Antibiotic De-escalation in Culture Negative Pneumonia

Antibiotic De-escalation in Culture Negative Pneumonia is on cefepime, azithromycin, and vancomycin for community-acquired pneumonia . On day 3, 1500 mg azithromycin has been completed, the patient has improved , and a sputum culture shows normal respiratory flora. The antibiotics are deescalated to oral amoxicillin-clavulanate. Is this appropriate? How did others respond? Reveal the answer …

Cerebrospinal Fluid Analysis

Cerebrospinal Fluid Analysis A is started on empiric antibiotics for suspected bacterial meningitis. A lumbar puncture is performed and cerebrospinal fluid (CSF) analysis reveals 0 WBC, protein 45 mg/dL, and a CSF/plasma glucose ratio of 0.6. Additionally, no organisms are seen on Gram stain and a CSF PCR is negative. Antibiotics are de-escalated. Is this …

Imipenem-Resistant Morganella

Imipenem-Resistant Morganella is diagnosed with a hepatic abscess. Blood cultures reveal Morganella morganii resistant to imipenem but susceptible to ertapenem. Can ertapenem be used for outpatient parenteral antibiotic therapy? How did others respond? Reveal the answer Best Answer: Yes Explanation: Proteus, Morganella, and Providencia spp. are inherently less susceptible to imipenem through non-carbapenemase mechanisms. Cross-resistance …

Shiga Toxin-Producing E. coli

Shiga Toxin-Producing E. coli An otherwise healthy presents to the ED for dehydration from frequent . A GI panel is sent and the patient is discharged after receiving IV fluids. The GI panel returns positive with Shiga toxin-producing E. coli. What antibiotics should be prescribed? A. CiprofloxacinB. AzithromycinC. No antibiotics How did others respond? Reveal …

Carbapenems in Beta-Lactam Allergies

Carbapenems in Beta-Lactam Allergies is admitted to the with ESBL E. coli pyelonephritis. They have allergies (difficulty breathing) to TMP/SMX, ciprofloxacin, and ceftriaxone. Meropenem is ordered. Is this SAFE to give? How did others respond? Reveal the answer Best Answer: Yes Explanation: 2022 AAAAI/ACAAI Drug Allergy Practice Parameter states in patients WITHOUT severe delayed hypersensitivity …

Penicillin Allergy History

Penicillin Allergy History Two patients are admitted with neurosyphilis and penicillin allergies. 1: father was penicillin allergic, has not taken 2: difficulty breathing after 1st dose of amoxicillin Which patient(s) likely require DESENSITIZATION to penicillin? How did others respond? Reveal the answer Best Answer: Patient 2 πŸ‘±πŸΌβ€β™€οΈ Explanation: Patient 2 πŸ‘±πŸΌβ€β™€οΈ has a previous SEVERE …

Salmonella Management

Salmonella Management A 30 year old with no past medical/travel history presents to clinic for 2 days of diarrhea. She has not changed her diet but has been eating raw vegetables A stool sample is positive for Salmonella spp. What is the MOST APPROPRIATE option? A. Rehydration onlyB. CeftriaxoneC. CiprofloxacinD. Salmonella vaccine How did others …