ACA D E M I C I N D E X & C O U R S E C RO S SWA L K C OVE R S H E E T • 2 0 2 0 2 7 ACA D E M I C Y E A R
UTA NURS 5334 & WCU NURS 180 / NR 565 — Master Antimicrobial Quick-
Index & Exam Alignment
ACADEMIC CYCLE TARGET EXAM BENCHMARKS
▪ University of Texas at Arlington (UTA): NURS 5334 Antimicrobial Recall Exam
2026/2027 Academic Year ▪ West Coast University (WCU): NURS 180 Week 7 (Antimicrobials & Chemotherapy Exam)
▪ Chamberlain University: NR 565 Week 6 (Advanced Pharmacology)
SECTION 1: COURSE EXAM CROSSWALK
1. UTA NURS 5334 Antimicrobial Recall Exam
TARGET COURSE REQUIREMENT & TESTED COMPETENCY UNTOUCHED 12-PAGE GUIDE MODULE
Gram-Positive vs. Gram-Negative Cellular Targets & Beta-Lactam Resistance → Module 1 (Page 2) & Module 2 (Page 3)
Vancomycin AUC/MIC (400–600) & Aminoglycoside Peak/Trough TDM Rules → Module 3 (Page 4)
Signature Black Box Warnings, CYP450 Traps & High-Alert Toxicities → Module 5 (Page 6)
25-Question Board-Style Practice Vignettes with Rationales → Module 6 (Pages 7–12)
2. WCU NURS 180 (Week 7) & NR 565
TARGET COURSE REQUIREMENT & TESTED COMPETENCY UNTOUCHED 12-PAGE GUIDE MODULE
Empiric Prescribing Algorithms by Syndrome (CAP, HAP/VAP, Meningitis, UTI, C. diff,
→ Module 4 (Page 5)
SBP)
Cellular Sites of Action (Cell Wall, 30S/50S Ribosome, DNA Gyrase, Folate) → Module 1 (Page 2)
Master 2D Bug-Drug Spectrum Matrix → Module 2 (Page 3)
Practice Case Scenarios with Distractor Rationales → Module 6 (Pages 7–12)
SECTION 2: HIGH-ALERT EXAM PASS PROTOCOL (5 CORE RULES)
1. Vancomycin Trough-Only Monitoring is Obsolete: 2026/2027 guidelines mandate AUC24/MIC 400–600 mg·h/L.
2. Daptomycin Surfactant Inactivation: Strictly contraindicated in pneumonia due to alveolar surfactant lipid binding.
3. Linezolid + SSRI/SNRI Trap: Non-selective MAO inhibition precipitates life-threatening Serotonin Syndrome.
4. Ertapenem "APE" Coverage Gap: Lacks coverage against Acinetobacter, Pseudomonas, and Enterococci.
5. Ceftriaxone Neonatal Contraindication: Biliary sludging and fatal calcium-ceftriaxone micro-precipitates in neonates (≤28 days).
COMPLETE REFERENCE ARCHITECTURE (PRECEDING UNTOUCHED 12-PAGE MASTER GUIDE)
• Guide Page 1: High-Alert Empiric vs. Contraindicated Matrix & Solved • Guide Page 4 (Mod 3): PK/PD Indices, Vanc/AG TDM & Renal Rules
Vignette
• Guide Page 2 (Mod 1): Cellular Targets, Ambler Classes & • Guide Page 5 (Mod 4): 10 High-Yield IDSA Empiric Prescribing
Resistance Traps Algorithms
• Guide Page 3 (Mod 2): Master 2D Bug-Drug Spectrum Matrix • Guide Page 6 (Mod 5) & Pages 7–12 (Mod 6): Toxicities & 25
(2026/2027) Vignettes
Legal & Authorship Footer: "Independently authored educational synthesis and original clinical practice bank created for academic revision during the 2026/2027
cycle. Not affiliated with or reproduced from any proprietary university exam or testing board."
UTA NURS 5334 • WCU NURS 180 • Chamberlain NR 565 — Course Crosswalk Cover Sheet Cover Sheet (Page 1) + 12-Page Intact Core Guide
, PHARMD | USMLE STEP 1 & 2 CK | NAPLEX | BCPS | NR 565 | 2026/2027 ACADEMIC CYCLE
THE ULTIMATE ANTIMICROBIAL BUG-DRUG SPECTRUM MATRIX &
EMPIRIC THERAPY GUIDE
Curriculum Alignment: Doctor of Pharmacy (Pharm.D), Medical (MD/DO) & APRN | Aligned Texts: Katzung's Basic & Clinical
Pharmacology, Lippincott Illustrated Reviews & IDSA 2026/2027 Clinical Practice Guidelines
Legal & Authorship Disclaimer: Independently authored educational synthesis and original clinical practice bank created for
academic revision during the 2026/2027 cycle. Not affiliated with or reproduced from any proprietary university exam or testing
board. All scenarios, tables, and rationales are 100% original clinical formulations.
