A 63-year-old female presented to the emergency department with a 3-day history of fever, dysuria, and flank pain. On examination, she has tenderness in the right costovertebral angle. Urine analysis revealed bacteriuria, pyuria, and WBC casts. Serum and urine cultures revealed grown extended-spectrum beta-lactamase (ESBL) E. coli. What is the drug of choice for this patient?
سؤال مجاني 3 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: D. IV imipenem
This is acute pyelonephritis caused by ESBL-producing E. coli. Carbapenems (imipenem, meropenem, ertapenem) are the drug of choice for ESBL organisms. ESBL enzymes hydrolyse third- and fourth-generation cephalosporins, so ceftriaxone and cefepime are unreliable. Vancomycin has no Gram-negative activity.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Ceftriaxone is a third-generation cephalosporin (CAP, gonorrhea, meningitis, intra-abdominal infection). The drug the lecture gives for ESBL organisms is a carbapenem.
✓ Antibiotics 🍓.pdf · p. 1 -
B
ليش غلط
Vancomycin only covers gram-positive bacteria (MRSA, strep, enterococcus) and has no activity against gram-negative bacteria such as E. coli.
✓ Antibiotic-1 (3).pdf · p. 20 -
C
ليش غلط
Cefepime is a fourth-generation cephalosporin used for Pseudomonas. The drug of choice for ESBL organisms is a carbapenem.
✓ Antibiotics 🍓.pdf · p. 1 -
D
ليش صح
Carbapenems (imipenem, meropenem, ertapenem) are the drug of choice for ESBL organisms and cover gram-negatives, so imipenem is right for ESBL E. coli pyelonephritis.
✓ Antibiotic-1 (3).pdf · p. 17
- المصدر
- Antibiotic-1 (3).pdf · p. 17
- المحاضرة
- Antimicrobials · Infectious Diseases · Module B
- ظهر في
- ID bank · MED43 ♀ Compre · MED42 Compre B