A 45-year-old woman with a history of rash following amoxicillin 10 years ago presents to the emergency department with a 3-day history of productive cough with purulent sputum, pleuritic chest pain, and dyspnea. She denies prior episodes of urticaria, angioedema, bronchospasm, or anaphylaxis. Vital signs: BP 128/82 mmHg, HR 102/min, RR 22/min, temperature 38.5°C, SpO2 94% on room air. Examination reveals decreased breath sounds and dullness to percussion at the left lung base. Laboratory findings show WBC 14,200/mm³ with left shift. Chest radiograph shows left lower lobe consolidation. Beta-lactam skin testing is negative for immediate-type hypersensitivity reactions to penicillins and negative to third-generation cephalosporins. Which of the following is the most appropriate empiric antibiotic for community-acquired pneumonia in this patient?
- A)Amoxicillin-clavulanate
- B)Cefazolin
- C)CeftriaxoneGABARITO
- D)Clarithromycin
- E)Piperacillin-tazobactam
Explicação
Ceftriaxone is the most appropriate choice for this patient with community-acquired pneumonia and a penicillin allergy. The key clinical detail is that beta-lactam skin testing shows NO cross-reactivity between the penicillin class and third-generation cephalo... Ver explicação completa e trilha adaptativa →