The laboratory reports his sputum gram stain as gram + diplococci. Culture will be available tomorrow and antibiotic-sensitivity the next day. Click here to see the stained smear. What should your initial therapy be?
A) Penicillin
Sorry...
Probably not the best choice. Even though penicillin has been used for years to treat pneumococcae infections, there is an increase in penicillin-resistant pneumococci (especially in large cities) so that cephalosporins are now advocated as initial therapy. If the culture returns showing penicillin sensitive organisms, you may want to switch to penicillin as it is cheaper and has less side effects.
