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Author Question: A patient at high risk of developing VAP has acquired late-onset VAP. Which of the following ... (Read 30 times)

mynx

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on: Jul 16, 2018
A patient at high risk of developing VAP has acquired late-onset VAP. Which of the following combinations of antibiotics is suitable for this patient to receive as initial combination therapy? I. methicillin-sensitive Staphylococcus aureus II. antipseudomonal fluoroquinolone plus vancomycin III. antipseudomonal, cephalosporin, beta-lactam/beta-lactamase inhibitor IV. carbapenems plus aminoglycoside
 
  A. I, IV only
  B. II, III only
  C. II, III, IV only
  D. I, II, III, IV

Question 2

Which of the following antibiotics are bactericidal in time-dependent fashion? I. aminoglycosides II. fluoroquinolones III. vancomycin IV. beta-lactams
 
  A. I, II only
  B. II, III only
  C. III, IV only
  D. I, II, IV only


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wilsonbho

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Reply #1 on: Jul 16, 2018
Answer to Question 1

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Using antibiotics from different classes will increase the chance of covering pathogens resistant to the class of antimicrobial the patient received. An antipseudomonal, cephalosporin, beta-lactam/beta-lactamase inhibitor, or carbapenems plus an aminoglycoside, or antipseudomonal fluoroquinolone plus anti-MRSA antibiotic (linezolid or vancomycin) is the recommended initial combination for late-onset and for VAP in high-risk patients.
D. Incorrect response: See explanation C

Answer to Question 2

ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Aminoglycosides and fluoroquinolones are bactericidal in a concentration-dependent fashion with postdose effect. Beta-lactams and vancomycin are bactericidal in time-dependent manner with no postantibiotic effect.
D. Incorrect response: See explanation C.


mynx

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Reply #2 on: Jul 16, 2018
Correct answers!


wilsonbho

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Reply #3 on: Jul 16, 2018
Great! Please up vote :D


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