AMS part III

What is your next course of action?What is your next course of action?

• Continue with IV Meropenem

• Switch to PO Nitrofurantoin (macrocrystals) 100 mg Q6H

• Switch to PO Fosfomycin 3 g single dose

• Switch to IV Ertapenem 500 mg Q24H

• Switch to IV Amikacin 15 mg/kg single dose

Does this antibiotic prescription require any changes?

• No. All good. Continue the same

• Yes. Suggest to change the Ertapenem dose to 1 g Q12H

• Yes. Suggest to change the Tazocin 4.5g TDS, infused over 4 hours.

• Yes. Suggest to change the antibiotic to IV Meropenem 500mg BD

Which of the following is not classified as moderate risk AmpC producer?

• Enterobacter cloacae

• Klebsiella aerogenes

• Klebsiella pneumonia

• Citrobacter freundii

Does this antibiotic regimen require any change?

• Yes. Escalate to IV Meropenem

• No. May continue with IV Pip/Tazo with prolonged infusion

• Yes. Switch to IV cefepime and continue clindamycin

• Yes. Switch to IV Cefepime

•Does this antibiotic regimen require any change?

• Yes. Escalate to IV Meropenem

• No. May continue with IV Cefepime with prolonged infusion

• Yes. Switch to IV Zavicefta+ aztreonam

• Yes. Switch to IV Polymyxin B

What would you suggest for the antibiotic therapy?

• Switch to IV ceftazidime 2g TDS

• Cont. meropenem. Add on PO Bactrim 10 mg/kg/day

• Off meropenem. Switch to PO Co-trimoxazole 10 mg/kg/day + PO Levofloxacin 750 mg Q24H

• Off meropenem. Escalate to IV colistin

What should we do?

• Continue Bactrim + Levoflox. Refer for dialysis

• Continue Bactrim + Levoflox. Add on Kalimate

• Switch to Levoflox + minocycline

• Switch to minocycline monotherapy

• Switch to Bactrim + minocycline

Which statements are TRUE about Pseudomonas aeruginosa:

• Ceftazidime is the only 3rd generation cephalosporin with antipseudomonal coverage

• MDR and DTR P. aeruginosa are not interchangeable terms

• Oral options for antibiotics against P. aeruginosa include Levofloxacin

• All carbapenems can be used for P. aeruginosa infections

Based on patient’s clinical condition, what would you suggest for the antibiotic regimen?

• Switch to IV Polymyxin B 25,000 units/kg STAT, 15,000 units/kg Q12H

• Switch to IV Ceftolozane-Tazobactam 3 g Q8H over 3 hours

• Cont. meropenem. Add on IV Ciprofloxacin 400 mg Q8H

• Switch to IV Ceftazidime-Avibactam 2.5 g Q8H over 3 hours

Based on C&S result, what would you recommend:

• Switch to IV Unasyn 3g QID + IV polymyxin B

• Switch to IV Unasyn 9g TDS + IV polymyxin B

• Monotherapy with IV unasyn 9g TDS

• Monotherapy with IV colistin