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* resp 7
  dolly123 - 10/31/06 21:33
  A 36-year-old Hispanic female presented to the emergency room with fever, chills and productive cough. The resident, who was on call, suspected community acquired pneumonia and has prescribed azithromycin for 5 days. After 5 days, she returns to your office with no improvement of her symptoms and worsening foul smelling sputum. Further inquiry reveals that she had undergone upper GI endoscopy for a long history of heartburn and suspected acid peptic disease 8 days ago. She also has a history of manic type bipolar disorder. Her vital signs are, Blood Pressure: 130/80 mm of Hg; Pulse Rate: 108/min; Temperature: 38.7C(101.6F); Respiratory Rate: 26/min. Which of the following antibiotics is the most appropriate therapy that should be considered before sending the patient for further investigations?

A. Doxycycline
B. Levofloxacin
C. Trimethoprim-sulphamethoxazole
D. Clindamycin
E. Gentamycin + ampicillin

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* Re:resp 7
  ben - 10/31/06 21:42
  E. Gentamycin + ampicillin
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* Re:resp 7
  airmax - 10/31/06 21:48
  d. clindamycin  
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* Re:resp 7
  xwxf - 10/31/06 21:49
  D. Clindamycin  
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* Re:resp 7
  dolly123 - 10/31/06 22:22

does anyone have a good protocol for rem these abx ?
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* Re:resp 7
  airmax - 10/31/06 22:49
  pneumonia due to aspiration = clindamycin

for community acquired pneumonia
if you admitting him giv iv levoflox / gatiflox
outpatient azithro or doxy
if for pseudomonas then cefipime / cefepime

correct me as me also not tht good at these

hey whn u givin ur exam dolly???
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* Re:resp 7
  ben - 10/31/06 23:18
  all you guys are rite, clindamycin above the diaphram and metro below the dipharm. Is gentamycin not also for anaerobes and ampicilin to cover other orgs  
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* Re:resp 7
  airmax - 10/31/06 23:45
  no ben gentamycin has got poor coverage on anaerobes... it is mainly for gr -ve
dint u get the mail i had sent u earlier regarding the antibiotic coverage graphs... refer to it.. they are good
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* Re:resp 7
  dolly123 - 11/01/06 08:12
  bena nd airmax..can one of you pl send me these notes too or post them here
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* Re:resp 7
  airmax - 11/01/06 08:14
  dolly hav u got davidson.... those wre pics taken frm tht book... its got good pie diagrams depicting the coverage of various antibiotics...  
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* Re:resp 7
  dolly123 - 11/01/06 08:22
  no ..i only have cmdt..old editions!!
anything online that i could use ? i will look around too, or make notes from all mcqs etc to get a sense of the whole thing

going offline right now...very sick myself ...bad cold....maybe i need some of that abx coverage myself!
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