A 45-year-old man with COPD presents with sudden-onset fever (39.2°C), productive cough with blood-tinged sputum, and pleuritic chest pain. Vital signs show HR 108/min, RR 22/min, BP 128/82 mmHg, and SpO2 94% on room air. Sputum culture grows gram-positive diplococci that are optochin-sensitive and bile-soluble. Chest X-ray demonstrates left lower lobe consolidation. He denies recent antibiotic use. Which of the following is most appropriate initial therapy?
- A)Fluoroquinolone monotherapy
- B)Macrolide monotherapy
- C)Penicillin G or high-dose amoxicillinGABARITO
- D)Metronidazole plus ceftriaxone
- E)Vancomycin alone
Explicação
Streptococcus pneumoniae (identified by optochin sensitivity and bile solubility) is the most common cause of community-acquired bacterial pneumonia. Penicillin G or high-dose amoxicillin is first-line for susceptible strains; patient has no risk factors for r... Ver explicação completa e trilha adaptativa →