40-year-old female patient presented to the ER with UTI symptoms, (+Klebsiella), what is the most appropriate treatment for this case?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
المصادر مختلفة. ملفات الدفعة فيها إجابتين، وما نرجّح وحدة على الثانية. سبب كل وحدة في الشرح تحت:
- إجابة: D. IV Meropenem
- إجابة ثانية: A. IV Ceftriaxone
The intended answer is IV meropenem, because carbapenems are the drug of choice for ESBL-producing gram-negatives such as Klebsiella and E. coli. That only holds if the Klebsiella is ESBL-producing, and the recalled stem leaves this out.
- Why disputed: for a non-ESBL Klebsiella UTI, a narrower agent such as IV ceftriaxone (A) would be reasonable. The cohort sources don't cover treatment of a non-ESBL Klebsiella UTI.
- Clindamycin (C) has no useful gram-negative cover.
ليش كل خيار صح أو غلط
-
A
ليش صح
Disputed. In the antibiotics summary, ceftriaxone is a 3rd-generation cephalosporin listed for CAP, community meningitis, gonorrhea and intra-abdominal infection, while carbapenems are listed for ESBL organisms. The stem does not say whether this Klebsiella produces ESBL, and this answer assumes it does not.
✓ Antibiotics 🍓.pdf · p. 1 -
B
ليش غلط
Oral amoxicillin-clavulanate is listed for sinusitis, otitis media and odontogenic infection. The lecture's empiric UTI choices are oral TMP/SMX or oral ciprofloxacin.
✓ Inefctious Diseases 🦠.pdf · p. 6 -
C
ليش غلط
Clindamycin covers gram-positive cocci and anaerobes (staph infections of bone, joint, diabetic foot), not gram-negative bacilli such as Klebsiella.
✓ Antibiotics.pdf · p. 3 -
D
ليش صح
Disputed. Supported by the antibiotics lecture: carbapenems such as meropenem are the drug of choice for ESBL organisms and cover gram-negatives. The stem does not say whether this Klebsiella produces ESBL, and this answer assumes it does.
✓ Antibiotic-1 (3).pdf · p. 17
- المصدر
- Antibiotic-1 (3).pdf · p. 17
Antibiotics 🍓.pdf · p. 1 - المحاضرة
- Antimicrobials · Infectious Diseases · Module B
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