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NAPLEX Review UWorld > ID Part 2 > Flashcards

ID Part 2 Flashcards

1
Q

VK is a 67-year-old female with diabetes, overactive bladder and hypothyroidism who has been started on Cipro for treatment of a urinary tract infection, based on susceptibility testing. All of the following counseling points are appropriate for VK EXCEPT:

A. This medication can cause tendon rupture.

B. Separate this medication from antacids such asMaalox.

C. This medication is associated with a risk of myelosuppression.

D. Thismedication can make the skin more sensitive to the sun. Use sunscreen and protective clothing.

E. Monitor blood glucose carefully while taking this medication if you have diabetes.

A

This medication is associated with a risk of myelosuppression.

Quinolones can cause many CNS toxicities (including seizures) and muscle toxicities (including tendon rupture).

They cause photosensitivity.

They should be separated from divalent cations to avoid chelation and reduced absorption.

Quinolones can cause hypoglycemia or hyperglycemia, so patients with diabetes should monitor blood glucose closely during therapy.

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2
Q

Extended infusion piperacillin-tazobactam is a dosing strategy that optimizes which of the following pharmacodynamic parameters?

A. Peak:MIC ratio

B. AUC:MIC ratio

C. Peak concentration

D. Time above MIC (T > MIC)

E. Minimum bactericidal concentration

A

Time above MIC (T > MIC)

As a beta-lactam antibiotic, piperacillin/tazobactam kills or inhibits bacterial growth when drug concentrations exceed the minimum inhibitory concentration (MIC).

Extending the infusion (from the traditional 30 minutes to infusing over 4 hours) results in greater T > MIC and is one way to optimize the activity of beta-lactams and effectively treat more resistant (higher MIC) organisms.

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3
Q

KD is a 35-year-old female with no known past medical history. She is married to an HIV-positive man. She has received a prescription for pre-exposure prophylaxis. Which labs must be performed before beginning therapy? (Select ALL that apply.)

A. TB skin test

B. CD4+ count

C. HIV test

D. Hepatitis B test

E. Hepatitis A test

A

HIV test
Hepatitis B test

Patients eligible for pre-exposure prophylaxis (PrEP) must be screened and test negative for HIV prior to initiation and then every 3 months after starting PrEP. It is important to evaluate this information, as the 2-drug NRTI PrEP regimen is not adequate for treatment of a patient diagnosed with HIV.

Patients must also be screened for hepatitis B and STI’s. Abrupt discontinuation of PrEP in patients with hepatitis B can exacerbate the condition.

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4
Q

PrEP

Before starting

A

Confirm the patient is HIV negative (blood test)

Screen for recent symptoms of HIV

Lab tests: SCr, hepatitis B serologies

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5
Q

PrEP

Treatment options

A

Oral Truvada or Descovy, 1 tablet once daily (≤ 90-day supply)

IM cabotegravir (Apretude) monthly x 2 doses, then Q2 months

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6
Q

PrEP

Follow-up

A

Test for HIV every 3 months (if negative, continue PrEP)

Screen for STIs, monitor renal function and other potential adverse effects PRN (schedule varies)

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7
Q

PEP

Before starting

A

Obtain HIV test, SCr, and hepatitis B serologies

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8
Q

PEP

Treatment

A

Start ASAP (ideally within 72 hours) of exposure

Complete 3-drug regimen x 28 days:
Truvada (if CrCl ≥ 60)
+
Dolutegravir (Tivicay) or raltegravir (Isentress)

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9
Q

PEP

Follow-up

A

Follow-up HIV testing

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10
Q

Commonly Used Drugs for Specific Pathogens

Methicillin-susceptible Staphylococcus aureus (MSSA)

A

Dicloxacillin, nafcillin, oxacillin

Cefazolin, cephalexin (and other 1 and 2nd generation cephalosporins)

Amoxicillin/clavulanate, ampicillin/sulbactam (Unasyn)

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11
Q

Commonly Used Drugs for Specific Pathogens

Methicillin-resistant Staphylococcus aureus (MRSA)

A

Ceftaroline

Daptomycin (not in pneumonia)

Linezolid

Vancomycin (consider using alternative if MIC ≥ 2)

SMX/TMP (CA-MRSA SSTIs)

Clindamycin (CA-MRSA SSTIS)

Doxycycline, minocycline (CA-MRSA SSTIs)

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12
Q

Commonly Used Drugs for Specific Pathogens

Vancomycin-resistant Enterococcus (VRE)

