Professional and Linguistic Assessments Board (PLAB) Practice Exam

For hospital-acquired pneumonia diagnosed within 5 days of admission, which treatment is recommended?

1. Co-amoxiclav or Cefuroxime

2. Piperacillin with Tazobactam

3. Erythromycin and Doxycycline

4. Vancomycin and Aztreonam

The correct answer is: Co-amoxiclav or Cefuroxime

In the context of hospital-acquired pneumonia (HAP) diagnosed within the first five days of admission, the recommended treatment typically includes broad-spectrum antibiotics effective against common pathogens encountered in this setting. Co-amoxiclav or Cefuroxime are suitable choices because they cover typical bacteria associated with early-onset pneumonia, such as Streptococcus pneumoniae, haempohilus influenzae, and some strains of Escherichia coli. These antibiotics provide adequate coverage for the pathogens expected in patients who are not severely ill and do not show a high risk for multidrug-resistant organisms, which is the key reason this treatment is appropriate for early-onset HAP. The timing of diagnosis (within 5 days) suggests that the risk of more resistant organisms is lower compared to later phases of hospitalization, where broader spectrum agents might be necessary. The concentration of the others reflects a different clinical scenario. Piperacillin with Tazobactam is usually reserved for cases where healthcare-associated pneumonia with a higher risk for resistant infections or severe illness is suspected. Erythromycin and Doxycycline are more common in atypical pneumonia and may not adequately cover the typical pathogens in this context. Meanwhile, Vancomycin and Aztreonam could be necessary