Discuss NABP NAPLEX Exam Topic 4 Question 13

JT is a 58-year-old women who is on vancomycin empirically for pyomyositis confirmed by MRI. Surgical debridement has successfully removed infected tissue and pus. C&S of the infected tissue comes back MSSA sensitive to everything on the panel. JT is allergic to PCN (rash), she has had cephalosporin for her UTI in the past with no problem.

What would be the most appropriate antibiotics to switch to while JT is still in the hospital?

Suggested Answer: E

Cefazolin or an antistaphylococcal penicillin (oxacillin or nafcillin) is recommended for this patient because the C&S results indicate MSSA. Since the patient develops a rash to penicillins, it would be acceptable to use cefazolin in this case.

https://academic.oup.com/cid/article/59/2/e10/2895845/Practice-Guidelines-for-the-Diagnosis-and

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12 comments · newest first

Jaleesa 11 months ago

Daptomycin would be overkill for MSSA, right?

Elsa 12 months ago

Ceftaroline? Not sure that's necessary in this case.

Mona 12 months ago

Wait, can she really handle cephalosporins after a PCN allergy?

Lemuel 12 months ago

Totally agree, MSSA is sensitive to it!

Juan 1 year ago

Oxacillin seems like the best choice here.

Beatriz 1 year ago

I’m leaning towards ceftaroline because it’s broad-spectrum, but I’m not sure if it’s necessary in this case since we have a sensitive organism.

Kenia 1 year ago

Daptomycin seems like a safer choice since it’s not a beta-lactam, but I feel like I’ve seen practice questions where oxacillin was the preferred treatment for MSSA.

Kathryn 1 year ago

I think cefazolin could be a good option since she tolerated cephalosporins before, but I’m not completely confident about the allergy cross-reactivity.

Fredric 1 year ago

I remember that MSSA is usually treated with beta-lactams, but I'm unsure if oxacillin is the best choice given her PCN allergy.

Aretha 1 year ago

XWL-RPC? I've never heard of that before. I'm going to have to do some research to figure out if that's a real Magento API or if it's a trick question.

Lezlie 1 year ago

Hmm, this is a tricky one. I'm not entirely sure which option would be the best approach. I'll need to do some research on the different authentication and registration methods available in Experience Cloud.

Darell 1 year ago

Hmm, this is tricky. I need to carefully consider the implications of the connectivity loss and how that might impact user sign-in capabilities.

NABP NAPLEX Exam - Topic 4 Question 13 Discussion