Block 9 - Drug of Choice

Question 1

Staphylococcus auerus

Answer 1

Vancomycin for MRSA or serious infection w/ unknown susceptibility

Penicillinase-resistant ß-lactams (nafcillin) used pending susceptibility tests

Question 2

Staphylococcus epidermidids

Answer 2

Remove colonized indwelling devices.

Multiple antibiotic resistance common

Drugs. guided by susceptibility testing

Question 3

Staphylococus saprophyticus

Answer 3

TMP-SMX (except in late 3^rd trimester pregnancy or nursing)

Question 4

Streptococcus pyogenes

Answer 4

Penicillin G

Question 5

Streptococcus agalactiae (Group B strep)

Answer 5

Penicillin G

Question 6

Streptococcus pneumoniae

Answer 6

Penicillin G if susceptible

3rd generation cephalosporins if resistant

Question 7

Streptococcus sanguis

Answer 7

Penicillin

Question 8

Enterococcus faecalis

Answer 8

Ampicillin

Question 9

Enterococcus faecium

Answer 9

Ampicillin or vancomycin (linezolid or daptomycin if resistant)

Question 10

Treponema pallidum

Answer 10

Benzathine Penicillin G (effective w/ one dose IM or IV)

Question 11

Leptospira interrogans

Answer 11

Penicillin

Question 12

Borrelia recurrentis

Answer 12

Doxycycline or erythromycin

Question 13

Borrelia burgdorferi

Answer 13

Doxycycline, ampicillin or ceftriaxone depending upon disease presentation

Question 14

Neisseria meningitidis

Answer 14

Pencillin

Question 15

Neisseria gonorrhoeae

Answer 15

Ceftriaxone + Azithromycin or Doxycycline

Question 16

Chlamydia trachomatis

Answer 16

Azithromycin - effective with 1 large dose

(Other options require days or weeks of treatment)

Question 17

Chlamydia pneumoniae

Answer 17

Doxycycline

Question 18

Chlamydia psittaci

Answer 18

Doxycycline

Question 19

Trichomonas vaginalis

Answer 19

Metronidazole

Question 20

Toxoplasma gondii

Answer 20

Spiramycin for prenatal infection

Pyrimethamine + sulfadiazine in immunocompromised

Question 21

Yersinia pestis

Answer 21

Doxycycline OR streptomycin or gentamicin

Question 22

Brucella sp.

Answer 22

Doxycycline PLUS streptomycin or gentamicin

Question 23

Capnocytophaga canimorsus

Answer 23

Penicillin plus ß-lactamase inhibitor, or ceftriaxone

Question 24

Francisella tularensis

Answer 24

Streptomycin or gentamicin

Question 25

*Pasteurella multocida*

Answer 25

Penicillin plus ß-lactamase inhibitor

Question 26

*Trichophyton sp.*

Answer 26

Skin: Topical azoles, allylamines (terbinafine), tolnaftate. Oral griseofulvin for tinea capitis Nails: Oral itraconazole or terbinafine

Question 27

*Microsporum sp.*

Answer 27

Skin: Topical azoles, allylamines (terbinafine), tolnaftate. Oral griseofulvin for tinea capitis Nails: Oral itraconazole or terbinafine

Question 28

*Epidermophyton floccosum*

Answer 28

Skin: Topical azoles, allylamines (terbinafine), tolnaftate. Oral griseofulvin for tinea capitis Nails: Oral itraconazole or terbinafine

Question 29

*Malassezia furfur*

Answer 29

Azoles

Question 30

*Rhizopus sp.*

Answer 30

Amphotericin B

Question 31

*Mucor sp.*

Answer 31

Amphotericin B

Question 32

*Apergillus sp.*

Answer 32

Itraconazole or voriconazole

Question 33

*Pneumocytstis jiroveci*

Answer 33

Trimethoprim-sulfamethoxazole (TMP-SMX) or pentamidine

Question 34

*Candida albicans*

Answer 34

Skin or mucosal infections: Nystatin, azoles Candidemia: echinocandins or amphotericin B

Question 35

*Candida krusei*

Answer 35

Echinocandins or amphotericin B

Question 36

*Cryptococcus neoformans*

Answer 36

Non-meningial infections: azoles Meningitis: Amphotericin B + 5-Flucytosine, then follow with fluconazole. Fluconazole for prophylaxis

Question 37

*Blastomyces dermitidis*

Answer 37

Itraconazole

Question 38

*Histoplasma capsulatum*

Answer 38

Itraconazole

Question 39

*Coccidiodes immitis*

Answer 39

Itraconazole

Question 40

*Paracoccidiodes sp.*

Answer 40

Itraconazole

Question 41

*Sporothrix schenckii*

Answer 41

Itraconazole

Question 42

*Penicillium marneffei*

Answer 42

Itraconazole

Question 43

Chromoblastomycosis or fungal mycetoma (conditions with variety of fungal etiologies)

Answer 43

Surgical excision followed by prolonged itraconazole

Question 44

Dengue | (Flavivirus)

Answer 44

None

Question 45

Yellow Fever | (Flavivirus)

Answer 45

None

Question 46

Hantaviruses | (Bunyavirus)

Answer 46

None

Question 47

Chickungunya | (Togavirus)

Answer 47

None

Question 48

Lassa fever | (Arenavirus)

Answer 48

Ribavirin

Question 49

Marburg and Ebola | (Filoviruses)

Answer 49

None