POST TEST

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* 1. A 62-year-old man has been hospitalized following a myocardial infarction and requires mechanical ventilation. After 4 days, he develops fever and a chest radiograph reveals new pulmonary infiltrates. Rapid molecular diagnostics is performed on a BAL sample and identifies P. aeruginosa. The unit-based antibiogram reveals that over 65% of P. aeruginosa isolates exhibit multidrug resistance. Which of the following would be the most appropriate initial antimicrobial agent?

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* 2. A 56-year-old woman who has been hospitalized for 6 days is diagnosed with hospital-acquired pneumonia caused by a Gram-negative rod as determined by Gram stain. She is initiated on piperacillin-tazobactam. After 2 days, there is little clinical improvement and culture and susceptibility results reveal a carbapenem-resistant K. pneumoniae. The best course of action is to:

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* 3. Which of the following agents would be preferred as initial treatment of hospital-acquired pneumonia caused by a Gram-negative rod in an ICU that is currently experiencing an outbreak of metallo-beta-lactamases?

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* 4. When considering pharmacokinetics in critically ill patients, which of the following will typically result in decreased plasma drug concentration?

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* 5. When considering the penetration of beta-lactams into the epithelial lining fluid (ELF) in critically ill patients with pneumonia, which of the following is most accurate?

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