QUIZ #2 – INF

Antibiotic therapy in critically ill patients

Correct Answer: C
Explanation:
Combination antibiotic therapy is not a routine practice due to the potential for increased toxicity, cost, and selection for resistance. Its use should be reserved for specific situations.
• A is incorrect: Routine use is discouraged. It increases the risk of adverse effects and resistance .
• B is incorrect: If a single antibiotic is reliably effective against the identified organism, combination therapy offers no advantage and exposes the patient to unnecessary risks.
• C is correct: Combination therapy is most appropriate in situations where:
     o Multi-drug resistant organisms are suspected or confirmed, and synergy between antibiotics is expected (e.g., carbapenem-resistant Enterobacteriaceae).
     o Broadening empiric coverage is necessary in severe infections like septic shock, especially when the likely pathogens are unknown or resistance is prevalent. This allows for broader initial coverage while awaiting culture results, after which therapy should be de-escalated.
• D is incorrect: Prophylactic use of combination antibiotics is generally not recommended and can promote the emergence of resistant strains.