CICM SAQ 2013.2 Q15


15.1 For each of the microbes listed below, list the most appropriate antibiotic(s) for treatment of infection resulting from these organisms:

a) Candida glabrata
b) Clostridum perfringens
c) Listeria monocytogenes
d) Neisseria meningitides
e) Multi-resistant Acinetobacter
f) Nocardia
g) Penicillin-intermediate pneumococcus
h) Vancomycin-resistantenterococcus

15.2 Briefly outline the dosing adjustment and the monitoring necessary for each of the following drug groups in patients with established septic shock and moderate to severe renal dysfunction (without dialysis):

  • a) Aminoglycosides
  • b) Fluoroquinolones
  • c) Beta-Lactams
  • d) Carbapenems
  • e) Glycopeptides


Answer and interpretation



a) Aminoglycosides

  • High initial dose and monitor trough concentrations. Extend interval. May be necessary to decrease dose and monitor with MIC data

b) Fluoroqinolones

  • Reduce frequency but maintain dose
  • Monitor QT interval

c) Beta Lactams

  • Can reduce dose OR frequency
  • Monitoring unnecessary

d) Carbapenems

  • As for Beta Lactams

e) Glycopeptides

  • High dosing on day one dose adjustments according to Cmin and dependent on degree of renal dysfunction
Exams LITFL ACEM 700

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BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital.  Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |

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