Medici MD-AI-powered text generation tool.

Example

Community-acquired pneumonia (non-severe, outpatient, no comorbidities or MRSA/Pseudomonas risks): amoxicillin 1,000 mg PO three times daily for 5–7 days; or doxycycline 100 mg PO twice daily for 5–7 days;Medici MD overview or azithromycin (only if local pneumococcal resistance <25%) 500 mg PO on day 1, then 250 mg PO daily on days 2–5. If comorbidities or high macrolide resistance, a respiratory fluoroquinolone is reasonable, e.g., levofloxacin 750 mg PO once daily for 5 days. Key cautions: macrolide/fluoroquinolone QT prolongation and drug–drug interactions; fluoroquinolone tendon/CNS risks; beta-lactam allergy considerations.

Scenario

Hospitalist pre-rounding on a stable outpatient with new CAP wants a fast, dose-precise regimen and contraindication check with direct links to the primary guideline. Evidence: ATS/IDSA 2019 CAP guideline (https://www.atsjournals.org/doi/full/10.1164/rccm.201908-1581ST).

Example

Suspected PE in a stable outpatient: estimate Wells pretest probability. If ‘PE unlikely’ (≤4) and PERC = 0, many patients can forgo testing. If testing is indicated, use high-sensitivity D-dimer with age-adjusted cutoff for adults >50 years (age × 10 µg/L FEU). Positive D-dimer → CTPA. If acute PE confirmed and patient is hemodynamically stable without cancer, apixaban 10 mg PO twice daily for 7 days, then 5 mg PO twice daily (consider 2.5 mg PO twice daily for extended secondary prevention after initial treatment phase). Contraindications/considerations: severe renal impairment (CrCl <15 mL/min) or dialysis, significant hepatic disease, pregnancy (prefer LMWH), hemodynamic instability (consider thrombolysis).

Scenario

ED clinician needs a one-page plan that sequences Wells → PERC → age-adjusted D-dimer → imaging, then gives first-line DOAC dosing with caveats and cites primary studies. Evidence: Age-adjusted D-dimer (ADJUST-PE): Righini et al., N Engl J Med. 2014;370:1287–1297 (https://www.nejm.org/doi/full/10.1056/NEJMoa1309726); Apixaban for acute VTE (AMPLIFY): Agnelli et al., N Engl J Med. 2013;369:799–808 (https://www.nejm.org/doi/full/10.1056/NEJMoa1302507).

Example

Hospital-acquired/ventilator-associated pneumonia (empiric, pending cultures, non-ESBL risk, consider local antibiogram): antipseudomonal β-lactam such as piperacillin–tazobactam 4.5 g IV q6h (extended infusion per local protocol) or cefepime 2 g IV q8h; add MRSA coverage when risk factors present: vancomycin 15–20 mg/kg IV q8–12h targeting AUC/MIC 400–600 (monitor levels and adjust) or linezolid 600 mg IV/PO q12h. De-escalate within 48–72 h based on culture data; typical duration 7 days for uncomplicated HAP/VAP if clinical response is adequate. Renal dose adjustments: required for piperacillin–tazobactam, cefepime, and vancomycin (protocolized by CrCl).

Scenario

ICU fellow initiates empiric HAP coverage at 2 a.m. and wants dose-accurate options, MRSA indications, de-escalation and duration guidance, plus vancomycin AUC targets with a primary-source link. Evidence: IDSA/ATS HAP/VAP guideline 2016 (Kalil et al.), Clin Infect Dis. 2016;63(5):e61–e111 (https://academic.oup.com/cid/article/63/5/e61/2235930); 2020 consensus for vancomycin AUC monitoring (ASHP/IDSA/PIDS/SIDP): IDSA guideline page (https://www.idsociety.org/practice-guideline/vancomycin/).