DOCUMENT ARCHITECTURE (PAGES 1–12): Mod 1: Cellular Targets, Bactericidal vs. Bacteriostatic & Resistance Mechanisms
(p. 2) • Mod 2: Master 2D Bug-Drug Spectrum Matrix (p. 3) • Mod 3: PK/PD Indices, Vancomycin AUC/MIC & Aminoglycoside TDM
+ Renal Exceptions (p. 4) • Mod 4: 10 High-Yield IDSA Empiric Clinical Prescribing Algorithms (p. 5) • Mod 5: Signature Toxicities,
Black Box Warnings & CYP450 Traps (p. 6) • Mod 6: 25-Question Board-Style Clinical Vignette Exam Bank with Full Distractor
Rationales (p. 7–12).
PREVIEW HOOK: HIGH-ALERT EMPIRIC VS. CONTRAINDICATED ANTIMICROBIAL PRESCRIBING MATRIX
Clinical Syndrome 1st-Line Empiric Exact Mechanism of Contraindications & Mandatory TDM &
Regimen Action Black Box Labs
MRSA Bacteremia / 1st Line Vancomycin IV Vanc: Binds D-Ala-D-Ala CONTRAINDICATED Vanc: AUC24/MIC
Endocarditis or Daptomycin 8–10 terminus → blocks Never use Daptomycin 400–600 mg·h/L;
(Invasive Gram+) mg/kg IV q24h transglycosylation. in pneumonia SCr.
Dapto: Ca2+-dependent (inactivated by Dapto: Baseline &
membrane depolarization. pulmonary surfactant weekly Serum CK
lipids). Avoid Vanc + (myopathy).
Pip/Tazo (AKI).
HAP / VAP 1st Line Cefepime 2g β-Lactams: Acylate PBPs BLACK BOX Sputum/blood
(Nosocomial / ICU q8h (or Meropenem) + → block peptidoglycan Linezolid + cultures; CBC weekly
Ventilator) Vancomycin (or cross-linking. SSRIs/SNRIs triggers if Linezolid >14d
Linezolid) Linezolid: Binds 50S (23S fatal Serotonin (thrombocytopenia);
rRNA) → blocks 70S Syndrome (reversible renal panel.
initiation. non-selective MAOI).
Carbapenem- KPC: 1st Line Avibactam: EXAM TRAP Carbapenemase
Resistant (CRE) Ceftazidime/Avibactam Diazabicyclooctane inhibits Avibactam, PCR/phenotypic
(KPC vs. NDM-1) NDM-1 (Metallo): Ambler Class A/C/D. Vaborbactam & testing; CrCl for dose
Cefiderocol Cefiderocol: Siderophore Relebactam have ZERO adjustment; LFTs.
iron-transport PBP3 activity against Ambler
inhibitor. Class B Metallo-β-
lactamases (NDM).
Fulminant C. 1st Line Fidaxomicin: Inhibits FATAL TRAP IV WBC (≥15,000 =
difficile Colitis OralFidaxomicin (Initial) bacterial RNA polymerase Vancomycin does NOT severe), SCr (≥1.5 =
(Shock / Megacolon) Fulminant: PO sigma subunit. cross into the gut lumen severe), stool toxin
Vancomycin 500mg QID Metro: PFOR-reduced and is 100% ineffective EIA/NAAT, abdominal
+ IV Metronidazole nitro free-radical DNA for C. diff colitis. X-ray.
strand breaks.
PREVIEW SOLVED VIGNETTE: A 64-year-old male in the ICU with ventilator-associated pneumonia (MRSA +
Pseudomonas risk) and major depression (on Sertraline 100 mg daily) has Stage 4 CKD (eGFR 22 mL/min).
Which anti-MRSA agent is safest, and why are two other common MRSA options contraindicated?
• Verified Clinical Rationale: Initiate renally-adjusted IV Vancomycin (guided by AUC24/MIC 400–600 target) or
Ceftaroline. Daptomycin is strictly contraindicated because pulmonary surfactant phospholipids sequester and inactivate
the lipopeptide in alveolar fluid. Linezolid (although requiring zero renal adjustment) is contraindicated with active
Sertraline therapy because Linezolid inhibits Monoamine Oxidase (MAO-A/B), precipitating life-threatening Serotonin
Syndrome (clonus, hyperthermia, autonomic instability).
