PAEA Surgery End Of Rotation (EOR) Practice Exam

Which class of antibiotics is recommended if surgery is not performed for appendicitis?

1. Cephalosporins

2. Fluoroquinolones and metronidazole

3. Penicillins

4. Tetracyclines

The correct answer is: Fluoroquinolones and metronidazole

In the case of appendicitis when surgery is not performed, the choice of antibiotics is crucial for effectively managing the infection. The recommended regimen often includes a combination of fluoroquinolones and metronidazole due to their broad-spectrum activity. Fluoroquinolones are effective against a variety of gram-negative bacteria, including those commonly found in the gastrointestinal tract. This is particularly important in appendicitis, where the source of infection typically involves gut flora that can become pathogenic once the appendix is inflamed and potentially perforated. Metronidazole adds additional coverage specifically for anaerobic bacteria, which are also present in the gut and can be responsible for more complex intra-abdominal infections. By combining these two classes, the treatment effectively targets both aerobic and anaerobic organisms, maximizing the likelihood of successfully managing the infection in non-surgical cases. Other classes of antibiotics, while they may have some effectiveness, do not provide the same breadth of coverage. Cephalosporins, for instance, are generally effective against a range of infections, but may not cover the full spectrum of anaerobic bacteria as effectively as the combination of fluoroquinolones and metronidazole. Penicillins and tetracyclines also lack the