A patient at high risk of developing VAP has acquired late-onset VAP. Which of the following combinations of antibiotics is suitable for this patient to receive as initial combination therapy? I. methicillin-sensitive Staphylococcus aureus II. antipseudomonal fluoroquinolone plus vancomycin III. antipseudomonal, cephalosporin, beta-lactam/beta-lactamase inhibitor IV. carbapenems plus
aminoglycoside
A. I, IV only
B. II, III only
C. II, III, IV only
D. I, II, III, IV
?ANS: C
A. Incorrect response: See explanation C.
B. Incorrect response: See explanation C.
C. Correct response: Using antibiotics from different classes will increase the chance of covering pathogens resistant to the class of antimicrobial the patient received. An antipseudomonal, cephalosporin, beta-lactam/beta-lactamase inhibitor, or carbapenems plus an aminoglycoside, or antipseudomonal fluoroquinolone plus anti-MRSA antibiotic (linezolid or vancomycin) is the recommended initial combination for late-onset and for VAP in high-risk patients.
D. Incorrect response: See explanation C
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