presents with perforated diverticulitis and is started on empiric antibiotics and taken to surgery. After surgery, she is hemodynamically stable and in the ICU. Should empiric micafungin be added? How did others respond? Reveal the answer Best Answer No Explanation: In the ICU, empiric antifungal therapy should be reserved for patients with substantial risk factors …
has a diabetic foot infection and is started on empiric ceftriaxone and vancomycin. The wound is without necrosis or gas formation and there are no concerns with limb ischemia. Should metronidazole be added? How did others respond? Reveal the answer Best Answer No Explanation: Anaerobic bacteria presence in DFI is often under-identified by conventional culture. …
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 57-year-old male with a recent hospitalization 1 month ago for pneumonia presents with fevers, and hypotension. Should next-generation sequencing (NGS) be ordered alongside blood cultures? How did others respond? Reveal the answer Best Answer No Explanation: Limited patient outcomes data exists with NGS and is not well defined. Cultures are reliable for detection of …
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 …
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 …
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. …