ALL THE COMSAE| 217 QUESTIONS
AND CORRECT ANSWERS. 2025/2026.
Giardia lamblia
tinidazole or nitazoxanide (alt: metronidazole)
Entamoeba histolytica
metronidazole or tinidazole, then paromomycin or iodoquinol
Ascaris lumbricoides
albendazole or mebendazole
Necator americanus
albendazole (alt: mebendazole)
Trichinella spiralis
albendazole + prednisone
Enterobius vermicularis
mebendazole
Shistosoma spp.
praziquantel
Diphyllobothrium latum
praziquantel (alt: niclosamide)
Yersinia Pestis
Streptomycin (alt: gentamicin
Adenovirus (severe infection)
cidofovir + probenecid
Influenza A (seasonal), Influenza B, adn avian flu (H5N1)
zanamivir or oseltamivir
Measles
-Children: vitamin A
-Adults: ribavirin
Smallpox
smallpox vaccine within 4 days of exposure + cidofovir + probenecid
Osteomyelitis (<4 months old)
,nafcillin or oxacillin + ceftazidime or cefepime
Osteomyelitis (4 months - adult)
nafcillin or oxacillin
Herpes Encephalitis
-acyclovir
-if HSV (+): acyclovir
-If not HSV (+): DOC for specific etiologic agent
Encephalitis due to Rickettsia, Anaplasma, Ehrlichia, Bartonella, or Mycoplasma
Doxycycline
Encephalitis due to Borrelia burgdorferi
Ceftriaxone
Meningitis in neonate, child, or adult
ampicillin + cefotaxime + gentamicin + ceftriaxone or cefotaxime + dexamethasone + vacomycin
Meningitis in alcoholics, people >50, people with severe comorbid diseases, or anyone who is
immunocompromised
ceftriaxone or cefotaxime + dexamethasone + vacomycin + ampcillin
Meningitis prophylaxis if hemophilus influenzae
rifampin
Meningitis prophylaxis if neisseria meningitidis
rifampin or ceftriaxone or ciprofloxacin
Otitis externa
acetic acid + propylene glycol + hydrocortisone drops
or
Cirpofloxacin + hydrocortisone drops
Otitis media
-amoxicillin if <2 y/o
-analgesics if >2 with no pain or fever
Viral conjunctivitis
nothing or chilled artificial tears
Bacterial conjunctivitis
fluoroquinolone drops
Neonatal conjunctivitis with onset within 1st day of life
nothing
, Neonatal conjunctivitis with onset within 2-4 days of life
IV ceftriaxone + PO erythromycin
Neonatal conjunctivitis with onset within 3-10 days of life
PO erythromycin
Neonatal conjunctivitis with onset within 2-16 days of life
topical antivirals + IV acyclovir
Ophthalmia neonatorum prophylaxis
tetracycline ointment or erythromycin ointment
Post-antibiotic diarrhea
Metronidazole
Travel associated diarrhea
fluoroquinolone or rifaximin
-if a child or pregnant: azithromycin
Diarrhea prophylaxis during travel
fluoroquinolone + loperamide with first loose stool
Mild-moderate diarrhea
fluids + lactose and caffeine free diet
-may add anti-diarrheal agents if >4 loose stools/day
Severe diarrhea
ciprofloxacin or levofloxacin + metronidazole + lactose and caffeine free diet
-Children: trimethoprim-sulfamethoxazole
Acute bronchitis
antitussives +/- inhaled beta-2 agonists
Anthrax prophylaxis post-exposure
ciprofloxacin or doxycycline + biothrax vaccine
Pneumonia <1 months old
ampicillin + gentamicin +/- cefotaxime (+ vancomycin if MRSA)
Pneumonia 1-3 months old
-erythromycin or azithromycin
-febrile: cefotaxime or ceftriaxone
Pneumonia >3 months old - 18 years old
ampicillin (if vacc. up to date) or cefotaxime (if vacc. not up to date) +/- azithromycin +/- vancomycin
AND CORRECT ANSWERS. 2025/2026.
