Antibiotic Quiz Flashcards by Carter Berg

What is the most appropriate antibiotic to administer empirically for a serious Staphylococcus aureus infection in a patient allergic to penicillin?

vancomycin

erythromycin

gentamicin
ciprofloxacin

vancomycin

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Which statement is TRUE with respect to ciprofloxacin?

it has good activity against many gram negative aerobes

it provides good coverage of anaerobic organisms

it produces lower urinary concentrations than moxifloxacin

it can be co-administered with Maalox (aluminum
hydroxide/magnesium hydroxide) without any interaction

it has good activity against many gram negative aerobes

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What is the mechanism responsible for penicillin-resistant Streptococcus pneumoniae?

production of beta-lactamase enzymes

alteration of penicillin-binding proteins

mutation of ribosomal binding sites

active efflux of penicillin out of the cell

altered outer membrane porins

alteration of penicillin binding proteins

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Amoxicillin has which of the following advantages over ampicillin?

broader spectrum of activity

penicillinase resistance

produces fewer hypersensitivity reactions

better absorbed from the gastrointestinal tract, especially in the presence of food

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Which antibiotics can be used to treat an infection caused by Pseudomonas aeruginosa?

azithromycin

cefuroxime

ciprofloxacin

amoxicillin

ciprofloxacin

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Which antibiotic has activity against methicillin resistant Staphylococcus aureus?

cloxacillin

linezolid

clarithromycin

cephalexin

linezolid

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Which antibiotic does NOT require dosage adjustment in reduced renal function?

vancomycin

gentamicin

ceftriaxone

cefazolin

ceftriaxone

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What is the most common adverse effect associated with amoxicillin/clavulanate?

diarrhea

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Which class of antimicrobials is likely to have the most CYP450 mediated drug interactions?

macrolides

glycopeptides

cephalosporins

azoles

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Tendon rupture is a known adverse effect of which antibiotic?

levofloxacin

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Which antibiotic is most commonly implicated as a cause of C. difficile infection?

clindamycin

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Which statement regarding valacyclovir and acyclovir is true?

oral acyclovir can be given BID, like valacyclovir

both drugs can be given IV and orally

valacyclovir is the prodrug of acyclovir

neither drug requires adjustment in renal dysfunction

valacyclovir is the prodrug of acyclovir

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Which cephalosporins have activity against Pseudomonas aeruginosa?

cephalexin
cefazolin
cefotaxime
ceftazidime

ceftazidime

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Which drug has activity against Enterococcus sp.?

ampicillin
cloxacillin
ceftriaxone
ceftazidime

ampicillin

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Which antibiotic should be avoided if a patient is on a medication that can prolong the QTc interval?

moxifloxacin

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Which antibiotic should be avoided if a patient is on a nephrotoxic drug?

doxycycline
penicillin V
cefuroxime
gentamicin

gentamicin

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Which statement about vancomycin is NOT true?

the oral formulation is not absorbed from the gut

therapeutic drug monitoring can help to guide dosing

a major adverse effect is hepatotoxicity

infusion rates can be slowed to prevent vancomycin flushing syndrome

a major adverse effect is hepatotoxicity

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Which of the following antibiotics are aminoglycosides EXCEPT?

amikacin,
gentamicin,
tobramycin
Vancomycin

vancomycin

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Which class of drugs is generally avoided in children due to possible joint toxicity?

fluoroquinolones

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What are the two most serious side effects associated with aminoglycosides?

ototoxicity and nephrotoxicity

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Do second generation cephalosporins have greater activity against gram negative bacilli such as E. coli compared to first generation cephalosporins?

True

Are most skin rashes associated with amoxicillin true hypersensitivity reactions?

Which drug is most likely to be effective against an infection on the skin?

Cephalexin

Cephalexin is often used for skin infections caused by Staphylococcus aureus.

Which drug is the best empiric therapy for a bacterial infection in the throat?

Penicillin VK

Penicillin VK is commonly prescribed for throat infections, particularly streptococcal pharyngitis.

What organism is likely responsible for an infected cut from a knife?

Staphylococcus aureus (Staph aureus) ## Footnote Staphylococcus aureus is a common cause of skin infections following cuts.

Which drug was most likely prescribed for an atypical bacterial infection in a cough?

Azithromycin ## Footnote Azithromycin is effective against atypical bacteria such as Mycoplasma pneumoniae.

Which medication has the most activity against gram-negative bacteria? Amoxicillin Azithromycin Cephalexin Cefuroxime

Cefuroxime ## Footnote Cefuroxime is a cephalosporin antibiotic effective against various gram-negative organisms.

Which medication would you expect to have activity against a S.aureus infection?

Cephalexin ## Footnote Cephalexin is effective against methicillin-sensitive Staphylococcus aureus (MSSA).

Which bug(s) would you expect Amoxicillin/Clavulanate to be effective against? MRSA Enterococcus faecium Streptococcus pneumoniae All of the above

Streptococcus pneumoniae ## Footnote Amoxicillin/Clavulanate is effective against Streptococcus pneumoniae and other bacteria.

What organism is most likely responsible for a UTI treated with Nitrofurantoin?

Escherichia coli ## Footnote Escherichia coli is the most common cause of urinary tract infections.

