Factors that place a patient at risk of developing an antimicrobial-resistant organism
include:
1. Age over 50 years
2. School attendance
3. Travel within the U.S.
4. Inappropriate use of antimicrobials - answer 4. Inappropriate use of antimicrobials
Infants and young children are at higher risk of developing antibiotic-resistant infections
due to:
1. Developmental differences in pharmacokinetics of the antibiotics in children
2. The fact that children this age are more likely to be in daycare and exposed to
pathogens from other children
3. Parents of young children insisting on preventive antibiotics so they don't miss work
when their child is sick
4. Immunosuppression from the multiple vaccines they receive in the first 2 years of life
- answer 2. The fact that children this age are more likely to be in daycare and exposed
to pathogens from other children
Providers should use an antibiogram when prescribing. An antibiogram is:
1. The other name for the Centers for Disease Control guidelines for prescribing
antibiotics
2. An algorithm used for prescribing antibiotics for certain infections
3. The reference also known as the Pink Book, published by the Centers for Disease
Control
4. A chart of the local resistance patterns to antibiotics developed by laboratories -
answer 4. A chart of the local resistance patterns to antibiotics developed by
laboratories
There is often cross-sensitivity and cross-resistance between penicillins and
cephalosporins because:
1. Renal excretion is similar in both classes of drugs.
2. When these drug classes are metabolized in the liver they both produce resistant
enzymes.
3. Both drug classes contain a beta-lactam ring that is vulnerable to beta-lactamase-
producing organisms.
4. There is not an issue with cross-resistance between the penicillins and
cephalosporins. - answer 3. Both drug classes contain a beta-lactam ring that is
vulnerable to beta-lactamase-producing organisms.
Jonathan has been diagnosed with strep throat and needs a prescription for an
antibiotic. He says the last time he had penicillin he developed a red, blotchy rash. An
appropriate antibiotic to prescribe would be:
1. Penicillin VK, because his rash does not sound like a serious rash
2. Amoxicillin
3. Cefadroxil (Duricef)
4. Azithromycin - answer 4. Azithromycin
, Woo - 24 - Drugs used to treat Infections
Sarah is a 25-year-old female who is 8 weeks pregnant and has a urinary tract infection.
What would be the appropriate antibiotic to prescribe for her?
1. Ciprofloxacin (Cipro)
2. Amoxicillin (Trimox)
3. Doxycycline
4. Trimethoprim-sulfamethoxazole (Septra) - answer 2. Amoxicillin (Trimox)
Pong-tai is a 12-month-old child who is being treated with amoxicillin for acute otitis
media. His parents call the clinic and say he has developed diarrhea. The appropriate
action would be to:
1. Advise the parents that some diarrhea is normal with amoxicillin and recommend
probiotics daily.
2. Change the antibiotic to one that is less of a gastrointestinal irritant.
3. Order stool cultures for suspected viral pathogens not treated by the amoxicillin.
4. Recommend increased fluids and fiber in his diet. - answer 1. Advise the parents that
some diarrhea is normal with amoxicillin and recommend probiotics daily.
Lauren is a 13-year-old child who comes to clinic with a 4-day history of cough, low-
grade fever, and rhinorrhea. When she blows her nose or coughs the mucous is
greenish-yellow. The appropriate antibiotic to prescribe would be:
1. Amoxicillin
2. Amoxicillin/clavulanate
3. TMP/SMZ (Septra)
4. None - answer 4. None
Joanna had a small ventricle septal defect (VSD) repaired when she was 3 years old
and has no residual cardiac problems. She is now 28 and is requesting prophylactic
antibiotics for an upcoming dental visit. The appropriate antibiotic to prescribe according
to current American College of Cardiology and American Heart Association guidelines
is:
1. None, no antibiotic is required for dental procedures
2. Amoxicillin 2 grams 1 hour before the procedure
3. Ampicillin 2 grams IM or IV 30 minutes before the procedure
4. Azithromycin 1 gram 1 hour before the procedure - answer 1. None, no antibiotic is
required for dental procedures
To prevent further development of antibacterial resistance it is recommended that
fluoroquinolones be reserved for treatment of:
1. Urinary tract infections in young women
2. Upper respiratory infections in adults
3. Skin and soft tissue infections in adults
4. Community-acquired pneumonia in patients with comorbidities - answer 4.
Community-acquired pneumonia in patients with comorbidities