Giardia lamblia
tinidazole or nitazoxanide (alt: metronidazole)
Entamoeba histolytica
metronidazole or tinidazole, then paromomycin or iodoquinol
Ascaris lumbricoides
albendazole or mebendazole
Necator americanus
albendazole (alt: mebendazole)
Trichinella spiralis
albendazole + prednisone
Enterobius vermicularis
mebendazole
Shistosoma spp.
praziquantel
Diphyllobothrium latum
praziquantel (alt: niclosamide)
Yersinia Pestis
Streptomycin (alt: gentamicin
Adenovirus (severe infection)
cidofovir + probenecid
Influenza A (seasonal), Influenza B, adn avian flu (H5N1)
zanamivir or oseltamivir
Measles
-Children: vitamin A
-Adults: ribavirin
Smallpox
smallpox vaccine within 4 days of exposure + cidofovir + probenecid
Osteomyelitis (<4 months old)
,nafcillin or oxacillin + ceftazidime or cefepime
Osteomyelitis (4 months - adult)
nafcillin or oxacillin
Herpes Encephalitis
-acyclovir
-if HSV (+): acyclovir
-If not HSV (+): DOC for specific etiologic agent
Encephalitis due to Rickettsia, Anaplasma, Ehrlichia, Bartonella, or Mycoplasma
Doxycycline
Encephalitis due to Borrelia burgdorferi
Ceftriaxone
Meningitis in neonate, child, or adult
ampicillin + cefotaxime + gentamicin + ceftriaxone or cefotaxime + dexamethasone + vacomycin
Meningitis in alcoholics, people >50, people with severe comorbid diseases, or anyone who is
immunocompromised
ceftriaxone or cefotaxime + dexamethasone + vacomycin + ampcillin
Meningitis prophylaxis if hemophilus influenzae
rifampin
Meningitis prophylaxis if neisseria meningitidis
rifampin or ceftriaxone or ciprofloxacin
Otitis externa
acetic acid + propylene glycol + hydrocortisone drops
or
Cirpofloxacin + hydrocortisone drops
Otitis media
-amoxicillin if <2 y/o
-analgesics if >2 with no pain or fever
Viral conjunctivitis
nothing or chilled artificial tears
Bacterial conjunctivitis
fluoroquinolone drops
Neonatal conjunctivitis with onset within 1st day of life
nothing
, Neonatal conjunctivitis with onset within 2-4 days of life
IV ceftriaxone + PO erythromycin
Neonatal conjunctivitis with onset within 3-10 days of life
PO erythromycin
Neonatal conjunctivitis with onset within 2-16 days of life
topical antivirals + IV acyclovir
Ophthalmia neonatorum prophylaxis
tetracycline ointment or erythromycin ointment
Post-antibiotic diarrhea
Metronidazole
Travel associated diarrhea
fluoroquinolone or rifaximin
-if a child or pregnant: azithromycin
Diarrhea prophylaxis during travel
fluoroquinolone + loperamide with first loose stool
Mild-moderate diarrhea
fluids + lactose and caffeine free diet
-may add anti-diarrheal agents if >4 loose stools/day
Severe diarrhea
ciprofloxacin or levofloxacin + metronidazole + lactose and caffeine free diet
-Children: trimethoprim-sulfamethoxazole
Acute bronchitis
antitussives +/- inhaled beta-2 agonists
Anthrax prophylaxis post-exposure
ciprofloxacin or doxycycline + biothrax vaccine
Pneumonia <1 months old
ampicillin + gentamicin +/- cefotaxime (+ vancomycin if MRSA)
Pneumonia 1-3 months old
-erythromycin or azithromycin
-febrile: cefotaxime or ceftriaxone
Pneumonia >3 months old - 18 years old
ampicillin (if vacc. up to date) or cefotaxime (if vacc. not up to date) +/- azithromycin +/- vancomycin
