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Quizzes > Quizzes for Business > Healthcare

Take the Antibiotic Prescribing Knowledge Test

Evaluate Your Antibiotic Prescribing Proficiency in Practice

Difficulty: Moderate
Questions: 20
Learning OutcomesStudy Material
Colorful paper art quiz design on Antibiotic Prescribing Knowledge Test

I'm Joanna Weib, and I've designed this Antibiotic Prescribing Knowledge Test to challenge your decision-making with realistic cases and instant feedback. It's perfect for clinicians, pharmacists, or students refining antibiotic selection, emphasizing stewardship principles and dosing nuances. Want to strengthen your evidence-based prescribing skills? Explore the Antibiotic Stewardship Knowledge Test or review key systems in the Anatomy Knowledge Test. All questions are freely editable - head to the quizzes editor to tailor this quiz to your needs!

Which antibiotic is considered first-line therapy for streptococcal pharyngitis in an adult patient with no drug allergies?
Amoxicillin-clavulanate
Penicillin V
Azithromycin
Cephalexin
Penicillin V remains first-line against Streptococcus pyogenes due to its narrow spectrum and effectiveness. Alternatives are available for penicillin-allergic patients but are not first-line.
What is the mechanism of action of ceftriaxone?
Inhibits dihydrofolate reductase preventing folate synthesis
Blocks the 30S ribosomal subunit to inhibit protein synthesis
Inhibits DNA gyrase leading to DNA strand breaks
Inhibits peptidoglycan cross-linking by binding penicillin-binding proteins
Ceftriaxone is a third-generation cephalosporin that binds penicillin-binding proteins to inhibit peptidoglycan cross-linking in the bacterial cell wall. Other mechanisms describe fluoroquinolones, aminoglycosides, and trimethoprim.
Which pathogen is most commonly responsible for uncomplicated community-acquired urinary tract infections?
Escherichia coli
Pseudomonas aeruginosa
Staphylococcus saprophyticus
Klebsiella pneumoniae
Escherichia coli accounts for approximately 75 - 95% of uncomplicated UTIs due to its virulence factors and prevalence in the gut flora. Other organisms are less common in this setting.
What is the typical duration of a standard azithromycin regimen for community-acquired pneumonia?
3 days
5 days
10 days
7 days
Azithromycin is commonly dosed as 500 mg on day 1 followed by 250 mg daily for a total of 5 days in community-acquired pneumonia. Shorter or longer durations are less standard.
Which antibiotic is contraindicated in pregnancy due to potential fetal cartilage damage?
Ampicillin
Levofloxacin
Ceftriaxone
Erythromycin
Fluoroquinolones like levofloxacin are contraindicated in pregnancy because animal studies show fetal cartilage damage. Beta-lactams and macrolides are generally considered safer.
A 70 kg adult with normal renal function requires vancomycin therapy. Which dosing regimen is most appropriate?
500 mg intravenously every 8 hours
15 mg/kg intravenously every 24 hours
1 g intravenously every 8 hours
1 g intravenously every 12 hours
The standard dosing for vancomycin in adults with normal renal function is 15 mg/kg every 12 hours. For a 70 kg patient, this approximates to 1 g q12h.
Which effect does trimethoprim-sulfamethoxazole have on warfarin when co-administered?
Increased INR and bleeding risk
No significant effect on INR
Lowers warfarin plasma levels
Decreased INR and clotting risk
Trimethoprim-sulfamethoxazole inhibits CYP2C9, reducing warfarin metabolism and leading to increased INR and bleeding risk. Close monitoring of INR is required.
A microbiology report shows Pseudomonas aeruginosa with a ciprofloxacin MIC of 0.5 mg/L. The susceptible breakpoint is ≤1 mg/L. How should this result be interpreted?
Intermediate
Susceptible
Test result invalid - repeat testing
Resistant
Since the MIC of 0.5 mg/L is below the susceptible breakpoint of ≤1 mg/L, the isolate is classified as susceptible to ciprofloxacin. No repeat testing is needed.
Which empiric antibiotic regimen is most appropriate for a patient with suspected Pseudomonas sepsis pending culture results?
Piperacillin-tazobactam
Ampicillin
Metronidazole
Ceftriaxone
Piperacillin-tazobactam provides broad gram-negative coverage including Pseudomonas aeruginosa, making it suitable for empiric sepsis therapy. Ceftriaxone and ampicillin lack reliable Pseudomonas activity.
