Match each clinical scenario describing a recent infectious exposure or early clinical presentation with the most appropriate targeted empiric therapy or post-exposure prophylaxis.
- Deep puncture wound to the plantar surface of the foot sustained by stepping on a nail through a rubber-soled sneaker.Oral ciprofloxacin
- Closed-fist injury with an overlying laceration sustained after striking another individual in the mouth during an altercation.Oral amoxicillin-clavulanate
- Discovery of an expanding, painless targetoid skin lesion on the axilla one week after a hiking trip in Connecticut.Oral doxycycline
- Asymptomatic individual who shares a college dormitory room with a patient recently admitted for Neisseria meningitidis meningitis.Oral rifampin
Answer
Rubber-soled puncture matches with Ciprofloxacin; Human fight bite matches with Amoxicillin-clavulanate; Erythema migrans matches with Doxycycline; Meningococcal close contact matches with Rifampin.
Each exposure inherently links to a specific high-yield organism or prophylactic protocol on the USMLE: rubber soles to Pseudomonas (ciprofloxacin), human bites to Eikenella (amoxicillin-clavulanate), Ixodes tick habitats to Borrelia (doxycycline), and meningococcal close contacts to nasopharyngeal eradication (rifampin).
Step-by-Step Solution
Key Concept
Selection of targeted empiric antibiotic therapy and prophylaxis based on specific environmental exposures and anticipated pathogens.
Estimated Time:1m 30s