Which of the following is an example of a gram-negative rod? Mycoplasma pneumoniae Neisseria meningitidis Streptococcus pneumoniae Klebsiella pneumoniae

Klebsiella pneumoniae ## Footnote Klebsiella pneumoniae is a gram-negative bacterium often associated with pneumonia and UTIs.

What are the predominant organisms in acute otitis media?

M.cattarhalis, S.pneumoniae, H.influenzae ## Footnote These organisms are commonly associated with acute otitis media infections.

All of the following are criteria for watchful waiting EXCEPT: Child has a reliable caregiver Unilateral, mild ear pain Low-grade fever Perforated tympanic membrane

Perforated tympanic membrane ## Footnote This condition typically requires intervention rather than watchful waiting.

What is the rationale for using high-dose amoxicillin in AOM?

To overcome penicillin binding protein resistance of the causative organism ## Footnote High-dose amoxicillin is particularly effective against resistant strains.

In the context of AOM, which of these statements about azithromycin is FALSE? azithromycin can be used as empiric treatment for AOM azithromycin can be used for true Type-1 allergy to beta-lactams azithromycin has a long half-life and can be dosed once daily azithromycin has excellent atypical coverage

azithromycin can be used as empiric treatment for AOM ## Footnote While azithromycin covers certain atypical pathogens, its effectiveness for AOM is less compared to other antibiotics.

What are the predominant organisms in CAP?

* S.pneumoniae * H.influenzae * M.pnuemoniae ## Footnote CAP stands for community-acquired pneumonia, which is caused by various pathogens.

Which is the most appropriate empiric therapy for CAP for an outpatient less than 65 years of age and otherwise healthy? azithromycin doxycyline levofloxacin amoxicillin/clavulanate

doxycycline ## Footnote This therapy is recommended due to its effectiveness against common pathogens in healthy adults.

All of the following are true about doxycycline EXCEPT: safest option for young children * patients should be counselled to wear sunscreen * patients must take with a full glass of water * patients must be upright for 30 minutes after administration

* safest option for young children ## Footnote Doxycycline is not the safest option for young children due to potential side effects.

All of the following are useful monitoring parameters for a patient with community-acquired pneumonia, EXCEPT: * respiratory rate * oxygen saturations * breath sounds on auscultation * repeat chest x-ray

* repeat chest x-ray ## Footnote Monitoring parameters help assess the patient's respiratory status and response to treatment.

All of the following are predominant organisms in an uncomplicated UTI, EXCEPT: S.aureus E.coli K.pneumoniae S.saprophyticus

S.aureus ## Footnote Common organisms in uncomplicated UTIs include E.coli, K.pneumoniae, and S.saprophyticus.

Which symptom is a 'red flag' for UTI and would cause you to refer a patient to a physician?

Flank pain ## Footnote Flank pain may indicate a more serious condition like pyelonephritis.

On a urinalysis, which of the following is the most indicative of a possible UTI?

Positive nitrites ## Footnote Positive nitrites are a strong indicator of bacterial infection in the urinary tract.

Which of the following statements regarding nitrofurantoin is FALSE? This drug cannot be used in patients with a CrCl < 30 mL/min This drug can be used in pyelonephritis This drug can change the colour of a patient's urine Commercially, this drug is available as two different formulations

This drug can be used in pyelonephritis ## Footnote Nitrofurantoin is typically not used for pyelonephritis due to its limited effectiveness in kidney infections.

What is the best strategy to treat a penicillin-resistant S.pneumoniae infection?

Give increased doses of penicillin.

A new drug is being developed and seems to behave in a way that is similar to cephalosporins. What would be its most likely mechanism of action when killing bacteria?

Cell wall inhibition

Leshia is a 2 year old female, weight 12 kg, with acute otitis media who has failed watchful waiting and is being prescribed amoxicillin. She is otherwise healthy and is on no Rx, OTC or herbal medications except for a multivitamin daily. She has 2 older siblings and all 3 children go to the same daycare facility. She has no known drug allergies. Calculate an appropriate amoxicillin dose for her. You have amoxicillin 250 mg/5mL suspension available. The most appropriate amoxicillin regimen for her is:

11 mL po BID

Methicillin resistant Staph aureus may be susceptible to which list of antibiotics?

TMP/SMX, doxycycline, clindamycin

Joel is a 64 year old male who sees his doctor because of cough, shortness of breath and fever. He has high blood pressure (cardiovascular disease) and type 2 diabetes mellitus. He takes metoprolol for high blood pressure and glyburide for diabetes. He states he uses acetaminophen 3 – 4 times per month for headaches, famotidine occasionally for heart burn, Metamucil for occasional constipation, a multivitamin tablet and vitamin D daily. He does not use any herbal products. He has no known drug allergies. His doctor orders a chest x-ray and a diagnosis of pneumonia is confirmed. 2 ½ months ago he had sinusitis treated with TMP/SMX. The most appropriate antibiotic to treat his pneumonia is:

Azithromycin x 5 days pls amoxicillin/clavulanate 875 mg po BID

Which of the following organisms is a likely etiology for an acute bacterial meningitis in an adult?

S.pneumoniae

What is an appropriate EMPIRIC antibiotic regimen for an adult with query bacterial meningitis?

Ceftriaxone and vancomycin

What is the minimum duration of therapy for culture-proven S.pneumoniae meningitis?

10 days