TMP/SMX for Cellulitis

TMP/SMX for Cellulitis undergoes I&D in the emergency room and is sent home with TMP/SMX Wound culture grows MRSA & Streptococcus pyogenes Do antibiotics need to be changed? How did others respond? Reveal the answer Best Answer: No Explanation: TMP/SMX is active against MRSA and beta-hemolytic Streptococcus spp. Historically, it was thought TMP/SMX was INACTIVE …

Aerococcus Infection

Aerococcus Infection has dysuria & a urine culture growing Aerococcus urinae Which antibiotic is MOST LIKELY to be active against this isolate? A. CiprofloxacinB. PenicillinC. TMP/SMX How did others respond? Reveal the answer Best Answer: Penicillin Explanation: Various Aerococcus spp. can have different resistance patterns. Resistance in A. urinae is common with both ciprofloxacin and …

C. difficile Colonization

C. difficile Colonization 2 patients have a C. difficile PCR test and toxin EIA. 1: has cirrhosis, takes lactulose, normal WBC, no changes in diarrhea 2: febrile, took ciprofloxacin last week, having diarrhea Which patient(s) should be treated for C. difficile? How did others respond? Reveal the answer Best Answer: Patient 2 👨🏻‍🦰 Explanation: This …

Leukocytosis

Leukocytosis is admitted to the with lupus nephritis. She is started on therapy including a corticosteroid The next day, leukocytosis is noted. What is the MOST LIKELY explanation? A. New infectionB. Medication side effectC. MalignancyD. Lab error How did others respond? Reveal the answer Best Answer: Medication side effect Explanation: When corticosteroids are started, they …

Non-Purulent Cellulitis

Non-Purulent Cellulitis is admitted to the for cellulitis. NO purulence is noted on exam and she has no relevant past medical history Which antibiotic is NOT recommended per IDSA guidelines for non-purulent cellulitis? A. CefazolinB. DicloxacillinC. NafcillinD. Vancomycin How did others respond? Reveal the answer Best Answer: Vancomycin Explanation: IDSA skin/soft tissue guidelines state that …

Biofilms

Biofilms is on chronic TPN and admitted to the with a MRSA bloodstream infection related to her IV line. After 4 days of vancomycin therapy, her blood culture is still positive. What is the MOST LIKELY reason? A. Biofilm on IV lineB. Vancomycin resistanceC. TPN inhibits vancomycin How did others respond? Reveal the answer Best …

C. difficile Prevention

C. difficile Prevention with lymphoma is admitted to the ICU for sepsis from an unknown source. He has a history of C. difficile. Which intervention will DECREASE his risk of C. difficile? How did others respond? Reveal the answer Best Answer: Narrow antibiotics when able Explanation: Limiting antibiotic spectrum is an excellent way to prevent …

Understanding Urinalyses

Understanding Urinalyses presents to clinic for routine prenatal care and is feeling well. A urinalysis is positive for nitrites, leukocyte esterase and bacteria. Empiric antibiotics are prescribed. Is this APPROPRIATE? How did others respond? Reveal the answer Best Answer: Yes ✅ Explanation: The patient’s urinalysis is abnormal. In most cases, asymptomatic bacteriuria SHOULD NOT be …

Cystitis vs. Pyelonephritis

Cystitis vs. Pyelonephritis presents to clinic with dysuria, flank pain & fever   They are prescribed nitrofurantoin. Is this APPROPRIATE? How did others respond? Reveal the answer Best Answer: No 🚫 Explanation: Our patient has flank pain & fever, consistent with pyelonephritis. Nitrofurantoin is ONLY recommended in the treatment of cystitis. We should also consider …