BCPS BCPS Pharmacotherapy of Infectious Diseases

Question 1

A patient with a penicillin allergy (anaphylaxis) requires treatment for methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia. Which antibiotic is the preferred alternative?

Accepted Answer

Daptomycin

Answer

Daptomycin is a preferred alternative for MSSA bacteremia in patients with a history of anaphylaxis to penicillin where beta-lactams are contraindicated.

Question 2

Which pharmacokinetic parameter best guides vancomycin dosing optimization to maximize efficacy and minimize nephrotoxicity per current ASHP/IDSA/SIDP guidelines?

Accepted Answer

AUC/MIC ratio (24-hour AUC 400–600)

Answer

Current guidelines recommend AUC-guided vancomycin monitoring targeting an AUC/MIC of 400–600 mg·h/L to balance efficacy and nephrotoxicity.

Question 3

A patient with a creatinine clearance of 25 mL/min requires treatment for uncomplicated urinary tract infection caused by E. coli. Which agent is contraindicated due to lack of adequate urinary concentrations at this renal function level?

Accepted Answer

Nitrofurantoin

Answer

Nitrofurantoin is contraindicated when CrCl is below 30 mL/min because it fails to achieve therapeutic urinary concentrations and may accumulate to toxic levels.

Question 4

Which antifungal agent is the drug of choice for invasive aspergillosis in an immunocompromised patient according to IDSA guidelines?

Accepted Answer

Voriconazole

Answer

Voriconazole is the first-line treatment for invasive aspergillosis per IDSA guidelines due to superior efficacy and survival outcomes compared to amphotericin B.

Question 5

A patient is being treated for hospital-acquired pneumonia with a gram-negative organism that tests positive for an extended-spectrum beta-lactamase (ESBL). Which antibiotic class is the preferred treatment?

Accepted Answer

Carbapenems

Answer

Carbapenems are the drugs of choice for serious ESBL-producing gram-negative infections because ESBLs hydrolyze all penicillins and cephalosporins but not carbapenems.

(BCPS) Board Certified Pharmacotherapy Specialist Practice Test

(BCPS) Board Certified Pharmacotherapy Specialist Practice Test

BCPS BCPS Pharmacotherapy of Infectious Diseases