CICM SAQ 2013.2 Q15

Questions

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

Answers

Answer and interpretation

15.1

15.2

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

Examination Library

CICM

Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM with a passion for rugby; medical history; medical education; and informatics. Asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | vocortex |

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