An immunocompetent patient has developed early VAP. This patient has none of the risk factors for multidrug resistant pathogens, and Gram stains indicate the lack of high-risk pathogens. Based on this information, which of the following antibiotic therapies would be indicated? I. ceftriaxone II. ciprofloxacin III. vancomycin IV. ertapenem
A. I, II only
B. II, III only
C. I, II, IV only
D. II, III, IV only
ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Immunocompetent patients with early-onset VAP, having none of the risk factors for multidrug resistant pathogens, and Gram stains that are not suggestive of high-risk pathogens can be treated with agents that cover Streptococcus pneumoniae, Haemophilus influenzae, methicillin-sensitive Staphylococcus aureus (MSSA), and antibiotic-sensitive gram-negative bacilli. The antibiotics that cover these microbes are ceftriaxone, levofloxacin, moxifloxacin, ciprofloxacin, ampicillin/sulbactam, and ertapenem.
D. Incorrect response: See explanation C
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