Know Your Antifungal: Echinocandins

Know your Antifungal: Echinocandins A patient has candida endophthalmitis . Which echinocandin should be used? How did others respond? Reveal the answer Best Answer Neither Explanation: Echinocandin antifungals should not be used in CNS, eye, or urine infections. They are similar in characteristics such as spectrum of activity, tolerability, and distribution. None of the echinocandins …

Cefuroxime PO for Bacteremic UTI

Cefuroxime PO for Bacteremic UTI The available pharmacokinetic-pharmacodynamic data supports cefuroxime as a PO step-down option in patients with complicated urinary tract infections with secondary bacteremia. True or False? How did others respond? Reveal the answer Best Answer False Explanation: At a dose of 500 mg BID, good pharmacokinetic-pharmacodynamic target attainment may be only achieved …

Susceptible No More: Aminoglycoside Update​

Susceptible No More: Aminoglycoside Update has been hospitalized for 10 days and develops ventilator-associated pneumonia . Can gentamicin be added to cefepime for double Pseudomonas coverage? How did others respond? Reveal the answer Best Answer No Explanation: CLSI breakpoints were updated for aminoglycosides. Gentamicin should no longer be used for infections due to P. aeruginosa. …

Enterococcal Coverage in Diabetic Foot Infections

Enterococcal Coverage in Diabetic Foot Infections has a diabetic foot infection requiring surgery. Operative cultures grow ESBL E. coli and E. faecalis. The E. coli is resistant to quinolones and TMP-SMX. Would you use ertapenem monotherapy for home antibiotics? How did others respond? Reveal the answer Best Answer Maybe Explanation: Older guidelines have suggested that …

Ciprofloxacin for Pneumonia

Ciprofloxacin for Pneumonia is started on cefepime and vancomycin for pneumonia. Sputum cultures return with pan-susceptible Pseudomonas aeruginosa. Can ciprofloxacin be used? How did others respond? Reveal the answer Best Answer Yes Explanation: Ciprofloxacin is not a respiratory fluoroquinolone because it does not have reliable activity against Streptococcus pneumoniae. However, it i can still be …

Chelation with Fluoroquinolones and Tetracyclines

Chelation with Fluoroquinolones and Tetracyclines is started on oral ciprofloxacin for a UTI. They have a history of iron deficient anemia. Can they take cipro and iron supplements at the same time?   How did others respond? Reveal the answer Best Answer No Explanation: Fluoroquinolone and tetracycline serum concentrations are reduced when co-administered with polyvalent …

Non-AmpC Citrobacter spp

Non-AmpC Citrobacter spp   is admitted with pyelonephritis. Blood cultures grow a GNB that is identified as a Citrobacter spp by rapid diagnostics and cefepime is selected for treatment. Two days later, final identification and susceptibilities reveal a C. koseri susceptible to cefazolin. Can antibiotics be deescalated to cefazolin?   How did others respond? Reveal …

Non-faecium VRE

Non-faecium VRE   has a diabetic foot osteomyelitis . Blood cultures grow vancomycin-resistant Enterococcus gallinarum which is susceptible to ampicillin. The patient is on empiric vancomycin and piperacillin-tazobactam . Should vancomycin be changed to daptomycin for this VRE? How did others respond? Reveal the answer Best Answer No Explanation: Enterococcus gallinarum is intrinsically resistant to …