🦫 NAPLEX Infectious Disease — Empiric Therapy & Antibiotic Selection — 2026

NAPLEX Infectious Disease Review 2026

Antibiotic selection, MRSA treatment, CAP/HAP guidelines, CDI management, UTI therapy, HIV ART, and OI prophylaxis — high-yield infectious disease content for the NAPLEX.

Antibiotic Selection by Infection — NAPLEX High Yield

InfectionCommon Pathogen(s)First-Line TreatmentKey Notes
CAP (outpatient, healthy)S. pneumoniae, H. influenzae, atypicalsAmoxicillin or doxycyclineNo comorbidities
CAP (outpatient, comorbidities)Same + drug-resistant organismsResp FQ (levofloxacin) OR amox-clav + macrolideDM, COPD, CKD, immunosuppression
MRSA (skin/SSTI)CA-MRSATMP-SMX, doxycycline, or clindamycinI&D for abscesses
MRSA (bacteremia)MRSAVancomycin (AUC-guided) or daptomycinDaptomycin NOT for pneumonia
CDI (initial, non-severe)C. difficileFidaxomicin (preferred) or vancomycin POMetro no longer first-line
UTI (uncomplicated)E. coliNitrofurantoin (5d) or TMP-SMX (3d) if resistance <20%Nitrofurantoin CI if CrCl <30
HIV (treatment-naive)HIVBiktarvy (bictegravir/TAF/FTC) preferredINSTI-based regimen preferred

Vancomycin AUC-Guided Monitoring

2020 Vancomycin Guidelines: AUC/MIC-guided dosing (target AUC 400-600 mg·h/L) has replaced trough-only monitoring. Bayesian software is preferred for AUC estimation. Trough-only monitoring (15-20 mcg/mL) is no longer recommended as a primary target — it correlates poorly with efficacy and increases nephrotoxicity risk.

HIV OI Prophylaxis Thresholds

OICD4 ThresholdProphylaxis
PCP (Pneumocystis)<200TMP-SMX DS daily (preferred)
Toxoplasma<100TMP-SMX DS daily (if IgG+)
MAC<50Azithromycin 1200mg weekly
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