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 …
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 …
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 …
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. …
Antibiotics For Abscesses A 23-year-old patient receives incision and drainage in the ED for a small abscess on his back and is discharged. Should he have received a prescription for TMP-SMX? How did others respond? Reveal the answer Best Answer Yes Explanation: Incision & drainage (I&D) alone without antibiotics was recommended in the 2014 IDSA …
Higher Cefazolin Urine Breakpoint A 32-year-old patient is sent home from the ED on cephalexin for an uncomplicated UTI. A few days later the urine culture results with a “cefazolin, uncomplicated UTI susceptible” E. coli with an MIC of 8 µg/mL. Does a new prescription need to be called in? How did others respond? Reveal …
Dual β-Lactam Indications A 62-year-old patient is empirically started on ceftriaxone and vancomycin for suspected bacterial meningitis. Later ampicillin is ordered. Should both ampicillin and ceftriaxone be continued, despite both being beta-lactams? How did others respond? Reveal the answer Best Answer Yes Explanation: While sometimes ordered in error, dual β-lactam therapy is appropriate in certain …
Linezolid For Line Infections A patient presents with pain and erythema around a PICC line. The line was removed, blood cultures grew CoNS, and the patient is ready to go home. Is PO linezolid an option? How did others respond? Reveal the answer Best Answer Yes Explanation: Linezolid is a recommended option as definitive therapy …
What To Do When the Vanc MIC is 2? A patient is on D4 of vancomycin for MRSA bacteremia 2nd to a drained skin abscess. Pt is afebrile and wbc wnl. Repeat blood cultures are no growth to date. The MRSA vancomycin MIC is 2 mg/L. Change vanco to dapto? How did others respond? Reveal …
Beat the Bug: Lactobacillus spp A patient started on empiric ceftriaxone and metronidazole is found to have Lactobacillus rhamnosus bacteremia. Should the antibiotics be changed? How did others respond? Reveal the answer Best Answer Yes Explanation: Lactobacillus spp. can cause clinically significant infections, and usual treatment includes penicillin or broader spectrum options, if needed. Penicillin, …