Pneumonia USMLE Step 1 Practice Question
A 32-year-old woman at 28 weeks gestation presents to the emergency department with a 3-day history of fever, productive cough with purulent sputum, and progressive dyspnea. She reports no recent travel or sick contacts and denies antimicrobial use in the past month. Vital signs are temperature 39.1°C, heart rate 108/min, respiratory rate 24/min, blood pressure 120/80 mmHg, and oxygen saturation 92% on room air. Physical examination reveals crackles in the right lower lobe. Chest radiograph shows a right lower lobe infiltrate with air bronchograms. Laboratory studies show WBC 14,500/μL with 88% neutrophils and 12% bands. Blood cultures and sputum gram stain are pending. Which of the following is the most appropriate empiric antibiotic regimen for this patient?
Answer choices
- ACefepime plus gentamicin
- BCeftriaxone plus azithromycinCorrect answer
- CLevofloxacin monotherapy
- DAmoxicillin-clavulanate plus doxycycline
- ETrimethoprim-sulfamethoxazole monotherapy
- FPiperacillin-tazobactam monotherapy
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