mjl1717
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what med would you use to treat enterobacter cloace?
a)pennicillin
b)doxycycine
c)azithromycin
d)erythromycin
e)imipenam
f)nitrofurantoin
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| mjl1717
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cmon guys
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| bactitech
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It's more like which one WOULDN'T you use to treat E. cloacae with? There are a number of them in there you wouldn't use. Also, from what SITE is the E. cloacae? Urinary? Respiratory? These might call for different approaches.
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| mjl1717
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ok -its from the urinary system
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| bactitech
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If I were a doc (which I'm not) I would probably try Nitrofurantoin first, as this is a drug used strictly for UTI and is cheap! Pen and Erythro are for gram positive infections; Azithro is for respiratory infections. Imipenem is usually reserved for very resistant organisms. We don't report it unless the organism is an ESBL or a Pseudomonas. Doxycyline is a tetracycline and can be used in many different infections. It is the main reason I hesitated before guessing on this one. I don't believe, however, that doxycycline is used much for UTI's. However, doxy is used for gram negative infections (and others, including Mycoplasma) so that's why I hesitate.
Now, docs-to-be, what's YOUR take on this question? I hung my neck out on it ?
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| p53
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e)imipenam
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| mjl1717
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p53 wrote:
e)imipenam
correct!-since imipenam covers resitant organisms as bactitech mentions.
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| bactitech
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But that's WAY too expensive a big gun to aim at E. cloacae UNLESS it's an ESBL. Your patient is going to pay a fortune for that drug. Your PharmD is going to wonder WHY you are using this expensive drug on a fairly simple enterobacteriace infection. I have to disagree - we only release the results of Imipenem for certain situations. It is NOT a first line drug.
Enterobacters are usually resistant to Amp and Cefazolin and sensitive to the rest of our panel (unless we're talking ESBL's and that's a whole different can of worms). Some E. cloacae's are pretty resistant. This is why you look at the results we send out and change to Imipenem ONLY if the sensitivity result warrants it.
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