Which stewardship principle involves narrowing antibiotic coverage once culture results are available?
Empiric broadening
De-escalation
Loading dose optimization
Pharmacodynamic enhancement
De-escalation is the practice of narrowing antibiotic therapy based on culture and susceptibility data to limit resistance and adverse effects. Empiric broadening is the opposite approach.
Which antibiotic requires renal dose adjustment in a patient with decreased kidney function?
Azithromycin
Vancomycin
Clindamycin
Linezolid
Vancomycin is primarily renally cleared and requires dose adjustment in renal impairment to prevent toxicity. Linezolid, clindamycin, and azithromycin do not need routine renal adjustment.
Which antibiotic is considered safe and effective for treating a urinary tract infection in a pregnant patient?
Cephalexin
Doxycycline
Chloramphenicol
Levofloxacin
Cephalexin is a beta-lactam antibiotic with a well-established safety profile in pregnancy for UTIs. Doxycycline, fluoroquinolones, and chloramphenicol are contraindicated or avoided.
An ESBL-producing Escherichia coli urinary isolate is resistant to ceftriaxone but susceptible to meropenem. Which is the best targeted therapy?
Ceftriaxone
Meropenem
Ciprofloxacin
Nitrofurantoin
ESBL-producing organisms hydrolyze ceftriaxone, making carbapenems like meropenem the treatment of choice. Fluoroquinolones or nitrofurantoin are not reliable against ESBL producers.
Which antibiotic exhibits time-dependent killing and requires maintaining concentrations above the MIC?
Linezolid
Daptomycin
Gentamicin
Piperacillin-tazobactam
Beta-lactams such as piperacillin-tazobactam rely on time-dependent killing; efficacy correlates with time above the MIC. Aminoglycosides and daptomycin are concentration-dependent.
When monitoring aminoglycoside therapy, which levels should be measured to optimize efficacy and minimize toxicity?
Only trough levels
Only peak levels
Both peak and trough levels
Random single level
Aminoglycosides require both peak and trough monitoring to ensure therapeutic peaks for efficacy and low troughs to reduce nephrotoxicity and ototoxicity. Single levels are insufficient.
A patient with Enterococcus faecalis endocarditis shows synergy susceptibility to gentamicin. Which regimen provides the best synergistic bactericidal activity?
Daptomycin alone
Ampicillin plus gentamicin
Vancomycin monotherapy
Linezolid monotherapy
Enterococcal endocarditis requires synergistic bactericidal therapy with a cell-wall agent (ampicillin) plus gentamicin. Vancomycin and linezolid are insufficient as monotherapy for synergy.
Which describes the interaction between rifampin and warfarin?
Rifampin has no effect on warfarin metabolism
Rifampin inhibits warfarin metabolism, increasing INR
Rifampin displaces warfarin from protein binding, increasing free drug
Rifampin induces warfarin metabolism, decreasing INR
Rifampin is a potent inducer of CYP450 enzymes, increasing warfarin metabolism and lowering INR. Monitoring and dose increases of warfarin are often necessary.
In a ventilator-associated pneumonia patient, Pseudomonas aeruginosa isolates show MICs: piperacillin-tazobactam ≤16 mg/L, ceftazidime ≤8 mg/L, meropenem ≤4 mg/L. Which targeted therapy is most appropriate to minimize resistance selection?
Meropenem
Colistin
Piperacillin-tazobactam
Ceftazidime
De-escalation favors using the narrowest effective agent. Piperacillin-tazobactam covers Pseudomonas with the least broad spectrum compared to meropenem or colistin.
A patient with CrCl 20 mL/min requires ciprofloxacin for a complicated UTI. Which dosing adjustment is most appropriate?
250 mg orally once daily
250 mg orally twice daily
500 mg orally once daily
500 mg orally twice daily
In severe renal impairment (CrCl <30 mL/min), the usual ciprofloxacin dose for UTI is reduced to 250 mg once daily to prevent accumulation and toxicity.
What is meant by an 'antibiotic time-out' in stewardship?
Switching to oral therapy without reviewing cultures
A brief interruption of antibiotic infusion for side effect evaluation
A scheduled reassessment of ongoing antibiotic therapy at 48 - 72 hours
Holding all antibiotics for 24 hours to check fever patterns
An antibiotic time-out is a deliberate reassessment of antibiotic therapy 48 - 72 hours after initiation to review culture data, de-escalate therapy, and ensure appropriateness.
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Learning Outcomes

