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 …
Cidal vs Static A is admitted to the ICU for community-acquired pneumonia . They have a history of MRSA and a vancomycin allergy. Should linezolid be avoided because it is bacteriostatic? A. YesB. No How did others respond? Reveal the answer Best Answer No Explanation: Bacteriostatic and bactericidal are not clinically relevant terms and …
De-escalation is For Everyone An ICU patient is on day 3 of empiric antibiotics for pneumonia. The patient is improving and cultures are negative. Which of the following is a benefit from antimicrobial de-escalation? A. Lower AKI riskB. Higher mortalityC. Cost increases How did others respond? Reveal the answer Best Answer Lower AKI risk Antimicrobial …
Duration of Therapy in Uncomplicated CoNS CLABSI An inpatient is diagnosed with a CoNS CRBSI. Her central line is removed, she is clinically stable, and repeat blood cultures are obtained. She has no implanted prosthetic material, but many antibiotic allergies. The team would like to monitor repeat blood cultures off antibiotics. Is this appropriate? How …
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Antibiotic Decision Making Moments Antibiotic decision making ends after a diagnosis is made, cultures are obtained, and empiric antibiotics are started. True or False? How did others respond? Reveal the answer Best Answer: False Explanation: There are four moments of antibiotic decision making. After the first two of 1) making a diagnosis and 2) obtaining …