Case 3 - pseudomonas central venous catheter infection

Question 1

General info - no need to memorize….

Answer 1

An 80 year old man is hospitalized because of acute pulmonary edema after a myocardial infarction. A central venous catheter is placed. Five days later fever
and chills develop. Empiric antibiotic therapy to cover Gram positive and Gram negative is started. Two days later blood cultures grow pseudomonas aeroginosa

Question 2

Tx: first thing?

Answer 2

Remove the line

Question 3

antibiotic good options - 3

Answer 3

Pipercillin, 4th gen cephalosporin, Fluoroquinolones

Question 4

4th gen cephalosporin - types - 2

Answer 4

Ceftazidime, Cefepime

Question 5

bad antibiotic options - 2

Answer 5

• Carbapenems are too broad spectrum, not a good option here

- Aminoglycosides are nephrotoxic, not good for elderly, and he didn’t have a UTI…

Question 6

Carbapenems - types and are they effective - 3

Answer 6

Meropenem, Imipenem

Ertapenem is NOT effective

Question 7

Fluoroquinolones - pro - 1

Answer 7

Can be given PO.