A 65-year-old man with second- and third-degree burns covering more than 25% of his entire body surface area is brought to the intensive care unit. His wounds are cleansed and debrided, and intravenous fluids and painkillers are provided. The patient gets a fever after 7 days, and his leukocyte count climbs to 16,000 cells/L. The burns on his left leg are surrounded by warmth, erythema, and induration. The photograph below shows a Gram stain of his injured tissue. Culture on MacConkey agar grows oxidase-positive colonies that do not ferment lactose. Which of the following is the best initial treatment for this patient?

Question

A 65-year-old man with second- and third-degree burns covering more than 25% of his entire body surface area is brought to the intensive care unit. His wounds are cleansed and debrided, and intravenous fluids and painkillers are provided. The patient gets a fever after 7 days, and his leukocyte count climbs to 16,000 cells/L. The burns on his left leg are surrounded by warmth, erythema, and induration. The photograph below shows a Gram stain of his injured tissue.  Culture on MacConkey agar grows oxidase-positive colonies that do not ferment lactose.  Which of the following is the best initial treatment for this patient?

Quizplus · Accepted Answer

Eductional Objective: In burn victims, Pseudomonas aeruginosa is a serious pathogen. Only a few penicillins (such as ticarcillin and piperacillin) and cephalosporins (such as ceftazidime and cefepime) show action against it. Certain aminoglycosides, fluoroquinolones (such as ciprofloxacin and levofloxacin) and carbapenems (such as imipenem and meropenem) are also effective.

A 65-Year-Old Man with Second- and Third-Degree Burns Covering More