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1. Amikacin 2. Vancomycin
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1. Ceftazidime 2. Ciprofloxacin
1. Ciprofloxacin 2. Vancomycin
1. Vancomycin 2. Amikacin
1. Vancomycin 2. Vancomycin
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An appropriate antibiotic regimen for pneumonia in a patient with cystic fibrosis in childhood is vancomycin and in adulthood is amikacin. Cystic fibrosis is caused by a defect in CFTR which causes a failure of chloride transport and thus a failure of water transport via osmosis. This can lead to thick respiratory secretions that lead to repeat pulmonary infections. In the pediatric population, the most common cause of pneumonia in a cystic fibrosis patient is Staphylococcus aureus which is best treated with vancomycin (which also covers MRSA). In adults with cystic fibrosis, the most common infectious agent is Pseudomonas aeruginosa which is best treated with an anti-pseudomonal antibiotic such as amikacin, ceftazidime, ciprofloxacin, or piperacillin-tazobactam. Figure A demonstrates a chest radiography with opacities suggestive of pneumonia. Incorrect Answers: Answers 1, 2, 3, & 5: The most common cause of pneumonia in a pediatric cystic fibrosis patient is S. aureus which requires anti-staphylococcal antibiotics such as vancomycin. The most common cause of pneumonia in an adult cystic fibrosis patient is P. aeruginosa which requires anti-pseudomonal antibiotics such as amikacin, ceftazidime, ciprofloxacin, or piperacillin-tazobactam. Bullet Summary: The most common cause of pneumonia in a pediatric cystic fibrosis patient is S. aureus, whereas the most common cause of pneumonia in an adult cystic fibrosis patient is P. aeruginosa.
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