Antimicrobials: nocardiosis treatment: practice question

A Pharmacology 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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Pharmacology · Antimicrobials: nocardiosis treatment

Sample item

A renal transplant recipient has pulmonary nodules and a brain abscess. Sputum shows beaded, branching Gram-positive filaments that are weakly acid-fast. Which drug is preferred?

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

The answer and the reasoning

D. Co-trimoxazole

Nocardia infection is treated with a sulfonamide, usually trimethoprim-sulfamethoxazole, and combination therapy is used for brain involvement. Nocardia is a bacterium, so antifungal agents do not help.

Option by option

  • A. Azithromycin

    Azithromycin is not a standard drug for nocardiosis.

  • B. Fluconazole

    Fluconazole is an antifungal, and Nocardia is a bacterium despite its filamentous look.

  • C. Metronidazole

    Metronidazole acts on anaerobes and protozoa, not aerobic actinomycetes.

  • D. Co-trimoxazole (correct)

    Correct. Sulfonamides such as co-trimoxazole are the drugs of choice for Nocardia.

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.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is D, Co-trimoxazole. Nocardia infection is treated with a sulfonamide, usually trimethoprim-sulfamethoxazole, and combination therapy is used for brain involvement.

Why is "Azithromycin" not the answer?

Azithromycin is not a standard drug for nocardiosis.

Why is "Fluconazole" not the answer?

Fluconazole is an antifungal, and Nocardia is a bacterium despite its filamentous look.

Why is "Metronidazole" not the answer?

Metronidazole acts on anaerobes and protozoa, not aerobic actinomycetes.

What concept does this question test?

It tests Antimicrobials: nocardiosis treatment in Pharmacology. Nocardia is a bacterium, so antifungal agents do not help.

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 Antimicrobials: nocardiosis treatment?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology 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.