Which is true about antibiotic prescribing to reduce the risk of antimicrobial resistance development?
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Most patients with asymptomatic bacteriuria should be treated with antibiotics to reduce risk of developing resistant E coli.
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Uncomplicated acute cystitis should be treated for a minimum of 14 days of antibiotics.
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Non-purulent uncomplicated cellulitis should be treated for a minimum of 5 days.
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Community-acquired pneumonia should be treated with antibiotics for a minimum of 21 days before considering discontinuation.
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Group A beta-hemolytic strep treated for less than 21 days is considered “partially treated” and risks transformation into resistant organisms.
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Can you identify this pill?
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cyclobenzaprine
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ropinirole
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alprazolam
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lorazepam
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(PubMed)—A 35-yo man w/ hx of Evans syndrome secondary to antiphospholipid syndrome presented w/ jaundice and SOB. Prior to presentation, his condition had been well controlled w/ cyclosporine 200 mg/day. Two months earlier he had been diagnosed w/ restrictive lung dz, which was treated w/ a steroid. To counteract steroid-related weight gain, the pt was prescribed orlistat, which he took at the same time as his cyclosporine. Other meds: warfarin. Labs—Hgb 9.3 g/dL, platelets 4 x109/L, INR 3.4, and positive direct Coombs tests—indicated a relapse of Evans syndrome.
What drug interaction could have led to the relapse?
What drug interaction could have led to the relapse?
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cyclosporine and orlistat
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orlistat and warfarin
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warfarin and cyclosporine
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orlistat and steroids
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Which of these are NOT recommended for treating/managing diabetic foot infections (DFIs)?
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Use of adjunctive therapies (e.g., G-CSF, topical antiseptics, silver, honey, bacteriophages, topical antibiotics, hyperbaric oxygen) are recommended to promote healing.
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In patients with DFI-associated osteomyelitis and amputation with positive bone margins, antibiotics are suggested for 3 weeks; for those patients without amputation, 6 weeks are recommended.
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For DFI involving skin and soft tissue, treatment duration is typically 1–2 weeks (up to 4 weeks if improvement is slow); empiric treatment should focus on gram-positive bacteria, including Staphylococcus aureus.
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Avoid antibiotics in the absence of signs or symptoms of infection in diabetic foot ulcers.
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Perform MRI if plain x-rays and probe-to-bone testing are inconclusive for suspected osteomyelitis.
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