A

Pen G or ampicillin (E. faecalis only)

Linezolid

Daptomycin

Cystitis only: nitrofurantoin, fosfomycin (Monurol), doxycycline (Vibramycin)

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13
Q

Commonly Used Drugs for Specific Pathogens

Atypical Organisms

A

Azithromycin, clarithromycin

Doxycycline, minocycline

Quinolones

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14
Q

Commonly Used Drugs for Specific Pathogens

HNPEK

Haemophilus, Neisseria, Proteus, E Coli, Klebsiella

A

Beta-lactam/beta-lactamase inhibitor

Cephalosporins (except 1st generation)

Carbapenems

Aminoglycosides

Quinolones

SMX/TMP

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15
Q

Commonly Used Drugs for Specific Pathogens

Pseudomonas aeruginosa

A

Aztreonam

Cefepime

Ceftazidime

Ceftazidime/avibactam

Ceftolozane/tazobactam (Zerbaxa)

Carbapenems (except ertapenem)

Ciprofloxacin, levofloxacin

Piperacillin/tazobactam (Zosyn)

Tobramycin

Colistimethate, polymyxin B

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16
Q

Commonly Used Drugs for Specific Pathogens

CAPES

Citrobacter, Acinetobacter, Providencia, Enterobacter, Serratia

A

Aminoglycosides

Cefepime

Carbapenems

Colistimethate, polymyxin B

Piperacillin/tazobactam

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17
Q

Commonly Used Drugs for Specific Pathogens

Extended-spectrum beta- lactamase (ESBL) producing gram-negative rods (E. coli, K. pneumoniae, P. mirabilis)

A

Carbapenems

Ceftazidime/avibactam

Ceftolozane/tazobactam (Zerbaxa)

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18
Q

Commonly Used Drugs for Specific Pathogens

Carbapenem-resistant gram-negative rods (CRE)

A

Ceftazidime/avibactam

Colistimethate, polymyxin B

Meropenem/vaborbactam (Vabomere)

Imipenem/cilastatin/relebactam (Recarbrio)

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19
Q

Commonly Used Drugs for Specific Pathogens

Gram-negative anaerobes (Bacteroides fragilis)

A

Beta-lactam/beta-lactamase inhibitor

Cefotetan, cefoxitin

Carbapenems

Metronidazole

Moxifloxacin (reduced activity)

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20
Q

Commonly Used Drugs for Specific Pathogens

C. difficile

A

Vancomycin (oral)

Fidaxomicin (Dificid)

Metronidazole

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21
Q

Refrigeration Required After Reconstitution

A

Penicillin VK

Ampicillin

Amoxicillin/Clavulanate

Cephalexin

Cefadroxil

Cefpodoxime

Cefprozil

Cefuroxime

Cefaclor

Vancomycin oral

Valganciclovir

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22
Q

Antibiotics

That do not require renal adjustment

A

Antistaphylococcal penicillins (e.g., dicloxacillin, nafcillin)

Ceftriaxone

Clindamycin

Doxycycline

Macrolides (azithromycin and erythromycin only)

Metronidazole

Moxifloxacin

Linezolid

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23
Q

How should efavirenz be administered to decrease CNS side effects?

A. In the morning with a large meal

B. At bedtime on an empty stomach

C. Twice a day with a pharmacokinetic booster

D. 30 minutes before breakfast

E. With the largest meal of the day

A

At bedtime on an empty stomach

NNRTI; Brand: Sustiva

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24
Q

NNRTIs Meds

A

REDEN
Rilpivirine (Edurant)
Efavirenz (Sustiva)
Doravirine (Pifeltro)
Etravirine (Intelence)
Nevirapine

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25
Q

NNRTIs MOA

A

Non-competitively inhibit the reverse transcriptase enzyme, preventing the conversion of HIV RNA to HIV DNA in stage 3 (reverse transcription) of the HIV life cycle

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26
Q

NNRTIs SE

A

Hepatotoxicity
Severe rash, including SJS/TEN

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27
Q

Which NNRTI has the highest risk of SJS/TEN?

