Antibiotic to cover coagulase negative G+ve and G-ve rods! - USMLE Forums
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Old 07-15-2011
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Drug Antibiotic to cover coagulase negative G+ve and G-ve rods!

Blood cultures from a patient with bacterial sepsis grow two organisms: coagulase-negative, gram-positive cocci and gram-negative rods. Which antibiotic regimen should this patient receive?
A. Ampicillin-sulbactam
B. Nafcillin
C. Vancomycin
D. Penicillin G
E. Metronidazole
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Old 07-15-2011
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ampicillin-salbactum
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broad spectrum apmicillin with sulbactum added to inhibit beta lactamases
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Old 07-17-2011
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A is the answer
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A. Ampicillin-sulbactam
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Old 07-17-2011
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seems like A
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answer A; AMPICILLIN
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Old 07-17-2011
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A. Ampicillin-sulbactam
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Ampicilline and sulbactum
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Default answer

The presence of coagulase-negative, gram-positive cocci suggests contamination by skin flora S. epidermidis, which doesn’t require treatment. The gram-negative rods, on the other hand, should be treated with an extended spectrum beta-lactam (e.g. ampicillin-sulbactam) or fluoroquinolone until it is speciated and sensitivities determined. From a clinical perspective, this type of decision-making comes up on a near-daily basis b/c S. epidermidis is such a frequent contaminant of blood cultures.

Vancomycin and nafcillin are commonly used to treat gram-positive organisms
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Quote:
Originally Posted by ricko335 View Post
The presence of coagulase-negative, gram-positive cocci suggests contamination by skin flora S. epidermidis, which doesn’t require treatment. The gram-negative rods, on the other hand, should be treated with an extended spectrum beta-lactam (e.g. ampicillin-sulbactam) or fluoroquinolone until it is speciated and sensitivities determined. From a clinical perspective, this type of decision-making comes up on a near-daily basis b/c S. epidermidis is such a frequent contaminant of blood cultures.

Vancomycin and nafcillin are commonly used to treat gram-positive organisms
This is only true if 1 of 3 blood culture is positive...but here we have blood cultureS...
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