CNS & Blood Infectious Disease

Question 1

Empiric Therapy for Bacterial Meningitis

age under 1 month

Answer 1

Ampicillin + Cefotaxime or

Ampicillin + aminoglycoside

Question 2

Pathogens common in bacterial meningitis

age under 1 month

Answer 2

Group B Strep, E. coli, Listeria monocytogenes, Klebsiella

Question 3

Pathogens common in bacterial meningitis

age 1-23 months

Answer 3

S. pneumo, N. meningitides, Group B Strep, H. flu, E. coli

Question 4

Empiric Therapy for Bacterial Meningitis

age 1-23 months

Answer 4

Vancomycin + Ceftriaxone/Cefotaxime

Question 5

Pathogens common in bacterial meningitis

age 2-50 yrs

Answer 5

N. meningitides, S. pneumo

Question 6

Empiric Therapy for Bacterial Meningitis

age 2-50 yrs

Answer 6

Vancomycin + Ceftriaxone/Cefotaxime

Question 7

Pathogens common in bacterial meningitis

age >50 yrs

Answer 7

S. pneumo, N. meningitides, L. monocytogenes, aerobic gram neg bacilli

Question 8

Empiric Therapy for Bacterial Meningitis

age >50 yrs

Answer 8

Vancomycin + Ampicillin + Ceftriaxone/Cefotaxime

Question 9

Basilar Skull Fracture Empiric Therapy

Answer 9

Vancomycin + Ceftriaxone/Cefotaxime

Question 10

Penetrating Trauma Empiric Therapy

Answer 10

Vancomycin + Cefepime/Ceftazidime/

Meropenem

Question 11

Postneurosurgery Empiric Therapy

Answer 11

Vancomycin + Cefepime/Ceftazidime/

Meropenem

Question 12

CSF Shunt Empiric Therapy

Answer 12

Vancomycin + Cefepime/Ceftazidime/

Meropenem

Question 13

Empiric Abx for Sepsis in 
Urinary Tract (Community Acquired)

Answer 13

Ceftriaxone or Ciprofloxacin/Levofloxacin

Question 14

Empiric Abx for Sepsis in 
Urinary Tract (Healthcare Acquired)

Answer 14

Ciprofloxacin/Levofloxacin or Ceftriaxone/Ceftazidime

Question 15

Empiric Abx for Sepsis in Respiratory Tract (CA)

Answer 15

Levofloxacin/moxifloxacin or Ceftriaxone + Azithromycin

Question 16

Empiric Abx for Sepsis in Respiratory Tract (HA)

Answer 16

Piperacillin/Tazobactam or
Ceftazidime/Cefepime + Levofloxacin/Ciprofloxacin or
Aminoglycoside

Question 17

Empiric Abx for Sepsis in Intraabdominal (CA)

Answer 17

Ertapenem/Tigecycline/Cipro/Levo + Metronidazole

Question 18

Empiric Abx for Sepsis in Intraabdominal (HA)

Answer 18

Piperacillin/Tazobactam or

Carbapenem

Question 19

Empiric Abx for Sepsis in Skin/Soft Tissue (CA)

Answer 19

Vancomycin or Linezolid or Daptomycin

Question 20

Empiric Abx for Sepsis in Skin/Soft Tissue (HA)

Answer 20

Vancomycin + Pip-Taz

Question 21

Empiric Abx for Sepsis in Catheter-related

Answer 21

Vancomycin

Question 22

Empiric Abx for Sepsis in Unknown

Answer 22

Pip-Taz or Ceftazidime/Cefepime or Imipenem/Meropenem with or without Vancomycin

Question 23

Beta lactams

Answer 23

AE: hypersensitivity rxn, Type I IgE mediated reaction, rash, hemolysis

Question 24

Carbapenems

Answer 24

AE: seizures (especially imipenem)

Question 25

Vancomycin

Answer 25

AE: nephrotoxic, ototoxic, red man syndrome

Question 26

Aminoglycosides

Answer 26

AE: nephrotoxic, neuromuscular blockade, ototoxic, teratogenic

Question 27

Fluoroquinolones

Answer 27

AE: photosensitivity, chelation, QT prolongation, tendinitis

Question 28

Ceftriaxone Contraindications (FDA MedWatch Program)

Answer 28

Hypersensitivity Neonates: ceftriaxone can displace bilirubin from binding to serum albumin, leading to risk of bilirubin encephalopathy Neonates requiring calcium IV solutions: risk of precipitation of ceftriaxone-calcium

Question 29

Community acquired meningitis empiric abx

Answer 29

Ceftriaxone, cefotaxime, vancomycin

Question 30

Listeria monocytogenes

Answer 30

Common in elderly & infants Ampicillin with or without gentamicin should be added empirically

Question 31

Start therapy ASAP when suspicion for meningitis exists

Answer 31

DO NOT withold abx for delay in lumbar puncture

Question 32

Fluconazole

Answer 32

For suspected nosocomial blood stream fungal infx | Caution: recent exposure to abx & fluconazole can cause resistance!

Question 33

Caspofungin

Answer 33

Potent against all Candida species as well as Aspergillus

Question 34

Acute Complicated UTI organisms

Answer 34

Pseudomonas, Serratia, Providencia