A

nevirapine

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28
Q

NNRTI Drug Intxn

A

Is a 3A4 substrate

Efavirenz & etravirine are moderate 3A4 inducers

Rilpivirine needs an acidic environment for absorption

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29
Q

Efavirenz SE

=

A

Psychiatric symptoms (depression, suicidal thoughts)

CNS effects (impaired concentration, abonormal/vivid dreams, confusion): usually resolve after 2-4 weeks

↑ TC & TGC

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30
Q

Rilpivirine SE

A

Depression

Artificial ↑ SCr (no effect on GFR)

Not rec if preTx VL > 100,000 or CD4 ct < 200 (higher failure rate)

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31
Q

How do you take rilpivirine?

A

Take with a meal and water (do not substitute with a protein drink)

Requires an acidic environment for absorption; do not use with PPIs and separate from H2RAs and antacids

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32
Q

Chlamydia Tx

A

Azithromycin 1 g PO x 1 OR
Doxycycline 100 mg PO BID 7d

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33
Q

Rifaximin maybe used in managementof all of the following EXCEPT:

A. Hepatic encephalopathy

B. IBS with diarrhea

C. Refractory C. difficile

D. Spontaneous bacterial peritonitis

E. Travelers’ diarrhea

A

Spontaneous bacterial peritonitis

PO only

Rifaximin (Xifaxin) is an antibacterial agent that is structurally related to rifampin.

It is indicated for the treatment of non-invasive E. colitravelers’ diarrhea, for reduction in the risk of overt hepatic encephalopathy and for IBS-D.

Since systemic drug absorption is minimal, it is not useful for spontaneous bacterial peritonitis (SBP).

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34
Q

Acute Cystitis

Empiric treatment

A

Nitrofurantoin 100 mg BID × 5 days
Fosfomycin 3 grams × 1 dose
Sulfamethoxazole/trimethoprim DS 1 tablet BID × 3 days (if no sulfa allergy)

Nitrofurantoin CI CrCl < 60

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35
Q

Treatment of Pyelonephritis

A

Bactrim
Urinary quinolones (ciprofloxacin, levofloxacin)

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36
Q

Which of the following statements are correct with regard to sulfamethoxazole/trimethoprim? (Select ALL that apply.)

A. It is a potent hepatic enzyme inducer resulting in reduced drug concentrations.

B. It has excellent bioavailability, thus can transition from intravenous to oral formulations in a 1:1 fashion.

C. It is active against Gram-positive pathogens, including Staphylococci, Gram-negative pathogens and opportunistic pathogens.

D. It should be avoided in a patient with a G6PD deficiency.

E. A negative Coombs test with sulfamethoxazole/trimethoprim indicates hemolytic anemia.

A

It has excellent bioavailability, thus can transition from intravenous to oral formulations in a 1:1 fashion.

It is active against Gram-positive pathogens, including Staphylococci, Gram-negative pathogens and opportunistic pathogens.

It should be avoided in a patient with a G6PD deficiency.

TMP/SMX is a potent CYP2C9 inhibitor (not inducer). It has 1:1 conversion from IV:PO dosing.

It is a broad spectrum agent with excellent Gram-positive, Gram-negative (not Pseudomonas) and opportunistic pathogen coverage.

It is partially cleared by the kidney and should be dosed reduced for CrCl < 30 mL/min.

A positive Coombs test in the labs (along with decreasing hemoglobin/hematocrit) would indicate the presence of hemolytic anemia and Bactrim should be discontinued.

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37
Q

Bactrim CI

A

Sulfa Allergy
Pregnant or breastfeeding

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38
Q

Bactrim Warnings

A

Skin Reactions (SJS/TEN)
G6PD deficiency

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39
Q

Bactrim SE

A

Photosensivity
↑ K
hemolytic anemia (+ Coombs test)
crystalluria

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40
Q

Bactrim Common Uses

A

Ca-MRSA
UTI
Pneumocystis pneumonia

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41
Q

Bactrim Drug Intxn

A

2C9 inhibitor → ↑ INR w/ warfarin

42
Q

Ciprofloxacin IV:PO

A

80%

43
Q

Which azole antifungal requires an acidic environment for absorption?

A. Fluconazole

B. Voriconazole

C. Ketoconazole

D. Isavuconazonium

E. Posaconazole

A

Ketoconazole

Ketoconazole requires an acidic environment for absorption.

If a PPI or H2RA must be used while on ketoconazole, taking an acidic beverage (such as non-diet soda) can improve absorption by providing an acidic environment.

44
Q

Azole Class Effects

A

↑ LFTs

Risk for QT prolongation (except isavuconazonium)

45
Q

What is the DOC for Aspergillus

A

Voriconazole

46
Q

Which azole is mostly used for onychomycosis?

