NABP Exam NAPLEX Topic 1 Question 93 Discussion

Actual exam question for NABP's NAPLEX exam

Question #: 93
Topic #: 1

MT is 47-year-old man who presents to the ER with painful, red, swollen area on his left leg. His temperature is 38.4, respiratory rate 30 and heart rate 95. He has been taking cephalexin day 4 today, as prescribed by his primary care physician. His CMP is normal a CBC shows elevated WBC of 16,000/mm3.

What would be the most appropriate antibiotic/s to initiate on MT empirically?

AVancomycin IV and Piperacillin/Tazobactam

BIV Doxycycline and Ceftazidime

CNafcillin

DVancomycin IV.

ECeftriaxone

Show Suggested Answer

Suggested Answer: A

This patient is displaying signs of a severe case of cellulitis. Severe cellulitis is defined as having one of the following: failed oral antibiotic treatment, immunocompromised, clinical signs of deeper infection, or meeting the SIRS criteria. Based on this patient's presentation they have failed antibiotic treatment and meet SIRS criteria. For severe cellulitis, IDSA SSTI guidelines recommend using Vancomycin along with Zosyn.

https://academic.oup.com/cid/article/59/2/e10/2895845/Practice-Guidelines-for-the-Diagnosis-and

by Weldon at Sep 18, 2024, 04:38 PM

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Delfina

2 months ago

Nafcillin seems like a good choice, as it's an effective antibiotic for skin and soft tissue infections like this. Plus, it's got a catchy name - who doesn't love a bit of 'nafcillin' in their life?

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Cecil

21 days ago

I would go with vancomycin IV and piperacillin/tazobactam for broader coverage.

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Lai

23 days ago

I think vancomycin IV would also be a good option to cover for MRSA.

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Suzi

25 days ago

I agree, nafcillin is a good choice for skin infections.

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Lenna

1 months ago

I would go with Vancomycin IV as well, it's a broad-spectrum antibiotic.

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Teddy

1 months ago

I think Vancomycin IV and Piperacillin/Tazobactam would be more appropriate in this case.

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Dottie

1 months ago

I agree, nafcillin is a good choice for skin and soft tissue infections.

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Delsie

2 months ago

The elevated WBC and fever suggest a bacterial infection, so I'd choose the IV Doxycycline and Ceftazidime option to target a wide range of gram-positive and gram-negative bacteria.

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Sharen

1 months ago

Vancomycin IV alone could also be effective, especially if MRSA is suspected.

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Tyisha

1 months ago

I think Nafcillin could also be a good option for gram-positive coverage.

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Marti

2 months ago

Wouldn't Vancomycin IV and Piperacillin/Tazobactam be a better choice for MRSA coverage?

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Laura

2 months ago

I agree, starting with IV Doxycycline and Ceftazidime would cover a broad spectrum of bacteria.

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Charlie

2 months ago

I'm not sure, but I think Vancomycin IV alone could also be a good choice.

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Mindy

3 months ago

I agree with Muriel, those antibiotics would cover a broad spectrum of bacteria.

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Muriel

3 months ago

I think the most appropriate antibiotics would be Vancomycin IV and Piperacillin/Tazobactam.

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Alyce

3 months ago

Hmm, the patient is already taking cephalexin, so I'd go with Vancomycin IV and Piperacillin/Tazobactam to cover a broader spectrum of potential pathogens.

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Dominga

2 months ago

Yes, it's important to consider broad spectrum coverage in this case, especially with the elevated WBC count.

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Ryan

2 months ago

I agree, Vancomycin IV and Piperacillin/Tazobactam would be a good choice to cover both gram-positive and gram-negative organisms.

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