Author: Matthew Song

A 48-year-old male presents with septic shock due to perforated diverticulitis. His eCrCL on admission is 32 ml/min whereas last month at an outpatient checkup it was 99 ml/min. Pip-tazo is ordered. Should the dose be immediately adjusted for renal impairment? How did others respond? Reveal the answer Best Answer No Explanation: Patients presenting with …

Read more “Adjust Your Adjustments: Considerations for Delayed Antibiotic Renal Dose Adjustments”

A 45-year-old male with an unremarkable past medical history is started on empiric ceftriaxone monotherapy for suspected cholecystitis. Should metronidazole be added? How did others respond? Reveal the answer Best Answer No Explanation: Routine broad anaerobic coverage may not be necessary in biliary tract infections since anaerobes are infrequently isolated and observational data suggests no …

Read more “Anaerobes in Biliary Tract Infections”

Fluconazole can be used to treat a Pichia kudriavzevii infection. True or False? How did others respond? Reveal the answer Best Answer False Explanation: Pichia kudriavzevii is the new name for Candida krusei, which is inherently fluconazole resistant. Many fungal pathogens once known as a Candida spp. have been reclassified with a new name due …

Read more “A Yeast By Any Other Name”

A 44-year-old female is on day 3 pip-tazo for a complicated UTI. Her urine culture grows P. aeruginosa and she is ready to go home. She has a history of rash to ciprofloxacin. Can she be discharged on levofloxacin? How did others respond? Reveal the answer Best Answer Yes Explanation: Patients with an allergy to …

Read more “Quinolone Cross-Reactivity”

A 52-year-old female who is post-op day 1 s/p lumbar spine surgery has a drain left in place following surgery. Does antimicrobial prophylaxis need to be continued while the drain is in place? How did others respond? Reveal the answer Best Answer No Explanation: Continuing prophylactic antibiotics beyond 24 hours post-operatively when is a drain …

Read more “Surgical Prophylaxis Duration with a Drain”

A 24-year-old male presents to the urgent care complaining of a recent tick bite. He reports he went hiking earlier in the day and found a tick bite attached afterwards. He removed the tick but did not keep it. Does he need prophylaxis? How did others respond? Reveal the answer Best Answer No Explanation: Lyme …

Read more “Limit Lyme”

A 65-year-old man has suspected acute bacterial prostatitis. Local E. coli resistance rates to quinolones and TMP-SMX are ~30%. Can empiric ceftriaxone be used? How did others respond? Reveal the answer Best Answer Yes Explanation: While quinolones and TMP-SMX are generally preferred for acute bacterial prostatitis, antimicrobial resistance may preclude use of these agents empirically. …

Read more “Antimicrobials for Acute Bacterial Prostatitis”