doxycycline
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Treatment of Infections Caused by Bacillus anthracis
For Inhalation Anthrax, a Second Agent Should be Added from the Following List: Rifampin Vancomycin Penicillin G Ampicillin Chloramphenicol Carbapenem: Imipenem Clindamycin Macrolide: Clarithromycin
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Gram-negative Bacteria: Enterobacteriaceae
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Escherichia coli
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Klebsiella
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Proteus
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Escherichia coli.
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Treatment of Infections Caused by: E. coli., K. pneumoniae, Proteus
Aminopenicillins: Ampicillin First Generation Cephalosporins: Cefazolin Sulfa drugs: Trimethoprim-sulfamethoxazole Quinolones: Ciprofloxacin, levofloxacin, moxifloxacin
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Treatment of Resistant Infections Caused by: E. coli. , K
Treatment of Resistant Infections Caused by: E. coli., K. pneumoniae, Proteus Third Generation Cephalosporins: Cefoxaxime, ceftriaxone, ceftizoxime Monobactam: Aztreonam Extended Spectrum penicillins + b-lactamase inhibitor: Piperacillin-tazobactam, ticarcillin-clavulanate Carbapenems: Imipenem, meropenem, ertapenem Carbapenem + aminoglycoside in serious infections: Add Gentamicin, Tobramycin, amikacin
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Treatment of Infections Caused by: Enterobacter, Serratia, Citrobacter, Providencia, and Morganella Spp. Carbapenems: Imipenem, meropenem, ertapenem Sulfa Drugs: Trimethoprim-sulfamethoxazole Quinolones: Ciprofloxacin, levofloxacin Fourth Generation Cephalosporins: Cefepime + aminoglycoside: Gentamicin, tobramycin, amikacin
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Treatment of Infections Caused by: Salmonella enterica, Shigella spp.
Quinolones: Ciprofloxacin Third-generation cephalosporins: Cefotaxime, ceftriaxone, ceftizoxime Macrolides: Azithromycin
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Treatment of Infections Caused by: Yersinia spp.
Aminoglycosides: Gentamicin, streptomycin Tetracyclines: Doxycycline Quinolones: Ciprofloxacin Sulfa drugs
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Gram-negative Bacteria: Pseudomonas
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Pseudomonas
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Resistance of Pseudomonas
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Treatment of Infections caused by Pseudomonas aeruginosa
Extended spectrum penicillins: Piperacillin, Ticarcillin Third Generation Cephalosporins: Ceftazidime Fourth-generation Cephalosporins: Cefepime Carbapenems: Imipenem, meropenem Monobactams: Aztreonam Quinolones: Ciprofloxacin, Levofloxacin Aminoglycosides: Gentamicin, tobramycin, amikacin
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Treatment of Serious Infections Caused by Pseudomonas aeruginosa
Antipseudomonal b-lactam + aminoclycoside: Ceftazidime + Tobramycin Extended-spectrum penicillin + antipseudomonal quinolone: Piperacillin + Ciprofloxacin
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Neisseria
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Neisseria meningitidis
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Neisseria gonorrhoeae
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Treatment of Infections Caused by Neisseria meningitidis
Penicillin G Third generation cephalosporins: Ceftriaxone, cefotaxime
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Treatment of Infections Caused by Neisseria Gonorrhoeae
Third Generation Cephalosporins: Ceftriaxone, cefixime
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Curved Gram Negative Bacilli
Includes: Campylobacter jejuni, Helicobacter pylori, Vibrio cholerae
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Campylobacter jejuni
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Campylobacter jejuni
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Treatment of Infection Caused by Campylobacter jejuni
Macrolides: Erythromycin, azithromycin, clarithromycin Quinolones: Ciprofloxacin
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Helicobacteri pylori
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Helicobacter pylori
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Helicobacter pylori
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Duodenal Peptic Ulceration Caused by Helicobacter pylori
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Treatment of Infection Caused by Helicobacter pylori
Amoxicillin + clarithromycin + proton pump inhibitor Metronidazole + clarithromycin + proton pump inhibitor Bismuth subsalicylate + metronidazole + tetracycline + proton pump inhibitor
