Antimicrobials USMLE Step 1 Practice Question
A 19-year-old previously healthy woman presents with sudden onset fever (39.8°C), severe headache, and petechial rash. Vital signs show BP 98/62, HR 118, RR 22, SpO2 98% on room air. CSF analysis reveals elevated protein (180 mg/dL) and low glucose (28 mg/dL). Blood cultures cannot be obtained before antibiotics due to rapid clinical deterioration. She denies recent antibiotic use. Which antimicrobial regimen is most appropriate for presumed meningococcal meningitis?
Answer choices
- ACeftriaxone plus vancomycin plus ampicillin
- BVancomycin monotherapy due to emerging cephalosporin resistance
- CPenicillin G monotherapy as first-line treatment
- DFluoroquinolone plus cephalosporin for synergy against Neisseria
- ECeftriaxone alone covers all likely pathogens adequatelyCorrect answer
- FChloramphenicol monotherapy for superior CSF penetration in meningitis
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