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Questions and Answers
Which type of infection is acquired by a person who has not been hospitalized or had a medical procedure within the past year?
Which type of infection is acquired by a person who has not been hospitalized or had a medical procedure within the past year?
- Superinfection
- Nosocomial infection
- Health care–associated infection
- Community-associated infection (correct)
What is a characteristic of health care–associated infections?
What is a characteristic of health care–associated infections?
- They are more difficult to treat because the causative microorganisms are often drug resistant (correct)
- They are typically acquired in the community
- They are caused by normal bacterial flora
- They are present or incubating in the patient on admission
What is the term for an infection that occurs when antibiotics reduce or completely eliminate the normal bacterial flora?
What is the term for an infection that occurs when antibiotics reduce or completely eliminate the normal bacterial flora?
- Community-associated infection
- Superinfection (correct)
- Health care–associated infection
- Nosocomial infection
What is an example of a superinfection caused by antibiotic therapy?
What is an example of a superinfection caused by antibiotic therapy?
What is the term for infections that occur in a hospital or institutional setting?
What is the term for infections that occur in a hospital or institutional setting?
What is a characteristic of normal flora?
What is a characteristic of normal flora?
What is a consideration for antibiotic dosing in the elderly?
What is a consideration for antibiotic dosing in the elderly?
What are two broad classes of antibiotics that people are commonly allergic to?
What are two broad classes of antibiotics that people are commonly allergic to?
What is the mechanism of action of Sulfonamides?
What is the mechanism of action of Sulfonamides?
What is a common indication for the use of SMX-TMP?
What is a common indication for the use of SMX-TMP?
What is a side effect of Sulfonamides?
What is a side effect of Sulfonamides?
What is the mechanism of action of Penicillins?
What is the mechanism of action of Penicillins?
What is a contraindication for the use of Penicillins?
What is a contraindication for the use of Penicillins?
What is a type of adverse reaction that can occur with Penicillins?
What is a type of adverse reaction that can occur with Penicillins?
What is a characteristic of Carbapenems?
What is a characteristic of Carbapenems?
What is an example of a Combination Agent?
What is an example of a Combination Agent?
What is essential to ask a patient about when prescribing antibiotics?
What is essential to ask a patient about when prescribing antibiotics?
What is a common adverse effect of cephalosporins?
What is a common adverse effect of cephalosporins?
Which generation of cephalosporins has the most potent activity against gram-negative bacteria?
Which generation of cephalosporins has the most potent activity against gram-negative bacteria?
What is the main purpose of carbapenems?
What is the main purpose of carbapenems?
What is the main characteristic of fifth-generation cephalosporins?
What is the main characteristic of fifth-generation cephalosporins?
What should patients taking cephalosporins be advised to do regarding oral contraceptives?
What should patients taking cephalosporins be advised to do regarding oral contraceptives?
What is a potential adverse effect of carbapenems?
What is a potential adverse effect of carbapenems?
Which antibiotic is used to treat bacterial endocarditis caused by S. aureus?
Which antibiotic is used to treat bacterial endocarditis caused by S. aureus?
What is the main difference between fourth-generation and fifth-generation cephalosporins?
What is the main difference between fourth-generation and fifth-generation cephalosporins?
Why should patients with a history of throat swelling or hives from penicillin not receive cephalosporins?
Why should patients with a history of throat swelling or hives from penicillin not receive cephalosporins?
Which of the following antibiotics is the only carbapenem currently indicated for treatment of bacterial meningitis?
Which of the following antibiotics is the only carbapenem currently indicated for treatment of bacterial meningitis?
What is the mechanism of action of macrolides?
What is the mechanism of action of macrolides?
Which macrolide is indicated only for the treatment of C. difficile–associated diarrhea?
Which macrolide is indicated only for the treatment of C. difficile–associated diarrhea?
What is a common adverse effect of macrolides?
What is a common adverse effect of macrolides?
Which of the following drugs interacts with macrolides through competition for hepatic metabolism?
Which of the following drugs interacts with macrolides through competition for hepatic metabolism?
Which of the following statements about doripenem is true?
Which of the following statements about doripenem is true?
What is the primary mechanism of action of aztreonam?
What is the primary mechanism of action of aztreonam?
Which of the following macrolides has minimal effects on the cytochrome P-450 enzymes?
Which of the following macrolides has minimal effects on the cytochrome P-450 enzymes?
What is the spectrum of activity of ertapenem?
What is the spectrum of activity of ertapenem?
Why should macrolides be used with caution when administered with statins?
Why should macrolides be used with caution when administered with statins?
What is the primary reason for avoiding milk products, iron preparations, antacids, and other dairy products when taking tetracyclines?
What is the primary reason for avoiding milk products, iron preparations, antacids, and other dairy products when taking tetracyclines?
What is the recommended time for monitoring patients after administration of penicillin for an allergic reaction?
What is the recommended time for monitoring patients after administration of penicillin for an allergic reaction?
What is the reason for taking oral administered cephalosporins with food?
What is the reason for taking oral administered cephalosporins with food?
What is the effect of taking macrolides on an empty stomach?