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Vibrio cholerae
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Vibrio cholerae
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Treatment of Infection Caused by Vibrio cholerae
Tetracyclines: tetracycline, doxycycline Sulfa drugs: Trimethoprim-sulfamethoxazole Quinolones: Ciprofloxacin Macrolides: Erythromycin, Azithromycin
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Haemophilus influenzae
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Haemophilus influenzae
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Haemophilus influenzae
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Treatment of Infections Caused by Haemophilus influenzae
Aminopenicillins + b-lactamase inhibitor: Amoxicillin/clavulanate Ampicillin/sulbactam Second-generation cephalosporin Cefuroxime Third-generation cephalosporin Ceftriaxone Cefotaxime
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Bordetalla pertussis
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Bordetella pertussis
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Treatment of Infection Caused by Bordetella pertussis
Macrolides: Azithromycin, Clarithromycin, Erythromycin
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Moraxella catarrhalis
Causes otitis media, pneumonia, and sinusitis Usually produces b-lactamase
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Treatment of Infections Caused by Moraxella catarrhalis
Extended spectrum penicillins: piperacillin, ticarcillin B-lactam/b-lactamase inhibitor combinations: piperacillin/tazobactam, ticarcillin/clavulanate Second and third-generation cephalosporins
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Acinetobacter Recent outbreak among soldiers in Iraq
Second leading cause of infection among troops during the Vietnam conflict
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Acinetobacter
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Treatment of Infection Caused by Acinetobacter
Sulbactam Carbapenems Quinolones
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Anaerobic Bacteria Gram positive: Clostridia spp.
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Clostridium tetani Clostridium tetani is the etiologic agent of tetanus Characterized by persistent tonic spasm, usually involving the masseter muscles (lockjaw) Usually caused by deep wound becoming infected with C. tetani spores.
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Clostridium botulinum
Clostridium botulinum is usually acquired by ingestion of food contaminated with C. botulinum spores Botulinum toxin leads to cranial neuroopathies and weakness rather than muscular spasm.
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Treatment of Infections Caused by Clostridium spp.
Penicillin G Metronidazole (may be associated with better outcomes
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Clostridium difficile
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Clostridium difficile
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Treatment of Infections Caused by Clostridium difficile
Oral metronidazole Oral vancomycin
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Clostridium perfringens is the cause of gas gangrene
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Treatment of Infections Caused by Clostridium perfringens
Penicillin + one of the following: Clindamycin Tetracycline Metronidazole
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Anaerobic Gram-negative Bacteria
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Common Anaerobic Gram-negative Pathogens
Bacteroides fragilis Usually produces b-lactamase Prevotella Porphyromonas
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Treatment of Anaerobic Gram-negative Infections
b-lactam/b-lactamase inhibitor combinations Ampicillin-sulbactam Piperacillin-tazobactam Ticarcillin-clavulanate Carbapenems: Imipenem, Meropenem, Ertapenem Metronidazole
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Atypical Bacteria: Chlamydia
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Chlamydia trachomatis
One of the most common sexually transmitted diseases Also a leading cause of blindness in some parts of the world
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Chlamydia trachomatis
Chlamydia is a bacterial infection of the genital tract spread through sexual contact. If untreated, it can result in various medical complications, including damage to the reproductive organs. The disease affects both women and men, although reported cases for women greatly exceed those for men. Chlamydia affects people in all age groups, but it is particularly prevalent among teenagers and young adults. According to the U.S. Centers for Disease Control and Prevention (CDC), the infection is most prevalent among women aged 20 to 25.
