A diabetic patient presents with cellulitis secondary to methicillin-resistant Staphylococcus aureus (MRSA). All of the following antibiotics would be appropriate except_____________?
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Answer: B. Imipenem
Explanation
Methicillin-resistant Staphylococcus aureus possesses altered penicillin-binding proteins conferring beta-lactam resistance. Imipenem is a broad-spectrum carbapenem beta-lactam antibiotic that cannot bind these resistant targets. Consequently, imipenem is ineffective and inappropriate for treating MRSA cellulitis infections. MRSA strains acquire the meca gene encoding PBP2a, which has low affinity for beta-lactams. Vancomycin, linezolid, and teicoplanin utilize alternative mechanisms to inhibit bacterial cell wall synthesis. Cellulitis caused by MRSA requires targeted antimicrobial therapy to ensure clinical resolution.
Antibiotic stewardship requires identifying resistant pathogens to avoid ineffective treatment choices. Diabetic patients with soft tissue infections are at higher risk for complicated MRSA presentations. Clinical microbiology reports guide physicians in selecting appropriate bactericidal agents for wounds. Vancomycin is a glycopeptide antibiotic that remains a primary treatment choice for MRSA infections. Teicoplanin is another glycopeptide agent effective against resistant gram-positive bacterial pathogens. Linezolid is an oxazolidinone antibiotic approved for treating severe skin and soft tissue MRSA.
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Answer: D. All of the above
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