USMLE Secrets antibiotics?

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tsbqb

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Hey everyone,

Has anyone gone over the empiric antibiotics the Infectious Disease chapter (page 161) in USMLE SEcrets?

It seems kinda off to me. First off, the antibiotic they list for the empiric treatment of meningits i know is wrong (they omit ampicillin) and on page 162 they listvancomycin as the treatment for strep pneumo??

Am I crazy or do they have a lot of errors?

Thanks!

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Hm.. not sure about the entire portion of your question, but I know emperic for meningitis is triple therapy (2 abx + 1 steroid), so vanco + genta / ampi & prednisone or something like that. But I've seen multiple instances where they only have 1 abx & 1 steroid (ex. KLN).

I'd keep the 3 in my head, if given i'd chose that, if not then i'd chose the option with the 2.
 
in general for meningitis questions you need to look at the age of the pt and then know the MCC, I'm guessing this was for adults:
s. pneumo - amp doesn't always cover, high rates of resistance so vanco is used empirically until a cx/sens comes back indicating amp would be ok
N. meningitis - 3rd gen ceph
if older/younger listeria is common - susceptible to amp

so usually I've been taught amp + 3rd gen ceph + vanco. utd agrees...but i think they're usually interested in testing MCC of a specific age group THROUGH abx selection. hope that helps/answers!
 

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