A

Itraconazole

47
Q

Meningitis Empiric Tx

A

Ceftriaxone + vancomycin ± Ampicillin (> 50 y/o)

48
Q

Neisseria meningitidis (Meningococcus) close contacts vaccine & antibiotics prophylaxis

A

Rifampin 600 mg PO BID for 2 days OR

Cipro 500 mg PO single dose OR

Ceftriaxone 250 mg single IM inj (most effective)

49
Q

Which of the following statements are accurate with regard to aminoglycosides? (Select ALL that apply.)

A. Active against most aerobic Gram-negative pathogens

B. Active against most Gram-positive pathogensas monotherapy

C. Demonstrate post-antibiotic effect

D. Cause hepatotoxicity

E. Demonstrate concentration-dependent bacterial killing

A

Active against most aerobic Gram-negative pathogens

Demonstrate post-antibiotic effect

Demonstrate concentration-dependent bacterial killing

Aminoglycosides are concentration-dependent killers and are active against Pseudomonas.

They are cleared by the kidney and associated with nephrotoxicity and ototoxicity, especially when trough levels remain high or when given for prolonged treatment courses.

When used in complicated Gram-positive infections (Staphylococcus and Enterococcus) they are used for synergy, which means that they must be given in combination with beta-lactams or vancomycin.

50
Q

Aminoglycosides Coverage

A

Gram-negatives, including Pseudomonas

Synergy for Gram-positives (Staphylococci/Enterococci) w/ beta-lactams

Low resistance & Cost

51
Q

Aminoglycosides Monitoring

A

Renal Functions

Serum Levels

Renal Damage & Ototoxicity

52
Q

Aminoglycosides Dosing

A

Gentamicin/tobramycin

Traditional (1-2.5 mg/kg IV Q8H)
* Peaks and troughs

Extended-interval: (4-7 mg/kg IV Q24H)
* Draw a random level and use nomogram

Concentration-dependent killing → give larger doses less frequently (extended interavl dosing) → allow the kidneys to recover

53
Q

Aminoglycosides: Traditional Dosing: Target Drug Concentations

When to draw trough and peak?

A

Draw trough 30 mins before 4th dose

Draw peak 30 mins after the end of the 4th dose infusion

54
Q

Aminoglycosides: Traditional Dosing: Target Drug Concentations

Gentamicin/tobramycin Peak/Trough Range

A

Peak: 5-10 mcg/mL

Trough: < 2 mcg/mL

55
Q

A hospitalized patient with no known drug allergies has cellulitis and the physician ordered vancomycin 1,000 mg IV Q12H and imipenem-cilastatin 1,000 mg IV Q8H. The medications were administered at the same time over 30 minutes. During the infusion, the patient experienced a profound drop in blood pressure. Her upper body, mostly in the trunk area, was covered with an erythematous rash. What is the likely cause of the patient’s symptoms?

A. Rhabdomyolysis

B. Vancomycin flushing reaction

C. Drug-induced lupus erythematosus

D. CYP2C9 drug interaction

E. Photosensitivity reaction

A

Vancomycin flushing reaction

The patient has experienced symptoms of vancomycin flushing, an infusion reaction due to a rapid administration of vancomycin.

Symptoms can include rash, pruritus, erythema and, less frequently, hypotension or angioedema.

Infusions should be limited to no more than 1 gram per hour.

56
Q

Vancomycin Coverage

A

Gram-positives (MRSA),

Streptococci,

Enterococci,

C. difficile (PO only)

57
Q

Vancomycin Dosing

A

IV: 15-20 mg/kg Q8-12H, using TBW

Dose/interval adjustment in renal failure

58
Q

Vancomycin Monitoring

A

SCr and avoid other nephrotoxic or ototoxic drugs (e.g., furosemide, aminoglycosides, cisplatin)

59
Q

What is 1st line for MRSA infections?

A

Vancomycin

e.g., pneumonia, meningitis, bacteremia, some skin infections

60
Q

Vancomycin Target Trough

A

15-20 mcg/mL

61
Q

Vancomycin C. difficile

A

PO only for C. difficile infections (125 mg QID x 10 days)

62
Q

Which antibiotic cause Red Man Syndrome?

