1 / 16

Antibiotic Cases and Recommendations by Pharmacist Nathan P. Samsa, Pharm.D., R.Ph.

Explore real-life cases and expert advice by pharmacist Nathan P. Samsa, Pharm.D., R.Ph., covering antibiotic selection and management for various patient scenarios, including community-acquired pneumonia, neonatal meningitis, and Pseudomembranous Colitis. Gain insights into common antibiotic choices, considerations, and best practices in clinical settings.

brooke-levy
Télécharger la présentation

Antibiotic Cases and Recommendations by Pharmacist Nathan P. Samsa, Pharm.D., R.Ph.

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Antibiotic Cases Nathan P. Samsa,Pharm.D., R.Ph.

  2. Case 1 • A 59yo female presents to the ER with community acquired pneumonia. • PMH: DM-2, HTN, CRF • Labs: • WBC: 14,500 • CrCl: 4.6 • BUN: 71

  3. Case 1 Question • What empiric antibiotic(s) would you start this patient on? • Cetriaxone • Levofloxacin • Azithromycin • Cetfriaxone + Levofloxacin • Ceftriaxone + Azithromycin

  4. Case 1 Answer • Ceftriaxone + Azithromycin • Key concept here is the CRF. Fluoroquinolones (levofloxacin) are renally eliminated. • Ceftriaxone + Azithromycin are hepatically eliminated. • Both are standard of care, but it comes down to liver & kidney status.

  5. Case 1 Discussion • Shortcut for CrCl: • (140-Age)/SrCr (x0.85 for female) • <50mL/min, drugs need to be adjusted • Patient’s is 15 • Azithromycin covers all bugs for pneumonia (atypicals & typicals) except for Strep pneumo, so that is why ceftriaxone is added.

  6. Case 2 • A 13 day old neonate has suspected meningitis.

  7. Case 2 Question • What empiric antibiotic(s) would you start this patient on? • Cetriaxone • Cefotaxime • Cefotaxime + Ceftriaxone • Cefotaxime + Ampicillin • Ceftriaxone + Ampicillin

  8. Case 2 Answer • Cefotaxime + Ampicillin • Ampicillin is added for Listeria monocytogenes coverage • Cefotaxime covers the other bugs • Why cefotaxime over ceftriaxone? • Ceftriaxone can cause kernicterus in a neonate

  9. Case 3 • A woman has a diagnosed case of Pseudomebranous Colitis.

  10. Case 3 Question 1 • What antibiotic is the most common cause? • Clindamycin • Vancomycin • Erythromycin • Gentamicin • Penicillin

  11. Case 3 Answer 1 • Clindamycin

  12. Case 3 Question 2 • Which antibiotic would you treat the above patient first line (with Pseduemembranous Colitis)? • Vancomycin • Clindamycin • Metronidazole • Pipercillin/tazobactam • Fluconazole

  13. Case 3 Answer 2 • Metronidazole • Both vancomycin and metronidazole are treatments, but metronidazole is 1st line because: • It’s cheaper • You don’t want to start out with your biggest guns

  14. Case 4 • Which agent is safe to give to a neonate? • Sulfamexthoxazole/trimethoprim • Penicillin • Ciprofloxacin • Minocycline • Chloramphenicol

  15. Case 4 Answer • Penicillin • SMX/TMP can cause kernicterus • Ciprofloxacin can cause tendon rupture • Minocycline can cause tooth malformation • Chloramphenicol can cause Grey Baby Syndrome

  16. The End

More Related