Antibiotic Drug Interactions A with epilepsy managed with valproic acid is admitted to the with undifferentiated shock. He is started on empiric antibiotics. Three (3) days later he has a seizure. His valproic acid level is undetectable despite receiving inpatient doses What antibiotic was likely started? A. Ciprofloxacin B. TMP/SMX C. Meropenem D. Vancomycin How …
Penicillin Allergy Management A 26 year old pregnant femalewith known Group B Streptococcus colonization is admitted for delivery. She has a history of a penicillin allergy. Her parent told her she had a rash as a child but she has no further details . What GBS prophylaxis should be used? A) ClindamycinB) CefazolinC) Vancomycin How did others …
Patient Case: AntiMRSA and Antipseudomonal Combination Therapy A 66 year old with AML and an ANC 200 presents with fever + dyspnea. Chest X-ray reveals a new RLL infiltrate. Port site is also red & tender. He has a history of recent C. difficile but no other MDR infection. What empiric therapy is best? A. Vancomycin + …
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Patient Case: Uncomplicated Gonorrhea A 23 year old, 70 kg presents to the with dysuria. He is started on ceftriaxone 1 g IV q24H for a presumed UTI. UA has pyuria but is negative for nitrites/bacteria and STI testing reveals gonorrhea At this point, what treatment for gonorrhea is most appropriate? A) No further therapy B) Ceftriaxone 500 …
Patient Case: Positive UA in Nursing Home Patient An 85 year old with dementia lives in a nursing home & has a fall. Staff noted malodorous urine earlier today.A UA is done and shows and pyuria. He denies dysuria and suprapubic/flank pain. What is the best approach to managing this patient? A) Urine culture and start antibiotic B) …
Patient Case: Enterococcus Urinary Tract Infection A 30 year old with no PMH comes to the ED with dysuria but no flank pain. She is sent with TMP/SMX. The urine culture from the ED grows pan-S Enterococcus spp. You review the culture and call the patient What is the best antibiotic treatment? A) Return to …
Patient Case: Sepsis and Sources A 59-year-old presents to the with fever , tachycardia, BP 90/60 mmHg, abdominal pain and distended abdomen. He is now being admitted to the ICU for close monitoring and work up. What is the most SPECIFIC indication for antibiotics? A) Sepsis B) Empiric C) Intra-abdominal Infection D) I’m just here for the answer How …
Patient Case: Gram-negative Bacteremia Duration of Treatment A 40 year old with no relevant PMH is hospitalized with pyelonephritis and cultures positive for Klebsiella pneumoniae. She has received 3 days of ceftriaxone and is now ready for dischargeWhat is the best TOTAL length of therapy? A) 7 DaysB) 14 Days C) I’m just here for the answer How did …
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Patient Case: Vancomycin for MSSA A 67 year old presents to the with an abscess and cultures growing MSSA. She was initially started on empiric vancomycin and ceftriaxone. What is the best antibiotic adjustment? A) Stop vanc, continue ceftriaxone B) Stop ceftriaxone, continue vancC) Stop both, start cefazolin How did others respond? Reveal the answer Best Answer Stop both vancomycin …
Patient Case: AmpC A 38 year old presents with suspected pyelonephritis and is started on empiric ceftriaxone. Hercultures grow Enterobacter cloacae with pending susceptibilities. What the best treatment? A) CeftriaxoneB) CefepimeC) Ceftazidime/Avibactam How did others respond? Reveal the answer Best Answer Cefepime AmpC beta-lactamase enzymes will hydrolyze most penicillins and many cephalosporins. These enzymes are often …