The Ultimate Antimicrobial Bug-Drug Spectrum Matrix & Empiric Therapy Guide (2026/2027) Page 1 of 12
UTA NURS 5334 & WCU NURS 180 / NR 565 — Master Antimicrobial Quick-
Index & Exam Alignment
ACADEMIC CYCLE TARGET EXAM BENCHMARKS
▪ University of Texas at Arlington (UTA): NURS 5334 Antimicrobial Recall Exam
2026/2027 Academic Year ▪ West Coast University (WCU): NURS 180 Week 7 (Antimicrobials & Chemotherapy Exam)
▪ Chamberlain University: NR 565 Week 6 (Advanced Pharmacology)
SECTION 1: COURSE EXAM CROSSWALK
1. UTA NURS 5334 Antimicrobial Recall Exam
TARGET COURSE REQUIREMENT & TESTED COMPETENCY UNTOUCHED 12-PAGE GUIDE MODULE
Gram-Positive vs. Gram-Negative Cellular Targets & Beta-Lactam Resistance → Module 1 (Page 2) & Module 2 (Page 3)
Vancomycin AUC/MIC (400–600) & Aminoglycoside Peak/Trough TDM Rules → Module 3 (Page 4)
Signature Black Box Warnings, CYP450 Traps & High-Alert Toxicities → Module 5 (Page 6)
25-Question Board-Style Practice Vignettes with Rationales → Module 6 (Pages 7–12)
2. WCU NURS 180 (Week 7) & NR 565
TARGET COURSE REQUIREMENT & TESTED COMPETENCY UNTOUCHED 12-PAGE GUIDE MODULE
Empiric Prescribing Algorithms by Syndrome (CAP, HAP/VAP, Meningitis, UTI, C. diff,
→ Module 4 (Page 5)
SBP)
Cellular Sites of Action (Cell Wall, 30S/50S Ribosome, DNA Gyrase, Folate) → Module 1 (Page 2)
Master 2D Bug-Drug Spectrum Matrix → Module 2 (Page 3)
Practice Case Scenarios with Distractor Rationales → Module 6 (Pages 7–12)
SECTION 2: HIGH-ALERT EXAM PASS PROTOCOL (5 CORE RULES)
1. Vancomycin Trough-Only Monitoring is Obsolete: 2026/2027 guidelines mandate AUC24/MIC 400–600 mg·h/L.
2. Daptomycin Surfactant Inactivation: Strictly contraindicated in pneumonia due to alveolar surfactant lipid binding.
3. Linezolid + SSRI/SNRI Trap: Non-selective MAO inhibition precipitates life-threatening Serotonin Syndrome.
4. Ertapenem "APE" Coverage Gap: Lacks coverage against Acinetobacter, Pseudomonas, and Enterococci.
5. Ceftriaxone Neonatal Contraindication: Biliary sludging and fatal calcium-ceftriaxone micro-precipitates in neonates (≤28 days).
COMPLETE REFERENCE ARCHITECTURE (PRECEDING UNTOUCHED 12-PAGE MASTER GUIDE)
• Guide Page 1: High-Alert Empiric vs. Contraindicated Matrix & Solved • Guide Page 4 (Mod 3): PK/PD Indices, Vanc/AG TDM & Renal Rules
Vignette
• Guide Page 2 (Mod 1): Cellular Targets, Ambler Classes & • Guide Page 5 (Mod 4): 10 High-Yield IDSA Empiric Prescribing
Resistance Traps Algorithms
• Guide Page 3 (Mod 2): Master 2D Bug-Drug Spectrum Matrix • Guide Page 6 (Mod 5) & Pages 7–12 (Mod 6): Toxicities & 25
(2026/2027) Vignettes
Legal & Authorship Footer: "Independently authored educational synthesis and original clinical practice bank created for academic revision during the 2026/2027
cycle. Not affiliated with or reproduced from any proprietary university exam or testing board."
UTA NURS 5334 • WCU NURS 180 • Chamberlain NR 565 — Course Crosswalk Cover Sheet Cover Sheet (Page 1) + 12-Page Intact Core Guide
, PHARMD | USMLE STEP 1 & 2 CK | NAPLEX | BCPS | NR 565 | 2026/2027 ACADEMIC CYCLE
THE ULTIMATE ANTIMICROBIAL BUG-DRUG SPECTRUM MATRIX &
EMPIRIC THERAPY GUIDE
Curriculum Alignment: Doctor of Pharmacy (Pharm.D), Medical (MD/DO) & APRN | Aligned Texts: Katzung's Basic & Clinical
Pharmacology, Lippincott Illustrated Reviews & IDSA 2026/2027 Clinical Practice Guidelines
Legal & Authorship Disclaimer: Independently authored educational synthesis and original clinical practice bank created for
academic revision during the 2026/2027 cycle. Not affiliated with or reproduced from any proprietary university exam or testing
board. All scenarios, tables, and rationales are 100% original clinical formulations.
