A patient who had been on meropenem and fluconazole for 6 days for intra- abdominal sepsis developed new fevers and grew a Gram negative organism in the blood. The initial sensitivities are given below. Further sensitivity testing will take another 24 hours.
|
Gentamicin |
Tobramycin |
Ampicillin |
Imipenem |
Ciprofloxacin |
Ticarcillin |
|
|
Gram negative rods |
R |
R |
R |
R |
R |
R |
List 3 likely causative organisms of the new sepsis. What is an appropriate antibiotic for each of the listed organisms, whilst waiting for the final sensitivity report?
Stenotrophomonas maltophilia - Bactrim
Multi-resistant Acinetobacter – Amikacin/colistin
Multi-resistant pseudomonas / Burkholderia - Amikacin
Enterobacter/proteus - Amikacin
This question is identical to Question 23.3 from the first paper of 2013, and to Question 25.3 from the second paper of 2009.