Lim
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A 35-year-old woman comes to the emergency department after a motor vehicle collision with burns covering 30% of her body surface area. After transportation to ther burn unit, the patient develops a fever , and her WBC count increases to 18000/mm3. Blood cultures show an aerobic, gram-negative rod that is non-lactose-fermenting and is oxidase-positive. The patient is started on vancomycin and piperacillin-tazobactaml 30 minutes later, she develops an erythematous rash on her skin as well as hypotension. The patient then reports that she has a penicillin allergy. Which of the following antibiotics shoud be given to treat to this patient's infection?
A. Aztreonam
B. Ceftazidime
C. Imipenem
D. Linezolid
E. Piperacillin-tazobactam at a lower dose.
why not imipenem?
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| Leopard
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It is true that imipenem and Aztreonam ,both are antipseudomonal but
Imipenem = beta Lactam derivative like penicillin
Aztreonam = Monobactam (though it is also beta lactam derivative) so different from peniccillin.
Imipenem and cephalosporin show Cross reaction with penicillin .
Best of luck
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| Lim
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Thank you veeeery much,Leopard.
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| drfax
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D
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| Leopard
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drfax wrote:
D
Linezolid is effective against gram-positive pathogens, notably Enterococcus faecium, Staphylococcus aureus, Streptococcus agalactiae, Streptococcus pneumoniae, and Streptococcus pyogenes. It has almost no effect on gram-negative bacteria and is only bacteriostatic against most Enterococcus species. Linezolid has been used to treat tuberculosis.[u][1][/u ]
Best of luck
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| fox
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what group/ classification does Linezolid fall into?
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| drfax
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so what is the answer, all cross-react with penicilin
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| khorshid
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A.in pts with gram neg rod infection who are allergic to pcn use aztreonam.
(for gram + who are allergic to pcn, use macrolids).
Imipenem has partial cross allergenicity with pcn.
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