A

Vancomycin

Infuse 1 g over 1 hr

63
Q

43 y/o Male

Physical Exam / Vitals:
Height: 5’9” Weight: 209pounds
BP: 102/59 mmHg HR: 100 BPM RR: 28 BPM Temp: 102°F Pain: 6/10

Plan: Acetaminophen per feeding tube for fever, empiric antibiotics for ventilator-associated pneumonia, to include meropenem + vancomycin + gentamicin (extended-interval dosing).
What dose of gentamicin should be initiated in MV as part of the empiric antibiotic regimen?

A. 95 mg

B. 160 mg

C. 560mg

D. 665 mg

E. 1125 mg

A

560mg

MV is obese, so his adjusted body weight (~80 kg) should be used for aminoglycoside dosing.

The dose used most commonly for extended interval dosing is 7 mg/kg (but may range from 4-7 mg/kg).

64
Q

When to use an alternative to vancomycin?

A

MIC ≥ 2

65
Q

Echinocandins Covers

A

Candida glabrata & krusei

66
Q

Echinocandins Forms

A

IV only

Warning for infusion reactions

67
Q

Echinocandins MOA

A

Blocks Beta-glucans synthesis

Few drug intxn

No renal dose adjustment

68
Q

Which antifungal is CI in pregnancy?

A

Griseofulvin

Can cause contraceptive failure

69
Q

Treatment Of Opportunistic Infections

Candidiasis (oropharyngeal/ esophageal)

A

Fluconazole

Alternatives: Itraconazole Posaconazole

70
Q

Treatment Of Opportunistic Infections

Cryptococcal meningitis

A

Induction: Amphotericin B (deoxycholate or liposomal) + flucytosine

Alternative: Fluconazole + flucytosine

Secondary PPx: Fluconazole (low dose)

71
Q

Treatment Of Opportunistic Infections

Cytomegalovirus (CMV)

A

Valganciclovir (PO) or Ganciclovir (IV)

If toxicities to ganciclovir or resistant strains: foscarnet, cidofovir

Secondary PPx: No agents recommended Maintain CD4+ count> 100 cells/mm³

Foscarnet & cidofovir - nephrotoxicity

72
Q

Treatment Of Opportunistic Infections

Mycobacterium avium complex infection

A

(Clarithromycin or azithromycin) + ethambutol

Add a 3rd or 4th agent using rifabutin, amikacin or streptomycin, moxifloxacin or levofloxacin

Secondary PPx: Same as treatment regimens

Ethambutol - ototoxicity

73
Q

BJ is on tobramycin IV every 8 hours for treating a gram-negative infection and his levels are reported as a peak of 8.3 mcg/mL and a trough of 2.5 mcg/mL. Which of the following recommendations should the pharmacist make to the medical team?

A. Increase the dose of tobramycin

B. Decrease the dose of tobramycin

C. Extend the dosing interval of tobramycin

D. Shorten the dosing interval of tobramycin

E. Continue the current regimen

A

Extend the dosing interval of tobramycin

The peak of tobramycin is within range, but the trough level is above the goal level(it should be less than 2 mcg/mL and ideally less than 1.5 mcg/mL).

By extending the dosing interval, the trough level will decrease and the toxicity risk is lowered without decreasing the peak for this concentration-dependent drug.

74
Q

Protease Inhibitors Meds

A

Atazanavir (Reyataz)

Darunavir (Prezista)

Fosamprenavir

Lopinavir/ritonavir (Kaletra)

Tipranavir (Aptivus)

“navir”

75
Q

All PIs

A

Rec w/ a PK booster (ritonavir or cobicistat)

No renal dose adjustments

76
Q

Which PIs do you take w/ food?

A

Darunavir (Prezista)

Atazanavir (Reyataz)

Reduces GI upset

77
Q

Which PI needs an acidic gut for absorption?

A

Atazanavir (Reyataz)

Avoid PPIs w/ unboosted atazanavir

Separate boosted atazanavir w/ PPI by 12 hours

No more than 20 mg of omeprazole or equivalent

78
Q

Which PI is used only for PK boosting?

A

Ritonavir

Low doses

79
Q

PIs SE

A

Diarrhea, nausea

Hyperglycemia/insulin resistance, dyslipidemia, lipodystrophy

Hepatotoxicity (eg, ↑ LFTs, hepatitis)

Hypersensitivity reactions (eg, rash, SJS/TEN)

80
Q

Atazanvir SE

A

Hyperbilirubinemia (reversible)

Yellow appearance to the skin or scleral icterus (yellow eyes)

81
Q

Which PIs should not be taken if the pt has a sulfa allergy?

