Antibiotics III- Clinical Application

Question 1

Uncomplicated Skin and soft tissue infections (2)

If allergic to first two then give (2)

Answer 1

1. Penicillins (ampicillin)
2. Cephalexin
3. if allergic– Vancomycin or Clindamycin

Question 2

Complicated Skin and Soft tissue infection

Answer 2

*Pencillin + lactamase inhibitor

Ticarcillin + calvulanate acid

Question 3

MRSA

Answer 3

Vancomycin
Daptomycin
Linezolid

Question 4

Osteomyelitis

Answer 4

Vancomycin or Cephalosporins (ceftriaxone or cefepime)

Question 5

Surgical infections

Answer 5

*Penicillin + lactamase inhibitor

Ticarcillin + calvulanate acid

Question 6

Septic Arthritis

Empiric and MRSA

Answer 6

Empiric: Ceftriaxone
MRSA: V, L, D

Question 7

Prosthetic Joint

Answer 7

Rifampin

Question 8

Acute sinusitis

Answer 8

Penicillin + lactamase inhibitor

*AMOXICILLIN + CLAVULANATE

Question 9

Pharyngitis

Answer 9

PENICILLIN or AMOXICILLIN

Question 10

Community acquired bacterial pneumonia- ambulatory

Answer 10

Macrolide (erythromycin, azithromycin, clarithromycin)

Question 11

Community acquired bacterial pneumonia- hospitalization

Answer 11

B-lactam + macrolide

Question 12

Community acquired bacterial pneumonia- MRSA

Answer 12

Vancomycin, linezolid (not sure why but daptomycin is not listed in ppt)

Question 13

Hospital or ventilator acquired bacterial pneumonia- Empiric

MRSA

Answer 13

Empiric: Ceftriaxone
MRSA: V + L, no D…that’s too bad…D is good sometimes

Question 14

Uncomplicated UTI- Cystitis

Answer 14

TMP-SMX

Question 15

Uncomplicated UTI- Pyelonephritis

Answer 15

TMP-SMX or Fluoroquinolone

Question 16

Complicated UTI

Answer 16

TMP-SMX or Fluoroquinolone

Question 17

Prostatitis

Answer 17

TMP-SMX or Fluoroquinolone

Question 18

Intra-abdominal Infections

Answer 18

Ticarcillin + calvulanate

Question 19

C. Diff infection

Answer 19

Metronidazole (moderate)

Vancomycin (severe)

Question 20

Community-acquired bacterial meningitis

Answer 20

Ceftriaxone or cefotaxime (3rd generation)

+ Vancomycin

Question 21

Neonatal meningitis

Answer 21

Ampicilin + cephalosporin +/- gentamicin

Question 22

Sepsis

Answer 22

3rd or 4th generation cephalosporin (*Cefepime) + vancomycin

Question 23

Endocarditis

Answer 23

Ceftriaxone + vancomycin

Question 24

Fever and neutropenia (empiric)

Answer 24

Ciprofloxacin + Amoxicillin/calvulanate

Question 25

MDR Enterococci

Answer 25

Linezolid
Daptomycin
Tigecycline

Question 26

MDR Gram negative bacteria

Expressing b-lactamase:

Answer 26

Imipenem or meropenem

Question 27

MDR Gram negative bacteria

Expressing carbapenemases

Answer 27

Polymyxin B or Tigecycline