Antimicrobial Use Metrics When looking at days of therapy (DOT) as an antimicrobial use metric, a patient receiving cefepime 2g q8h for 1 day would count as 1 DOT and a patient receiving cefepime 2g q12h for 1 day would also count as 1 DOT, despite different amounts of drug being administered. True or False? …
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 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 …
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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 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 …
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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 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 …
Penicillins for MSSA has pneumonia . A sputum culture grows methicillin-susceptible S. aureus susceptible to oxacillin, amoxicillin-clavulanate, and cefazolin. Oral amoxicillin is initially ordered. Is this appropriate? A. YesB. No How did others respond? Reveal the answer Best Answer No Explanation: MSSA commonly makes a penicillinase and should be considered resistant to penicillin, amoxicillin, and …
Ceftriaxone Guided IV to PO is admitted with pyelonephritis. Blood and urine cultures grow E. coli with the below susceptibilities. They have a QTc of 502 ms and a sulfa allergy. Amox – R Amox-clav – R Cefazolin – R Ceftriaxone – S Ciprofloxacin – S TMP-SMX – S Which of the following is best …
Cephalosporins for VGS is admitted with a dental abscess. Blood cultures grow Viridans Group Streptococcus (VGS) that is susceptible to penicillin. Is cephalexin and metronidazole a good oral stepdown option to complete therapy? YesNo How did others respond? Reveal the answer Best Answer No Explanation: Cephalexin has unreliable activity against VGS. Penicillin activity against VGS …