Bone infection: empirical antibiotic in children: practice question

A Orthopaedics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Orthopaedics · Bone infection: empirical antibiotic in children

Sample item

A 7-year-old with fever and a painful warm distal femur has a diagnosis of acute haematogenous osteomyelitis. After blood cultures, which empirical antibiotic choice targets the commonest organism?

AAn anti-staphylococcal penicillin such as cloxacillinBFluconazoleCStreptomycin aloneDOral metronidazole alone

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. An anti-staphylococcal penicillin such as cloxacillin

Staphylococcus aureus is the commonest cause of acute haematogenous osteomyelitis at all ages, so the empirical choice must cover it, for example cloxacillin or flucloxacillin, or a first-generation cephalosporin. In areas with high MRSA rates, vancomycin or clindamycin is added. Treatment is adjusted once cultures are available.

Option by option

A. An anti-staphylococcal penicillin such as cloxacillin (correct)
Correct. An anti-staphylococcal penicillin covers the commonest causative organism.
B. Fluconazole
Fluconazole is antifungal and has no role here.
C. Streptomycin alone
Streptomycin alone is inadequate for staphylococcal infection.
D. Oral metronidazole alone
Metronidazole covers anaerobes and misses staphylococci.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Orthopaedics question

What is the answer to this Orthopaedics question?

The best answer is A, An anti-staphylococcal penicillin such as cloxacillin. Staphylococcus aureus is the commonest cause of acute haematogenous osteomyelitis at all ages, so the empirical choice must cover it, for example cloxacillin or flucloxacillin, or a first-generation cephalosporin.

Why is "Fluconazole" not the answer?

Fluconazole is antifungal and has no role here.

Why is "Streptomycin alone" not the answer?

Streptomycin alone is inadequate for staphylococcal infection.

Why is "Oral metronidazole alone" not the answer?

Metronidazole covers anaerobes and misses staphylococci.

What concept does this question test?

It tests Bone infection: empirical antibiotic in children in Orthopaedics. In areas with high MRSA rates, vancomycin or clindamycin is added. Treatment is adjusted once cultures are available.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Bone infection: empirical antibiotic in children?

Pair each fracture with its classic complication and nerve injured. Then use the flashcards and the other Orthopaedics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.