  1. Analyse clinical scenarios to select appropriate antibiotics
  2. Evaluate dosing regimens based on patient-specific factors
  3. Apply stewardship principles to minimize resistance risks
  4. Identify potential drug - drug interactions and contraindications
  5. Master interpretation of susceptibility data for targeted therapy
  6. Demonstrate understanding of guidelines for common infections

Cheat Sheet

  1. Master the Basics of Antibiotic Stewardship - Think of yourself as an antibiotic detective: knowing when and how to use these powerful drugs helps keep them effective and stops nasty bacteria from outsmarting us. By mastering stewardship principles, you'll be part of the global effort to curb resistance and save lives. CDC Core Elements Overview
  2. Implement Hospital Antibiotic Stewardship Programs - Hospitals are like bustling cities of germs and medicine - learning the CDC's Hospital Core Elements helps you steer prescribing in the right direction. You'll pick up best practices for monitoring, feedback, and teamwork that keep antibiotic use on track. Hospital Stewardship Guidelines
  3. Follow Adult Outpatient Prescribing Guidelines - Prescribing for adults isn't one-size-fits-all, so dive into the CDC's outpatient recommendations for infections like sinusitis, UTIs, and more. With clear dosing charts and decision trees, you'll build confidence and give patients the right medicine at the right time. Adult Outpatient Guidelines
  4. Explore the WHO AWaRe Classification - AWaRe (Access, Watch, Reserve) is like a traffic light for antibiotics - green means go, yellow means use with caution, and red means save it for dire emergencies. Understanding this system helps you balance patient needs and resistance risks. WHO AWaRe Classification
  5. Spot Drug - Drug Interactions and Contraindications - Playing pharmacist, you'll learn to catch when two medicines clash or when antibiotics shouldn't be given at all. Identifying these pitfalls keeps patients safe and side effects minimal. CDC Antibiotic Use Home
  6. Interpret Susceptibility Data Like a Pro - Lab reports can look like hieroglyphics, but decoding MIC values and zone diameters lets you pick the antibiotic most likely to defeat the bug. It's a critical skill in personalized medicine and targeted therapy. Interpret Susceptibility Data
  7. Customize Dosing by Patient Factors - Every patient is unique: age, weight, kidney function and more influence the perfect dose. Tailoring regimens not only boosts success but also minimizes toxicity and resistance. Dosing Guidelines
  8. Analyze Clinical Scenarios for Smart Antibiotic Choices - Real-world cases train you to juggle infection site, severity, patient history, and lab data all at once - like a medical puzzle. Practice makes you quicker and more accurate under pressure. Clinical Scenario Toolkit
  9. Adhere to Evidence-Based Infection Guidelines - Staying up to date with the latest recommendations is your shield against bacteria's ever-evolving tricks. You'll learn to navigate guidelines confidently and apply them in everyday practice. Infection Treatment Guidelines
  10. Measure the Impact on Antimicrobial Resistance - Every prescription you write leaves a footprint; understanding its long-term effects empowers you to prescribe responsibly. By tracking trends and outcomes, you become an advocate for global health security. Antimicrobial Resistance Insights
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