An 18-year-old boy with cystic fibrosis presents to the Emergency Department with a 4-day history of progressively worsening productive cough, fever, and malaise. His temperature is 38.8°C, blood pressure is 110/75 mmHg, heart rate is 104 beats per minute, and respiratory rate is 24 breaths per minute. Chest x-ray demonstrates a right lower lobe infiltrate.
Which antibiotic would be most beneficial for empiric treatment of this patient?
A. VancomycinPiperacillin–tazobactam. Cystic fibrosis patients are particularly susceptible to Pseudomonas infections, and the only answer choice that has good coverage of Pseudomonas is D. (A) Vancomycin is used for resistant S. pneumoniae and MRSA. (B) Clindamycin is useful for anaerobic infections (e.g., aspiration pneumonia). (C) Azithromycin is the antibiotic of choice for outpatient treatment of community-acquired pneumonia (CAP). (E) Ceftriaxone is used for inpatient treatment of pneumonia. Trimethoprim– sulfamethoxazole is used for PCP pneumonia. Rifampin is used for the treatment of TB.