Pharmacy PEBC Practice Exam

TG, a 43 year old male, is admitted to the Emergency Room following a car accident. TG is diagnosed with an open femur fracture. In the trauma treatment area, the extensive leg wound requires thorough cleaning prior to fracture reduction. TG did not take any medications prior to the accident and is not known to have any medical conditions. The emergency physician asks the pharmacist what IV antibiotic prophylaxis should be given to TG for the open fracture. Which of the following would provide the most appropriate empiric antibiotic coverage for TG?

1. Cefazolin + metronidazole

2. Clindamycin + vancomycin

3. Metronidazole + gentamicin

4. Cefazolin + gentamicin

The correct answer is: Cefazolin + gentamicin

Option A Cefazolin + metronidazole would provide inappropriate coverage for TG's injury. Metronidazole is typically not used for bone infections and is usually reserved for abdominal or pelvic infections. In addition, Cefazolin alone may not provide sufficient coverage for open fractures. Option B: Clindamycin + vancomycin would not be the most appropriate choice for TG's age and health status. Clindamycin may have higher incidence of adverse effects in older patients, and vancomycin is typically reserved for patients with known MRSA infection or risk factors for MRSA. Option C: Metronidazole + gentamicin may not provide sufficient coverage for open fractures. Neither of these antibiotics are typically used as first-line agents for bone infections. Option D: Cefazolin + gentamicin is the most appropriate empiric antibiotic