A 78 yo female with a history of Type 2 DM and stroke was admitted to the hospit

Question

A 78 yo female with a history of Type 2 DM and stroke was admitted to the hospital 5 days prior for evaluation of an ulcer on her left heel. She received proper surgical management for the ulcer and awaits placement in the nursing home. Late last night, she developed acute shortness of breath and was transferred to the medical-respiratory unit for intubation. Chest x-ray reveals a right lower lobe consolidation. She has NKDA and her SCr is 1.1 mg/dL. Which of the following regimens would be most appropriate?

Moxifloxacin [Avelox] 400-mg IV daily

Clindamycin [Cleocin] 600-mg IV q 8h

Ceftriaxone [Rocephin] 1-g IV QD plus azithromycin 500 mg IV daily

Piperacillin/tazobactam [Zosyn] 4.5 g IV q 8 h

Explanation / Answer

Right lower lobe consolidation or lobar pneumonia treatment include the administration of appropriate antibitics. As she is not allergic to any medicines and with normal serum creatinine level, the drug of choice for her would be a second or third generation cephalosporin and azithromycin, that is Ceftriaxone (Rocephine) 1gm IV QD plus Azithromycin mg daily should be given as it ihas not an aspirational, or inhalational cause.

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