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Old 08-18-2012
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Default Treating Diverticulitis on CCS

Well I have a few bones to pick with USMLE WOrld and CCS practice. I do not agree with some of the treatment options they teach.

For example: Diverticulitis: Treat with Ampicillin and Sulbactam IV not
Cefoxitin or Cefotaxime, it seems a much better choice to me
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Old 08-18-2012
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Originally Posted by DRFP View Post
Well I have a few bones to pick with USMLE WOrld and CCS practice. I do not agree with some of the treatment options they teach.

For example: Diverticulitis: Treat with Ampicillin and Sulbactam IV not
Cefoxitin or Cefotaxime, it seems a much better choice to me
Well, I would go for broad spectrum. I don't really agree with any of those options. I would go for carbapenem, e.g. imipenem, or even pip/taz
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Old 08-18-2012
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Outpatient: amox/clav or TMP/SMX + metronidazole or fluoroquinolone + metronidazole.

Inpatient: metronidazole or clindamycine + aminoglycoside or monobactam or third generation cephalosporin. Alternatively: second gener cephalosp or beta lactamase inhib combinations.


That's what the guideline says.
Still:.... usually inpatient it's imipenen, pip/taz or metronidazole + 3rd gener cephalosp

Confusing....
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Old 08-18-2012
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Originally Posted by dr_mhm View Post
Outpatient: amox/clav or TMP/SMX + metronidazole or fluoroquinolone + metronidazole.

Inpatient: metronidazole or clindamycine + aminoglycoside or monobactam or third generation cephalosporin. Alternatively: second gener cephalosp or beta lactamase inhib combinations.


That's what the guideline says.
Still:.... usually inpatient it's imipenen, pip/taz or metronidazole + 3rd gener cephalosp

Confusing....
Hmm Sanford says something like that

In patient Pip-Tazo or Ticar clav Or Ertapenem Or Moxifloxacin if mild ( like in that case) if severe then Imipenem or Meropenem

So basically like I thought USMLE World needs to update CCS some and I would caution folks to look things up at times, I thought AMpicillin Sub was wrong and I now I'm sure of it.
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Old 08-18-2012
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Hmm Sanford says something like that

In patient Pip-Tazo or Ticar clav Or Ertapenem Or Moxifloxacin if mild ( like in that case) if severe then Imipenem or Meropenem

So basically like I thought USMLE World needs to update CCS some and I would caution folks to look things up at times, I thought AMpicillin Sub was wrong and I now I'm sure of it.
I agree, always double check. I haven't started CCS on UW yet, starting next week so I can't comment on that.

I guess you could still do amp sulbactam in outpatient...., if wouldn't be my first choice but it's not completely wrong.
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