Dual β-Lactam Indications

A 62-year-old patient is empirically started on ceftriaxone and vancomycin for suspected bacterial meningitis. Later ampicillin is ordered. Should both ampicillin and ceftriaxone be continued, despite both being beta-lactams?

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Yes

Explanation: While sometimes ordered in error, dual β-lactam therapy is appropriate in certain clinical scenarios and should be continued. Ampicillin is recommended in addition to ceftriaxone and vancomycin to provide activity against Listeria monocytogenes in patients aged 50 years and older with suspected acute bacterial meningitis. Other potential indications for dual beta-lactam therapy include enterococcal endocarditis, resistant gram-negative infections, surgical prophylaxis, and enterococcal coverage in intra-abdominal infections.

Dual β-Lactam Indications

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