Antibiotic Question

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If a person managed to get a lung infection from anarobes that originated from the gut is metronidizole the treatment?

 

Hm, interesting. I've always heard that metronidazole and clindamycin are for anaerobes below and above the diaphragm, respectively. I'd go with clindamycin. I assume we're treating Peptostreptococcus, Mobiluncus and/or Bacteroides (which are the three I remember from Robbin's as causing anaerobic pulmonary abscesses hardcore).

However, I could be wrong so who knows.

Actually, another reason I'd go with clindamycin is because I've encountered a practice question where a guy had pseudomembranous colitis secondary to MRSA pneumonia, and clindamycin was the answer for the drug that was used. Clindamycin and TMP-SMX can be used for MRSA pneumonia if you're not using vancomycin first-line.

 

"clindamycin is the best initial therapy for infections that are predominantly anerobic. examples include the following:
-Lung abscess
-Aspiration pneumonia (from oral- not abdominal--anaerobes "

Directly from kaplan pharm cards

 

Since the lung abscess is likely a mixed anaerobe/aerobe infection you use clindamycin. If you'd like to learn more, then eMedicine is pretty good.

http://emedicine.medscape.com/article/299425-treatment#showall

 

And btw, I just thought I'd throw in that by using the MRSA example, I'm aware that S. aureus isn't anaerobic, but nevertheless, clindamycin was used for the pulmonary infection (i.e. above the diaphragm).

 

Thanks.

 

And of course, always remember that since clinda kills Bacteroides + other anaerobes, C. diff infection could happen.

That would make for a great boards question: aspiration pneumonia gets treated then the patient gets diarrhea.