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814 SECTION VIII Chemotherapeutic Drugs

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C ASE STUD Y ANSWER

An intravenous third-generation cephalosporin (ceftriaxone patient has a history of rash to amoxicillin, the presentation
or cefotaxime) with adequate penetration into inflamed was not consistent with an anaphylactic reaction. The ami-
meninges that is active against the common bacteria that nopenicillins are frequently associated with rashes that are
cause community-acquired pneumonia and meningitis not caused by Type I hypersensitivity. In this instance, cross-
(pneumococcus, meningococcus, Haemophilus) should be reactivity with a cephalosporin is unlikely—particularly
ordered. Vancomycin also should be administered until with a third-generation drug—and the patient presents with
culture and sensitivity results are available in case the patient life-threatening illness necessitating appropriate and proven
is infected with a resistant pneumococcus. Although the antibiotic coverage.