FPGEE for National Association of Boards of Pharmacy (NABP) Practice Exam

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What must clindamycin be prescribed with for the treatment of P. carinii pneumonia?

Amoxicillin
Primaquine
Ciprofloxacin
Doxycycline

The correct answer is: Primaquine

Clindamycin, when used to treat Pneumocystis carinii pneumonia (now known as Pneumocystis jirovecii pneumonia), is typically prescribed alongside primaquine. This combination takes advantage of clindamycin's ability to inhibit bacterial protein synthesis and primaquine's role as an antiprotozoal agent effective against the specific pathogen involved in this type of pneumonia. By using both medications, the treatment effectively targets the unique characteristics of the infection, enhancing the overall therapeutic outcome. This synergy is essential since Pneumocystis jirovecii is a distinct organism that requires a specific approach for effective management, making primaquine a crucial component for efficacy in this context. The other options do not serve the same purpose in the treatment of P. jirovecii pneumonia, making primaquine the necessary adjunct to clindamycin for optimal treatment outcomes.