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Chapter 81. Osteomyelitis

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An 82-year-old woman with no known allergies was admitted to the hospital to receive surgical and medical management for suspected osteomyelitis of the tibia. During surgical debridement, a bone biopsy was obtained for culture and histopathology. The microbiology laboratory reported Staphylococcus aureus, susceptible to vancomycin, linezolid, daptomycin, trimethoprim-sulfamethoxazole but resistant to penicillin, oxacillin, ciprofloxacin, erythromycin, and clindamycin.

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Select an appropriate intravenous antimicrobial regimen for this patient.

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A. Linezolid

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B. Levofloxacin

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C. Nafcillin

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D. Trimethoprim-sulfamethoxazole

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E. Vancomycin

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An 82-year-old woman with no known allergies was admitted to the hospital to receive surgical and medical management for suspected osteomyelitis of the tibia. During surgical debridement, a bone biopsy was obtained for culture and histopathology. The microbiology laboratory reported Staphylococcus aureus, susceptible to vancomycin, linezolid, daptomycin, trimethoprim-sulfamethoxazole but resistant to penicillin, oxacillin, ciprofloxacin, erythromycin, and clindamycin.

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Which laboratory parameter(s) should be monitored weekly in this patient receiving intravenous antibiotic therapy?

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A. Liver function tests

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B. BUN/SCr

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C. Vancomycin trough

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D. A and B

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E. B and C

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An 82-year-old woman with no known allergies was admitted to the hospital to receive surgical and medical management for suspected osteomyelitis of the tibia. During surgical debridement, a bone biopsy was obtained for culture and histopathology. The microbiology laboratory reported Staphylococcus aureus, susceptible to vancomycin, linezolid, daptomycin, trimethoprim-sulfamethoxazole but resistant to penicillin, oxacillin, ciprofloxacin, erythromycin, and clindamycin.

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Response to therapy can be evaluated by the following laboratory test(s):

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A. CPK

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B. CRP

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C. ESR

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D. A and B

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E. B and C

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An 82-year-old woman with no known allergies was admitted to the hospital to receive surgical and medical management for suspected osteomyelitis of the tibia. During surgical debridement, a bone biopsy was obtained for culture and histopathology. The microbiology laboratory reported Staphylococcus aureus, susceptible to vancomycin, linezolid, daptomycin, trimethoprim-sulfamethoxazole but resistant to penicillin, oxacillin, ciprofloxacin, erythromycin, and clindamycin.

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Following 3 weeks of intravenous therapy with clinical improvement, the clinician would now like to switch to oral therapy. What do you recommend?

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A. Daptomycin

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B. Linezolid

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