RT Book, Section A1 Lampiris, Harry W. A1 Maddix, Daniel S. A2 Katzung, Bertram G. A2 Vanderah, Todd W. SR Print(0) ID 1176470047 T1 Clinical Use of Antimicrobial Agents T2 Basic & Clinical Pharmacology, 15e YR 2021 FD 2021 PB McGraw-Hill PP New York, NY SN 9781260452310 LK accessmedicine.mhmedical.com/content.aspx?aid=1176470047 RD 2024/03/28 AB CASE STUDYA 65-year-old man undergoes percutaneous nephrostomy for acute nephrolithiasis and urosepsis while travelling in India*. He receives systemic antimicrobial therapy with ciprofloxacin for 7 days and completely recovers. Two weeks later he returns to the USA and presents to the emergency department with confusion, dysuria, and chills. Physical exam reveals a blood pressure of 90/50, pulse 120, temperature 38.5°C and respiratory rate 24. The patient is disoriented but the physical exam is otherwise unremarkable. Laboratory test shows WBC 24,000/mm3 and elevated serum lactate; urinalysis shows 300 WBC per high power field and 4+ bacteria. What possible organisms are likely to be responsible for the patient’s symptoms? What antibiotic(s) would you choose for initial therapy of this potentially life-threatening infection?