A 48-year-old heavy smoker man has fever, headache, muscle ache, cough and diarrhea for 1 week. His Temp 38.8C, HR 110/min, BP 100/60 mmHg, RR 28/min, and oxygen saturation on room air 90%. His chest auscultation reveals right basal crepitation. He has high WBC 17,000. His chest x-ray shows right lower lobe infiltrate. Which of the following is the best empirical antibiotic/s for this patient?
سؤال مجاني 2 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: D. Ceftriaxone and Azithromycin
This is community-acquired pneumonia that needs hospital care: hypoxia (SpO₂ 90%), RR 28 and borderline BP. The diarrhea and headache in a smoker also suggest Legionella (atypical). Empiric inpatient treatment covers both S. pneumoniae and atypicals: IV ceftriaxone + azithromycin.
- Ceftriaxone alone (C) doesn't cover atypical organisms.
- Amoxicillin (A) is for mild outpatient CAP.
- Ciprofloxacin (B) is not a respiratory fluoroquinolone.
ليش كل خيار صح أو غلط
-
A
ليش غلط
Amoxicillin is a beta-lactam, and atypical bacteria such as Legionella do not respond to beta-lactams. Diarrhea and headache here suggest Legionella.
✓ Pulmonology 🫁.pdf · p. 15 -
B
ليش غلط
Ciprofloxacin covers enteric gram-negatives including Pseudomonas, but only moxifloxacin and levofloxacin have gram-positive activity, so ciprofloxacin does not reliably cover pneumococcus.
✓ Antibiotic-1 (3).pdf · p. 23 -
C
ليش غلط
Ceftriaxone alone is a beta-lactam. It misses atypical organisms, and the diarrhea and headache here suggest Legionella, so a macrolide must be added.
✓ Pulmonology 🫁.pdf · p. 15 -
D
ليش صح
The lecture's empiric choice for community-acquired pneumonia is IV ceftriaxone plus azithromycin, aimed at both S. pneumoniae and atypical organisms. This hypoxic smoker with pneumonia, diarrhea and headache needs both covered.
✓ Antibiotic-1 (3).pdf · p. 35
- المصدر
- Antibiotic-1 (3).pdf · p. 35
Step Up To Medicine 6th Edition 2024 (Pneumonia).pdf · p. 6 - المحاضرة
- Antimicrobials · Infectious Diseases · Module B
- ظهر في
- ID bank · Respi bank