What is the effect of taking macrolides on an empty stomach?
What is a sign of therapeutic effect of antibiotics?
What is a sign of therapeutic effect of antibiotics?
What is a potential interaction between certain cephalosporins and alcohol?
What is a potential interaction between certain cephalosporins and alcohol?
What is the primary mechanism of action of tetracyclines?
What is the primary mechanism of action of tetracyclines?
What is a common adverse effect of tetracyclines in children and pregnant or lactating women?
What is a common adverse effect of tetracyclines in children and pregnant or lactating women?
Which of the following can reduce the oral absorption of tetracyclines?
Which of the following can reduce the oral absorption of tetracyclines?
What is a unique indication for demeclocycline?
What is a unique indication for demeclocycline?
What is a potential consequence of tetracycline use during pregnancy?
What is a potential consequence of tetracycline use during pregnancy?
What is a common interaction between tetracyclines and other medications?
What is a common interaction between tetracyclines and other medications?
What is a common adverse effect of tetracyclines on the gastrointestinal system?
What is a common adverse effect of tetracyclines on the gastrointestinal system?
What is an important nursing implication for patients taking tetracyclines?
What is an important nursing implication for patients taking tetracyclines?
What is a characteristic of tetracyclines in relation to their interaction with calcium ions?
What is a characteristic of tetracyclines in relation to their interaction with calcium ions?
What is a potential consequence of altering the normal intestinal flora with tetracyclines?
What is a potential consequence of altering the normal intestinal flora with tetracyclines?
Study Notes
Community-Associated Infections
- Infections acquired by individuals who have not been hospitalized or undergone medical procedures (e.g., dialysis, surgery, catheterization) within the past year.
Health Care-Associated Infections
- Contracted in hospital or institutional settings.
- Not present or incubating in patients on admission to the facility.
- Occur more than 48 hours after admission.
- More difficult to treat due to drug-resistant and virulent microorganisms (e.g., MRSA).
Antibiotic Therapy: Superinfection
- Superinfection occurs when antibiotics reduce or eliminate normal bacterial flora.
- Normal flora consists of certain bacteria and fungi necessary for normal organ function.
- Killed bacteria or fungi allow other microorganisms to cause infection (e.g., vaginal yeast infections).
Allergic Reactions and Severe Reactions
- Allergic reactions: most common to penicillins and sulfonamides.
- Severe reactions: difficulty breathing, significant rash, hives, or skin reaction, and severe gastrointestinal intolerance.
Antibiotic Classes
Sulfonamides
- One of the first groups of antibiotics.
- Often combined with another antibiotic.
- Mechanism of action: bacteriostatic (inhibit bacterial growth).
- Indications: urinary tract infections (UTIs) caused by susceptible strains, pneumocystis jiroveci pneumonia.
- Adverse effects: hemolytic and aplastic anemia, thrombocytopenia, photosensitivity, nausea, vomiting, diarrhea, and hepatotoxicity.
Beta-Lactam Antibiotics
- Include penicillins, cephalosporins, carbapenems, and monobactams.
- Mechanism of action: bactericidal (kill bacteria).
- Indications: prevention and treatment of infections caused by susceptible bacteria.
Penicillins
- Examples: penicillin G, nafcillin, cloxacillin, oxacillin, dicloxacillin, amoxicillin, and piperacillin.
- Mechanism of action: inhibit bacterial cell wall synthesis, leading to cell death.
- Indications: gram-positive bacteria, including Streptococcus spp., Enterococcus spp., and Staphylococcus spp.
- Adverse effects: allergic reactions, nausea, vomiting, diarrhea, and abdominal pain.
Cephalosporins
- Examples: cefadroxil, cephalexin, cefaclor, cefprozil, and cefoxitin.
- Mechanism of action: bactericidal, similar to penicillins.
- Indications: surgical prophylaxis, susceptible staphylococcal infections, and gram-negative bacteria.
- Adverse effects: similar to penicillins, with potential cross-sensitivity.
Macrolides
- Examples: erythromycin, azithromycin, clarithromycin, and fidaxomicin.
- Mechanism of action: prevention of protein synthesis within bacterial cells, leading to bacterial death.
- Indications: streptococcal infections, mild to moderate upper and lower respiratory tract infections, and spirochetal infections.
- Adverse effects: nausea, vomiting, diarrhea, and abdominal pain.
Carbapenems
- Examples: imipenem, meropenem, ertapenem, and doripenem.
- Mechanism of action: broadest antibacterial action, reserved for complicated infections in acutely ill hospitalized patients.
- Indications: bone, joint, skin, and soft tissue infections, bacterial endocarditis, and intraabdominal infections.
Tetracyclines
- Examples: demeclocycline, oxytetracycline, tetracycline, doxycycline, minocycline, and tigecycline.
- Mechanism of action: bacteriostatic, inhibiting protein synthesis.
- Indications: wide spectrum, including gram-negative and gram-positive organisms, protozoa, and spirochetes.
- Adverse effects: tooth discoloration, superinfection, and photosensitivity.
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Description
Learn to distinguish between community-associated infections and health care–associated infections, including their definitions and key characteristics.
