Random ID Tidbits

Question 1

How does ertapenem compare to the other carbapenems?

Answer 1

Cons: Lack pseudomonas coverage! Also isn’t active against enterococci or acinetobacter.

Pro: Once daily admin. Nice for use at home. Retains ESBL activity for Enterobacteriaceae

Question 2

What is a normal CRP?

Answer 2

< 10 is normal

> 10 indicates infection/inflammation.

Question 3

What’s a normal ESR?

Answer 3

Erythrocyte sedimentation rate.
0-30 is normal
Higher may indicate infection or inflammation.

Question 4

Can Ancef be used for brain infections?

Answer 4

No, poor penetration

Question 5

Can Nafcillin be used for brain infections?

Answer 5

Yes

Question 6

Can oxacillin be used in CNS infections?

Answer 6

Yes

Question 7

How do you treat fungal native valve endocarditis?

Answer 7

Ampho + flucytosine for 6 weeks Plus valve replacement

Then lifelong suppression with an oral -azole

Question 8

Metalo-beta-lactamases hydrolyze all beta lactams except which one?

Answer 8

Aztreonam.

Question 9

EDTA can inhibit what kind of beta-lactamase?

Answer 9

metalo-beta-lactamases.

Question 10

What are the 3 metalobetalactamases?

Answer 10

IMP, VIM, NDM

Question 11

MexXY, MexAB, and AdeABC are examples of what?

Answer 11

Efflux pumps.

Question 12

Testing for inducible clinda resistance is indicated if:

Answer 12

For staph that is clinda susceptible but erythromycin resistant.

Question 13

At what age do you switch from dtap to tdap?

Answer 13

7 years old.

Question 14

Can appendicitis be treated with abx alone, and no surgery?

Answer 14

No. Need both.

Question 15

What is the duration of therapy for initial episode of C diff? And what is recommended therapy?

Answer 15

10 days of PO Vanc 125 mg q6h OR fidaxomicin 200 mg BID. (Flagyl is an alternative, but outcomes are worse)

*If the infection is fulminant (hypotension, shock, megacolon) VANC dose is 500 mg QID.

Question 16

When should you add flagyl to c diff therapy?

Answer 16

When there’s illeus present. (Give IV). Can also consider rectal vancomycin.

Question 17

What about first recurrence of C diff?

Answer 17

Try something new, including VAN pulsed and tapered, and FDX.

Question 18

What about second recurrence of C diff?

Answer 18

Can now consider following VAN 125 mg QID with 20 days of rifaximin 400 mg TID.

Can also consider FMT.

Question 19

When is C diff presentation considered severe (but not fulminant?)

Answer 19

WBC >/= 15k or SCr >/=1.5

Question 20

What is the significance of β-D-glucan testing?

Answer 20

β-D-glucan is a cell wall constituent of Candida and other fungal species. The use of a serum β-D-glucan has been approved by the FDA as an adjunct to blood cultures for the diagnosis of invasive fungal infections.

Question 21

What is the recommended duration of therapy for an initial non-severe C. difficile infection?

Answer 21

10 days

Question 22

Which FQ provides anaerobic coverage?

Answer 22

Moxifloxacin

Question 23

What about FQ’s and divalent cations?

Answer 23

Take the FQ 2 hours before or 6 hours after.

Question 24

Regarding HepB serology titers, what level of HBsAb indicated immunity?

Answer 24

10 mIU/L is the minimum. Less than that and you should receive a HebB booster shot.

Question 25

Can you use TAF in pts with CrCl = 15 ml/min?

Answer 25

Yes you can. Dose adjustment though?