DOCUMENT ARCHITECTURE (PAGES 1–12): Mod 1: Cellular Targets, Bactericidal vs. Bacteriostatic & Resistance Mechanisms
(p. 2) • Mod 2: Master 2D Bug-Drug Spectrum Matrix (p. 3) • Mod 3: PK/PD Indices, Vancomycin AUC/MIC & Aminoglycoside TDM
+ Renal Exceptions (p. 4) • Mod 4: 10 High-Yield IDSA Empiric Clinical Prescribing Algorithms (p. 5) • Mod 5: Signature Toxicities,
Black Box Warnings & CYP450 Traps (p. 6) • Mod 6: 25-Question Board-Style Clinical Vignette Exam Bank with Full Distractor
Rationales (p. 7–12).
PREVIEW HOOK: HIGH-ALERT EMPIRIC VS. CONTRAINDICATED ANTIMICROBIAL PRESCRIBING MATRIX
Clinical Syndrome 1st-Line Empiric Exact Mechanism of Contraindications & Mandatory TDM &
Regimen Action Black Box Labs
MRSA Bacteremia / 1st Line Vancomycin IV Vanc: Binds D-Ala-D-Ala CONTRAINDICATED Vanc: AUC24/MIC
Endocarditis or Daptomycin 8–10 terminus → blocks Never use Daptomycin 400–600 mg·h/L;
(Invasive Gram+) mg/kg IV q24h transglycosylation. in pneumonia SCr.
Dapto: Ca2+-dependent (inactivated by Dapto: Baseline &
membrane depolarization. pulmonary surfactant weekly Serum CK
lipids). Avoid Vanc + (myopathy).
Pip/Tazo (AKI).
HAP / VAP 1st Line Cefepime 2g β-Lactams: Acylate PBPs BLACK BOX Sputum/blood
(Nosocomial / ICU q8h (or Meropenem) + → block peptidoglycan Linezolid + cultures; CBC weekly
Ventilator) Vancomycin (or cross-linking. SSRIs/SNRIs triggers if Linezolid >14d
Linezolid) Linezolid: Binds 50S (23S fatal Serotonin (thrombocytopenia);
rRNA) → blocks 70S Syndrome (reversible renal panel.
initiation. non-selective MAOI).
Carbapenem- KPC: 1st Line Avibactam: EXAM TRAP Carbapenemase
Resistant (CRE) Ceftazidime/Avibactam Diazabicyclooctane inhibits Avibactam, PCR/phenotypic
(KPC vs. NDM-1) NDM-1 (Metallo): Ambler Class A/C/D. Vaborbactam & testing; CrCl for dose
Cefiderocol Cefiderocol: Siderophore Relebactam have ZERO adjustment; LFTs.
iron-transport PBP3 activity against Ambler
inhibitor. Class B Metallo-β-
lactamases (NDM).
Fulminant C. 1st Line Fidaxomicin: Inhibits FATAL TRAP IV WBC (≥15,000 =
difficile Colitis OralFidaxomicin (Initial) bacterial RNA polymerase Vancomycin does NOT severe), SCr (≥1.5 =
(Shock / Megacolon) Fulminant: PO sigma subunit. cross into the gut lumen severe), stool toxin
Vancomycin 500mg QID Metro: PFOR-reduced and is 100% ineffective EIA/NAAT, abdominal
+ IV Metronidazole nitro free-radical DNA for C. diff colitis. X-ray.
strand breaks.
PREVIEW SOLVED VIGNETTE: A 64-year-old male in the ICU with ventilator-associated pneumonia (MRSA +
Pseudomonas risk) and major depression (on Sertraline 100 mg daily) has Stage 4 CKD (eGFR 22 mL/min).
Which anti-MRSA agent is safest, and why are two other common MRSA options contraindicated?
• Verified Clinical Rationale: Initiate renally-adjusted IV Vancomycin (guided by AUC24/MIC 400–600 target) or
Ceftaroline. Daptomycin is strictly contraindicated because pulmonary surfactant phospholipids sequester and inactivate
the lipopeptide in alveolar fluid. Linezolid (although requiring zero renal adjustment) is contraindicated with active
Sertraline therapy because Linezolid inhibits Monoamine Oxidase (MAO-A/B), precipitating life-threatening Serotonin
Syndrome (clonus, hyperthermia, autonomic instability).
The Ultimate Antimicrobial Bug-Drug Spectrum Matrix & Empiric Therapy Guide (2026/2027) Page 1 of 12