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Chlamydia trachomatis
Some signs and symptoms that may be present in people infected with chlamydia are: Abnormal discharge from the penis or vagina Burning sensation during urination Lower abdominal or back pain Nausea Fever Pain during intercourse Burning or itching around the head of the penis Swollen or tender testicles Bleeding between menstrual cycles Proctitis (inflammation of the rectum)
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Treatment of Infections Caused by Chlamydia trachomatis
Tetracyclines Tetracycline Doxycycline Macrolides Azithromycin Erythromycin Telithromycin Quinolones Ofloxacin Moxifloxacin Gemifloxacin
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Mycoplasma pneumoniae
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Mycoplasma pneumoniae
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Treatment of Infections Caused by Mycoplasma pneumoniae
Macrolides: Azithromycin, clarithromycin, erythromycin telithromycin Tetracyclines: Tetracycline, doxycycline Quinolones: Levofloxacin, moxifloxacin, gemifloxacin
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Atypical Bacteria: Legionella
Legionella pneumophila is the most common species, and is the causative agent of Legionaires’ disease Once in the lung, Legionella organisms are taken up by macrophages and multiply within them.
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Legionalla pneumophila
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Treatment of Infections Caused by Legionella pneumophila
Macrolides: Azithromycin Quinolones: Levofloxacin, moxifloxacin
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Brucella Brucellosis is a disease of animals, that is occasionally transmitted to humans Contact with animals and/or ingestion of unpasteurized milk or cheese are risk factors
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Brucella
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Brucella
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Treatment of Infections Caused by Brucella spp.
Doxycycline + rifampin Dixycycline + gentamicin Doxycycline + streptomycin
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Francisella tularensis
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Francisella tularensis
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Treatment of Infections Caused by Francisella tularensis
Aminoglycosides: Streptomycin, Gentamicin Tetracyclines: Tetracycline, doxycycline
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Rickettsia spp
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Rickettsia rickettsii
Rocky Mountain spotted fever is the most severe and most frequently reported rickettsial illness in the United States. The disease is caused by Rickettsia rickettsii, a species of bacteria that is spread to humans by ixodid (hard) ticks.
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Treatment of Infections Caused by Rickettsia spp.
Tetracyclines Doxycycline Tetracycline
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Spirochetes: Treponema pallidum
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Treponema pallidum
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Treponema pallidum
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Treponema pallidum
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Treatment of Infections Caused by Treponema pallidum
Penicillin G (including benzathine penicillin) Tetracyclines Third Generation Cephalosporins
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Penicillin G benzathine
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Procaine penicillin G
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Borrelia borgdorferi
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Borrelia burgdorferi
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Borrelia burgdorferi is the causative agent of Lyme Disease
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Treatment of Infections Caused by Borrelia burgdorferi
Tetracyclines: Doxycycline Aminopenicillins: Amoxicillin
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Leptospira interrogans
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Leptospira interrogans
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Treatment of Infection Caused by Leptospira interrogans
Tetracyclines: Doxycycline Aminopenicillins: Amoxicillin Severe Disease can be treated with Penicillin G, Ampicillin, or Ceftriaxone
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Mycobacteria Mycobacterium tuberculosis Mycobacterium avium complex
Mycobacterium leprae
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Mycobacterium tuberculosis
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Mycobacterium tuberculosis
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Mycobacterium tuberculosis
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Treatment of Infections Caused by Mycobacterium tuberculosis
Active Disease Isoniazid + Rifampin + Pyrazinamide + Ethambutol for two months Followed by: Isoniazid + Rifampin for Four months Latent Disease Isoniazid for 9 months
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Mycobacterium avium complex
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Mycobacterium avium complex
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Treatment of Infections Caused by Mycobacterium avium complex (MAC)
Clarithromycin + ethambutol + rifabutin
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Mycobacterium leprae
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Mycobacterium leprae
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Leprosy
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Treatment of Infections Caused by Mycobacterium leprae
Dapsone + rifampin + clofazimine
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