Our college enjoys throwing exotic bugs at its candidates to see what we would try to kill them with. Here is a table of bug vs. antibug, from Question 15.1 of the second paper of 2013; it has been modified to include other organisms and clinical scenarios which have been asked about. Links point to discussions, or at least to the specific question which prompted the inclusion of this organism in the list.
Numerous other questions have asked some variation on the them of "which antibiotic would be the appropriate choice for this organism?" They have included the following:
Organism |
Agent |
Voriconazole or caspofungin or Amphotericin B |
|
Clostridium perfringens |
Peniciliin or Meropenem or Metronidazole |
Penicillin or Ampicillin |
|
Neisseria meningitides |
Ceftriaxone or Penicillin (high dose) |
Multi-resistant Acinetobacter |
Amikacin. Polymyxins |
Nocardia |
Sulphonamides |
Penicillin-intermediate pneumococcus |
Ceftriaxone or Vancomycin |
Toxoplasma gondii |
Pyrimethamine plus cotrimoxazole |
Enterococcus faecalis |
Ampicillin is usually enough (unless it is VRE) |
Linezolid Daptomycin Tigecycline |
|
Benzylpenicillin, doxycycline, ceftriaxone |
|
Meropenem |
|
Ceftriaxone |
|
Voriconazole or amphotericin |
|
Oral metronidazole or oral vancomycin |
|
Benzylpenicillin and metronidazole |
|
Vancomycin, ceftriaxone and dexamethasone |
|
Doxycycline plus ceftriaxone, or just ciprofloxacin |
|
Amikacin, colistin, cotrimoxazole |
|
Triple therapy: ampicillin, metronidazole, gentamicin Single agent therapy: timentin or tazocin |
|
Vancomycin |
|
Varicella Zoster |
Acyclovir, famciclovir or valaciclovir |
Cryptococcus neoformans (meningitis) |
Amphotericin |
Tuberculosis |
Isoniazid plus rifampicin plus ethambutol plus pyrazinamide |
Herpes simplex meningitis |
Aciclovir - 10mg/kg q8h. |
Mucor |
Amphotericin |
Pneumocystis j. |
Sulfamethoxazole and trimethoprim (Bactrim) |
Generally speaking, carbapenem-resistant Enterobacteriacea tend to receive treatment with older (more toxic) drugs such as amikacin and colistin.
For whatever reason the college seem to love Listeria. Most recently, they asked the candidates to not only identify it (the suspicious Gram-positive rod in a confused woman's blood culture, from ) but also to discuss the risk factors for such an infection.
These risk factors are discussed in two reference-worthy papers: J Rocourt (1996) and Schuchat et al (1992), which talks about food-related risk factors.
For the antibiotic choices, I have used the Sanford Guide.
Local practice may vary (wildly).
Morrill, Haley J., et al. "Treatment Options for Carbapenem-Resistant Enterobacteriaceae Infections." Open Forum Infectious Diseases. Oxford University Press, 2015.
Tichy, E. M., B. F. Luisi, and G. P. C. Salmond. "Crystal Structure of the Carbapenem Intrinsic Resistance Protein CarG." Journal of molecular biology 426.9 (2014): 1958-1970.
Schuchat, Anne, et al. "Role of foods in sporadic listeriosis: I. Case-control study of dietary risk factors." Jama 267.15 (1992): 2041-2045.
Rocourt, J. "Risk factors for listeriosis." Food Control 7.4 (1996): 195-202.