A

Darunavir (Prezista)

Fosamprenavir

Tipranavir (Aptivus)

82
Q

Which PI contatins alcohol?

A

Lopinavir/ritonavir (Kaletra) Sol

Disulfiram rxn w/ metronidazole

83
Q

PK Boosters Med

A

Cobicistat (Tybost)

Ritonavir (Norvir)

Take w/ food

84
Q

Which PK Booster can artificially ↑ SCr?

A

Cobicistat (Tybost)

85
Q

PI & PK Booster Drug interactions

CI or should be avoided

A

Alpha-1A blockers: alfuzosin, silodosin, tamsulosin

Amiodarone, dronedarone

Anticoagulants/antiplatelets: apixaban, rivaroxaban, ticagrelor

Azole antifungals: voriconazole, posaconazole, itraconazole, isavuconazole

Protease inhibitors for hepatitis C (eg, grazoprevir, glecaprevir)

Lovastatin & simvastatin

PDE-5 inhibitors used for pulmonary hypertension: sildenafil, tadalafil

Strong CYP3A4 inducers (eg, carbamazepine, rifampin, St. John’s wort)

Systemic, inhaled & intranasal steroids (except beclomethasone)

86
Q

Which of the following antimicrobialshas arisk foradditive QT prolongation when combined with amiodarone?

A. Zithromax

B. Penicillin V potassium

C. Invanz

D. Nitrofurantoin

E. Cleocin

A

Zithromax

All macrolides have a risk for QT prolongation and should be used cautiously in patients with cardiovascular disease or those taking other QT prolonging drugs.

87
Q

Macrolides Meds

A

Azithromycin (Zithromax)

Clarithromycin (Biaxin)

Erythromycin (E.E.S.)

88
Q

Macrolides Coverage

A

Atypical pathogens (Legionella, Chlamydia, Mycoplasma, Mycobacterium avium)

H. influenzae

S. pneumoniae

Azithromycin covers traveler’s diarrhea

89
Q

Common Uses

Macrolides

A

CAP, Strep throat

90
Q

Common Uses

Azithromycin

A

COPD exacerbations

Chlamydia

Gonorrhea

MAC PPx

And Traverlers’ diarrhea

91
Q

Common Uses

Clarithromycin

A

H. pylori

92
Q

Common Uses

Erythromycin

A

↑ gastric motility

e.g. gastroparesis

93
Q

Macrolides Safety Issues

A

QT prolongation: caution w/ CVD ↓ K/Mg, use of other QT-prolong drugs

Drug intxn:
Clarithromnycin/erythromycin Strong 3A4 inhibitors
CI w/ simvastatin/lovastatin

94
Q

JPhas a blood culture report showing Gram-positive cocci resembling Streptococci, Klebsiella pneumoniaeand anaerobes. Which of the following medications would provide adequate coverage for these organisms?

A. Ertapenem

B. Rifaximin

C. Metronidazole

D. Fosfomycin

E. Ciprofloxacin

A

Ertapenem

Carbapenems are very broad-spectrum antibiotics.

They cover gram positives, gram negatives and anaerobes.

Rifaximin, metronidazole and fosfomycin have a much narrower spectrum.

Ciprofloxacin does not have reliable strep coverage, nor does it cover anaerobes.

95
Q

Carbapenem Meds

A

Doripenem

Imipenem/Cilastatin (Primaxin I.V.)

Meropenem

Meropeneme/Vaborbactam (Vabomere)

Ertapenem (Invanz)

96
Q

Carbapenems Class Effects

A

All active against ESBL-producing organisms and (except ertapenem) Pseudomonas

Do not use with penicillin allergy

Seizure risk (with higher doses, failure to dose adjust in renal dysfunction, or use of imipenem/cilastatin)

97
Q

Carbapenems Coverage

A

Broad coverage, so remember what is not covered:

Atypicals, VRE, MRSA, C. difficile, Stenotrophomonas

ErtAPenem does not cover PEA: Pseudomonas, Enterococcus, Acinetobacter

98
Q

Carbapenems Common Uses

A

Polymicrobial infections (e.g., severe diabetic foot infection)

Empiric therapy when resistant organisms are suspected

ESBL-positive infections

Resistant Pseudomonas or Acinetobacter infections (except ertapenem)

99
Q

Carbapenems Form

A

IV only

100
Q

Ertapenem must be diluted in?

A

NS

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