new_n_lost
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A 35-year-old man presented with cellulitis of his right leg. On examination he was mildly confused and febrile (40.1°C) with a pulse was 120 / minute and BP 80/55 mmHg. He was treated with intravenous benzylpenicillin and flucloxacillin. Group A Streptococcus was isolated from two sets of blood cultures. There was no significant clinical improvement after 24 hours.
What antibiotic should be added?
1) Ciprofloxacin
2) Clindamycin
3) Gentamicin
4) Rifampicin
5) Vancomycin
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| salmonella
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streptococci resistant to penicillin are given vanco+/- rifampin
so if u want to add I think add rifampin
and if u wanna change give vanco+/- rifampin????
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| salmonella
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should be addsd an aminoglycoside if it was a grooup A streptococci(enterococci)
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| new_n_lost
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We Add Vancomycin When we find MRSA Methicillin Rsistant Staph Aureus not with Streptococci Grp A
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| new_n_lost
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Think Again of an Adjuvant which will be helpful in Dealing with Strep Pyogenes ( wud it cos Cellulits)
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| new_n_lost
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All the Questions Posted r Simple Concepts asked in a Different Way When i did them i wrote them off as difficult ones but later it turned out they had the simplest answer.
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| salmonella
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dear
sorry I wanted to write group D streptococci thats why I also wrote enterococci
for penicillin resistant group sretococci give vanco+/- rifampin
add an aminoglycoside if it was a grooup D streptococci(enterococci
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| new_n_lost
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Wht if its a Grp A Strept wht wud u add to it
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| me007
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cipro - gr-neg
clinda - anaerobes , also backup drug for strep -? not sure
genta - gr-neg
rifampin - carrier state meningococci and staph (besides TB)
vanco - drug-resistant gr-pos m/o, not only MRSA
5?
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| new_n_lost
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Strept Pyogenes is the Most common cause of Streptococcal Toxic Shock Syndrome. Clindamycin is the DOC for STSS ( Streptococcal Toxin Shock Syndrome) Also effective against aerobic and anaerobic streptococci (except enterococci).
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| new_n_lost
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Clindamycin is now also used in as back up drug for most gram +ve cocci n is used prophylactically in Valvular Endocarditis in pts who r allergeric to penicillin.
Both References Katzung
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| new_n_lost
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The patient has a severe cellulitis with features of Streptococcal toxic shock syndrome. Streptococcal TSS is mediated via Streptococcal exotoxins. Although clindamycin is a bacteriostatic antibiotic, it acts by switching-off protein synthesis within bacteria; this in turn will lead to decreased exotoxin expression, thereby removing the mediators of TSS.
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| me007
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does it mean that any in condition with TSS clindamycin should be added bcs it
switching-off protein synthesis within bacteria; this in turn will lead to decreased exotoxin expression, thereby removing the mediators of TSS.
Is it for sure?
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| new_n_lost
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Yup This is For Sure
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| epica
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Can not participate ( busy w my job) but it's very good Q.
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| mytime
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Clindamycin.skipped the discussion.
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