Q: 22 year old male is admitted to ICU with early signs of sepsis after his hand gets infected due to human bite after fighting at a basketball game. Which of the following Quinolones can be used as a monotherapy?
A) Ciprofloxacin
B) Levofloxacin
C) Moxifloxacin
D) Cinoxacin
E) Quinolones should not be used in human bites
Answer: C
Moxifloxacin is one of the quinolones which has good activity against anaerobes. Human bites involve both aerobic and anaerobic bacterias, including strep., S. aureus, Eikenella, Fusobacterium, Peptostreptococcus, Prevotella, and Porphyromonas spp. In sepsis due to human bites, parenteral antibiotics are required. The antibiotics which can be used as a monotherapy include Imipenem-cilastatin, Meropenem, Ertapenem, or Moxifloxacin.
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References:
1. Stevens DL, Bisno AL, Chambers HF, et al. Practice guidelines for the diagnosis and management of skin and soft tissue infections: 2014 update by the Infectious Diseases Society of America. Clin Infect Dis 2014; 59:147.
2. Kennedy SA, Stoll LE, Lauder AS. Human and Other Mammalian Bite Injuries of the Hand: Evaluation and Management. J Am Acad Orthop Surg. 2015 Jan. 23 (1):47-57.
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