A 22-year-old university student presents with a 2-day history of sore throat, fever, and tender anterior cervical lymphadenopathy. On examination, there is marked tonsillar erythema with exudates, but the patient denies any cough.
A rapid antigen detection test for group A Streptococcus is positive.
Question:
What is the most appropriate first-line treatment for this patient?
A) Amoxicillin
B) Bactrim (trimethoprim-sulfamethoxazole)
C) Ciprofloxacin
D) Cephalexin
Given her clinical presentation, she is diagnosed with an uncomplicated cystitis and requires an appropriate oral antibiotic
Which of the following antibiotics is the best choice for treating this patient’s cystitis?
A) Oral nitrofurantoin (Macrobid)
B) Oral trimethoprim-sulfamethoxazole (Bactrim)
C) Oral fosfomycin
D) Oral cefdinir
E) Oral ciprofloxacin
A 79-year-old woman with a history of chronic kidney disease (CKD stage 4, baseline creatinine 2.8 mg/dL), hypertension, and osteoarthritis is brought to the emergency department from her nursing home with fever (38.9°C), confusion, and dysuria for the past two days.
On arrival, she is lethargic with a blood pressure of 85/55 mmHg, heart rate 110 bpm, and oxygen saturation 94% on room air. She is confused and unable to provide a clear history.
She is diagnosed with sepsis secondary to a complicated urinary tract infection (UTI) and started on IV fluid resuscitation and empiric Meropenem.
The patient’s urine culture later grows Escherichia coli, which is sensitive to multiple antibiotics, including:
✅ Nitrofurantoin (Macrobid)
✅ Ceftriaxone , Cefepime and Meropenem
✅ Piperacillin-tazobactam
✅ Ciprofloxacin
✅ Bactrim
Which of the following is the most appropriate antibiotic choice for this patient?
A) Oral nitrofurantoin (Macrobid)
B) IV ceftriaxone
C) Oral fosfomycin
D) Oral trimethoprim-sulfamethoxazole (Bactrim)
E) Continue broad-spectrum IV piperacillin-tazobactam
A 64-year-old man with a history of chronic kidney disease (CKD stage 3, baseline creatinine 1.8 mg/dL), type 2 diabetes mellitus, and benign prostatic hyperplasia (BPH) presents with a 3-day history of fever (39.2°C), dysuria, perineal pain, and urinary hesitancy. He also reports chills and malaise.
On examination, he appears ill, with a blood pressure of 100/65 mmHg, heart rate 112 bpm, and mild suprapubic tenderness. Digital rectal examination reveals an enlarged, exquisitely tender prostate, raising suspicion for acute bacterial prostatitis.
After IV hydration and empiric ceftriaxone, the E. coli isolate is found to be sensitive to all tested antibiotics, including:
The patient is clinically stable for discharge
Which of the following is the most appropriate oral antibiotic regimen for treating acute bacterial prostatitis in this patient while minimizing nephrotoxicity?
