Antimicrobial Prescribing Flashcards
7 cards from real PSA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Antimicrobial Prescribing flashcards as text
A patient grows an ESBL-producing Klebsiella pneumoniae from a blood culture. Which antibiotic is the most appropriate definitive therapy?
Answer: Meropenem
Carbapenems such as meropenem are the treatment of choice for serious ESBL-producing Enterobacterales infections; beta-lactam/beta-lactamase inhibitors and cephalosporins are unreliable.
A patient with uncomplicated cellulitis responds well to IV antibiotics after 3 days. What is the evidence-based next step?
Answer: Switch to oral antibiotics and discharge
IV-to-oral switch at 48–72 hours in clinically improving cellulitis reduces hospitalization duration without compromising outcomes and is a core stewardship principle.
Initial blood cultures grow gram-negative rods and the patient is started on broad-spectrum coverage. Sensitivities return showing susceptibility to ceftriaxone. What should be done?
Answer: De-escalate to ceftriaxone based on susceptibilities
De-escalation to the narrowest effective agent once culture sensitivities are available is a fundamental antibiotic stewardship principle that reduces resistance and adverse effects.
A febrile patient has blood cultures drawn before antibiotics are started. The cultures return negative after 5 days. What is the most appropriate action?
Answer: Stop antibiotics if the clinical picture supports a non-infectious etiology
Negative cultures in context with improving or non-infectious clinical presentation support antibiotic discontinuation, which reduces resistance pressure and adverse effects.
Which scenario best represents appropriate empirical antibiotic prescribing?
Answer: Selecting an antibiotic based on likely organisms, local resistance patterns, and infection site
Empirical therapy should be guided by the most likely pathogens, site of infection, local antibiograms, and patient risk factors, not reflexively using the broadest agent.
Blood cultures taken from a patient with a central venous catheter grow coagulase-negative Staphylococcus in 1 of 4 bottles. What is the most appropriate interpretation?
Answer: This likely represents skin contamination and should be correlated with clinical findings
CoNS in a single blood culture bottle most commonly represents skin contaminant; clinical correlation and repeat cultures are needed before initiating prolonged treatment.
A patient with a mild UTI caused by a susceptible organism is being treated with amoxicillin-clavulanate. What is the stewardship concern with this choice?
Answer: It is broader than necessary and disrupts gut microbiome more than nitrofurantoin or trimethoprim
Amoxicillin-clavulanate is broader-spectrum than necessary for uncomplicated UTI and causes significant collateral microbiome disruption, increasing C. diff and resistance risk.