Cascade Reporting A is growing Pseudomonas aeruginosa with this susceptibility: Cefepime = S Piperacillin/tazobactam = S Meropenem = S Ciprofloxacin = R Is IMIPENEM susceptible? A. Yes B. No C. Maybe? Call lab How did others respond? Reveal the answer Best Answer Maybe? Call lab 📞 Explanation: Many labs use cascade reporting, where not …
Stenotrophomonas maltophilia Respiratory Culture has a chronic tracheostomy with a sputum culture growing Stenotrophomonas maltophilia. He is afebrile, has no change in secretions & doesn’t have consolidations on chest X-ray. Does he need treatment? How did others respond? Reveal the answer Best Answer: No, don’t treat 🛑 Explanation: Stenotrophomonas maltophilia is a nosocomial organism BUT …
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Antibiotic Selection in Pancreatitis presents to the with abdominal pain and infected pancreatic necrosis. Which empiric antibiotic regimen has appropriate coverage AND good pancreatic tissue penetration? How did others respond? Reveal the answer Best Answer: Piperacillin/tazobactam Explanation: Empiric regimens should target enteric gram-negatives and anaerobes. Not all antibiotics have proven efficacy or are known to …
PEN-FAST reports a penicillin allergy. You learn he had a non-itching rash in his early 20s but no difficulty breathing or need for treatment. Is it appropriate to challenge his penicillin allergy with oral amoxicillin? How did others respond? Reveal the answer Best Answer: Yes challenge 💊 Explanation: This patient is at very low risk …
Antibiotics in Pancreatitis presents to the with severe abdominal pain & WBCs. A CT scan shows acute pancreatitis without gas, abscess, or necrosis. Do they need antibiotics? How did others respond? Reveal the answer Best Answer No 🚫 Explanation: Antibiotics are NOT typically indicated in acute pancreatitis. Most cases are due to common noninfectious causes …
Altered Mental Status and Bacteriuria presents with confusion . A urinalysis finds bacteria . Does she need antibiotics? Yes No Need more information How did others respond? Reveal the answer Best Answer Need more information Explanation: 2019 IDSA guidelines on asymptomatic bacteriuria (ASB) recommend to OBSERVE elderly patients OFF antibiotics if they do not have …
Duration of Therapy in Necrotizing Fasciitis presented with necrotizing fasciitis from Streptococcus pyogenes. After 3 debridements, no further surgery is planned. He is afebrile x 48 hours after his last surgery and improving He is on penicillin + clindamycin. What is the BEST antibiotic plan? A. No changeB. Stop clindamycin C. Stop penicillin D. Stop …
Group A Strep Necrotizing Fasciitis presents with necrotizing fasciitis. cultures grow Streptococcus pyogenes (Group A Streptococcus). The team orders penicillin + clindamycin. Your student asks why clindamycin is added since penicillin covers GAS. You tell them… Anti-toxin effect C. difficile risk Penicillin resistance No reason How did others respond? Reveal the answer Best Answer Anti-toxin …
De-Escalation develops hospital-acquired pneumonia & started on empiric vancomycin + cefepime. Sputum cultures grow E. coli with the following susceptibilities: Ceftriaxone = S Cefepime = S Piperacillin/tazobactam = S How did others respond? Reveal the answer Best Answer: Ceftriaxone Explanation: Ceftriaxone will cover the E. coli 🦠 but does not unnecessarily cover Pseudomonas aeruginosa 🚫 …
Linezolid or Vancomycin for MRSA Pneumonia A was recently in the for influenza. He is readmitted 2 weeks later with pneumonia. Which EMPIRIC anti-MRSA agent is the best choice?1. Vancomycin2. Linezolid How did others respond? Reveal the answer Best Answer Vancomycin Explanation: Using empiric vancomycin can help preserve linezolid activity against vancomycin-resistant Enterococcus. Positioning …