What is the most appropriate empirical IV antibiotic…
Pharmacology questions in the ADC written exam test applied prescribing decisions, not rote recall of drug names. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.
Priya Sharma, a 24-year-old pregnant woman at 28 weeks gestation, presents to the emergency department with severe facial swelling and difficulty swallowing that started 2 days ago following dental pain from a lower left molar. She appears anxious and is sitting upright, leaning forward. On examination, there is bilateral swelling of the floor of mouth extending to the neck, trismus limiting mouth opening to 15mm, and muffled speech. Her temperature is 38.2°C, pulse 110 bpm, BP 125/85 mmHg, oxygen saturation 94% on room air. She reports increasing difficulty swallowing saliva. What is the most appropriate empirical IV antibiotic regimen for this patient given her pregnancy?
- A. Benzylpenicillin 1.8g IV 6-hourly plus metronidazole 500mg IV 12-hourly
- B. Cefazolin 2g IV 8-hourly plus metronidazole 500mg IV 12-hourly
- C. Clindamycin 600mg IV 8-hourly
- D. Amoxicillin 500mg orally 8-hourly
- E. Amoxicillin + clavulanate 2+0.2g IV 8-hourly only
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Show the answer and cited explanation
According to TG, for empirical antibiotic therapy in severe local or systemic infection without sepsis, use benzylpenicillin 1.8g IV 6-hourly plus metronidazole 500mg IV 12-hourly, which is safe in pregnancy.
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