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Old 09-23-2012
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Arrow Gyrus Daily Questions; Internal Medicine #26

A 28-year-old man comes to the emergency department with complaints of 1–2 days of fever, malaise, cough, green sputum production, and dyspnea. He is a cigarette smoker and works in a restaurant. He has no significant past medical history and takes no medications. He is uncomfortable but alert with temperature of 39.2°C, respiratory rate 28 breaths/min, blood pressure 110/70 mmHg, heart rate 105 beats/min, SaO2 on room air is 94%. His chemistry studies are normal. White blood cell (WBC) count is 15,500/μL. There are bronchial breath sounds in the right lower lobe, and chest radiograph shows consolidation in that area. Which of the following is the most appropriate antibiotic therapy?

A. Azithromycin
B. Ceftriaxone plus clarithromycin
C. Fluconazole
D. Piperacillin/tazobactam
E. Vancomycin
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B. Ceftriaxone plus clarithromycin
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Answer B.....
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B.. the **** xD
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A. Azithromycin

The outpatient treatment of CAP is macrolide.
This differs from the other question #27 because this is a young patient without hypoxia and does not require admission.
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I have studied about this in my college days. So, my answer will be B. Ceftriaxone plus clarithromycin is the antibiotic therapy.
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Would go with A, this is a case of community acquired pneumonia.
B would be appropriate for hospital acquired pneumonia.
D & E would be appropriate for ventilator associate pneumonia.
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Quote:
Originally Posted by Novobiocin View Post
A. Azithromycin

The outpatient treatment of CAP is macrolide.
This differs from the other question #27 because this is a young patient without hypoxia and does not require admission.
Quote:
Originally Posted by Anders View Post
Would go with A, this is a case of community acquired pneumonia.
B would be appropriate for hospital acquired pneumonia.
D & E would be appropriate for ventilator associate pneumonia.

The answer is A Azithromycin
This patient is a candidate for outpatient therapy because of his CURB-65 score of 0.

As shown below, an oral macrolide (azithromycin, clarithromycin) is the best choice. Respiratory fluoroquinolones may beused in the presence of comorbidities or recent antibiotics



Last edited by cingulate.gyrus; 09-24-2012 at 06:19 AM. Reason: Adding something
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its A.azithromycin
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