A 30-year-old woman presents with the acute onset of fever, pleuritic chest pain, and a productive cough. The patient's history is unremarkable except for recurrent cystitis for which she takes trimethoprim-sulfamethoxazole. She smokes cigarettes. On physical examination her temperature is 40 °C (104 °F), pulse rate is 120/min, respiration rate is 36/min, and blood pressure is 130/80 mm Hg. Abnormalities are localized to the right lung where crackles, rhonchi, and egophony are heard. Oxygen saturation is 85% by pulse oximetry. Chest radiograph shows a right lower lobe pneumonia. Sputum Gram stain is purulent with few epithelial cells and a predominance of gram-positive diplococci.
Which of the following antimicrobial agents would be the best initial therapy for this patient?
Ciprofloxacin
Vancomycin
Trimethoprim-sulfamethoxazole
Ceftriaxone
Ceftazidime
Answer
Category:
Infectious Diseases MCQs
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