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Chapter 69. Antimicrobial Regimen Selection

Student Questions

_____________ refers to development of resistance occurring in a patient's non-targeted flora that can cause secondary infections.

A. Collateral damage

B. De-escalation

C. Pharmacodynamics

D. Source control

Answer: A

Option A: Correct. Collateral damage refers to the development of resistance occurring in a patient's non-targeted flora.

Option B: Incorrect. De-escalation refers to the discontinuation of antibiotics that are providing a spectrum of activity greater than necessary to treat the infection.

Option C: Incorrect. Pharmacodynamics describes the relationship between drug exposure and pharmacologic effect of antibacterial activity or human toxicology.

Option D: Incorrect. Source control refers to control of the source of the infection—may involve removal of prosthetic materials or drainage of an abscess.

Which one of the following is true regarding the initial empiric selection of antimicrobial agents?

A. Empirical selection of antimicrobial therapy should be related to severity of illness.

B. Given several antimicrobial choices, the antimicrobial most associated with collateral damage is preferred.

C. In most cases, double coverage is synergistic, prevents the emergence of resistance, improves outcomes, and is superior to monotherapy.

D. Consideration of previous antimicrobial exposure is not necessary when choosing empiric therapy.

Answer: A

Option A: Correct. Patient severity of illness guides the selection of antimicrobial therapy.

Option B: Incorrect. In choosing antimicrobial therapy, you want to select the antibiotic that causes the least collateral damage.

Option C: Incorrect. Double coverage doesn't improve overall outcome and is not superior to monotherapy in most infections.

Option D: Incorrect. Previous antibiotic use should always be considered when selecting an antimicrobial regimen.

Which microbe is part of the microbiome of the skin?

A. Escherichia coli

B. Enterococcus sp

C. Staphylococcus epidermidis

D. Pseudomonas aeruginosa

Answer: C

Option A: Incorrect. Escherichia coli is found in the gastrointestinal tract.

Option B: Incorrect. Enterococcus is found in the gastrointestinal tract.

Option C: Correct. Staphylococcus epidermidis is found on the skin.

Option D: Incorrect. Pseudomonas aeruginosa is found in the gastrointestinal tract.

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