{"id":394089,"date":"2010-03-05T19:14:36","date_gmt":"2010-03-05T23:14:36","guid":{"rendered":"http:\/\/blogs.jwatch.org\/hiv-id-observations\/?p=766"},"modified":"2010-03-05T19:14:36","modified_gmt":"2010-03-05T23:14:36","slug":"test-question-on-mrsa%c2%a0bacteremia","status":"publish","type":"post","link":"https:\/\/mereja.media\/index\/394089","title":{"rendered":"Test Question on MRSA\u00a0Bacteremia"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignright size-thumbnail wp-image-767\" title=\"test_taking\" src=\"http:\/\/blogs.jwatch.org\/hiv-id-observations\/wp-content\/uploads\/2010\/03\/test_taking-150x150.gif\" alt=\"test_taking\" width=\"150\" height=\"150\" \/>I just happened to be taking a test the other day &#8212; something I do for fun every now and then, say <em><a href=\"http:\/\/www.abim.org\/default.aspx\" >every 10 years<\/a><\/em> or so &#8212; and I came across this question (slightly condensed\/changed to protect the innocent):<\/p>\n<blockquote>\n<p>Man with history of IDU admitted with fever, has bacteremia due to MRSA (MIC 2 mcg\/mL confirmed by E-test). Found to have mycotic aneurysm of superficial femoral artery. \u00a0Aneurysm is resected surgically on hospital day 3. On vancomycin 1 gm IV q12 hours, vancomycin trough is 15 \u03bcg\/mL. \u00a0Blood cultures drawn on hospital day 4 turn positive the next day; patient is subjectively improved but still febrile. WBC has declined from 16k to 11K.<\/p>\n<p>What is the best next step?<\/p>\n<p>1. Continue current rx<br \/>\n2. Increase vancomycin dose to achieve trough of 20 mcg\/mL<br \/>\n3. Change vancomycin to daptomycin<br \/>\n4. Change vancomycin to linezolid<\/p>\n<\/blockquote>\n<p style=\"text-align: left;\">So what&#8217;s the answer?<\/p>\n<p style=\"text-align: left;\">Does anyone <em>really <\/em>know what the best thing to do here is? \u00a0For the record, I got it &#8220;wrong.&#8221;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/feeds.feedburner.com\/~r\/HivAndIdObservations\/~4\/nUcOWNz-xUM\" height=\"1\" width=\"1\"\/><\/p>\n","protected":false},"excerpt":{"rendered":"<p>I just happened to be taking a test the other day &#8212; something I do for fun every now and then, say every 10 years or so &#8212; and I came across this question (slightly condensed\/changed to protect the innocent): Man with history of IDU admitted with fever, has bacteremia due to MRSA (MIC 2 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[],"class_list":["post-394089","post","type-post","status-publish","format-standard","hentry","category-news"],"_links":{"self":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/394089","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/comments?post=394089"}],"version-history":[{"count":0,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/posts\/394089\/revisions"}],"wp:attachment":[{"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/media?parent=394089"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/categories?post=394089"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mereja.media\/index\/wp-json\/wp\/v2\/tags?post=394089"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}