Match each patient's clinical and microbiological presentation with the most appropriate targeted antimicrobial therapy.
- An elderly patient with meningitis whose cerebrospinal fluid culture yields motile, Gram-positive bacilli.Intravenous ampicillin
- A hospitalized patient with pyelonephritis whose urine culture grows Escherichia coli resistant to third-generation cephalosporins.Intravenous meropenem
- A severely neutropenic patient with a cavitary lung lesion, hemoptysis, and positive serum galactomannan assay.Intravenous voriconazole
- A hemodialysis patient with a catheter-site infection and blood cultures growing Gram-positive cocci in clusters resistant to oxacillin.Intravenous vancomycin
Cevap
Listeria monocytogenes pairs with ampicillin; ESBL-producing E. coli pairs with meropenem; invasive aspergillosis pairs with voriconazole; and MRSA pairs with vancomycin.
Each pathogen has a distinct, well-established first-line treatment. Ampicillin is uniquely active against Listeria. Carbapenems (meropenem) are stable against extended-spectrum beta-lactamases produced by resistant Gram-negative rods. Voriconazole is the antifungal of choice for invasive Aspergillus. Vancomycin provides reliable coverage for oxacillin-resistant staphylococci (MRSA).
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Targeted Antimicrobial Therapy for Classic Pathogens
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