American Board of Internal Medicine (ABIM) Certification Practice Exam

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What is the recommended antibiotic therapy for infections caused by Vibrio vulnificus?

  1. Clindamycin plus ciprofloxacin

  2. Doxycycline plus ceftazidime

  3. Vancomycin plus aztreonam

  4. Amoxicillin plus clavulanate

The correct answer is: Doxycycline plus ceftazidime

The recommended antibiotic therapy for infections caused by Vibrio vulnificus is doxycycline combined with ceftazidime. This combination is preferred for several reasons. Doxycycline is effective against Vibrio species due to its ability to inhibit bacterial protein synthesis, making it a cornerstone treatment for various Vibrio infections, including those caused by Vibrio vulnificus, particularly in cases of skin and soft tissue infections or primary septicemia. Ceftazidime provides broad-spectrum coverage, particularly against Gram-negative organisms, which is essential because Vibrio vulnificus is a Gram-negative bacterium. The effectiveness of this combination is supported by clinical guidelines and recommendations based on the bacterium's susceptibility patterns. Other antibiotics listed may not cover the pathogen effectively or may not have the appropriate spectrum needed to treat Vibrio vulnificus infections adequately. This is why the combination of doxycycline and ceftazidime stands out as the most suitable choice for the treatment of these infections.