Medical Infections Classification
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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?

  • Superinfection
  • Nosocomial infection
  • Health care–associated infection
  • Community-associated infection (correct)

    • 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?

  • Community-associated infection
  • Superinfection (correct)
  • Health care–associated infection
  • Nosocomial infection

    • What is an example of a superinfection caused by antibiotic therapy?

    <p>Vaginal yeast infection</p> Signup and view all the answers

    What is the term for infections that occur in a hospital or institutional setting?

    <p>Health care–associated infections</p> Signup and view all the answers

    What is a characteristic of normal flora?

    <p>They are needed to maintain normal function in various organs</p> Signup and view all the answers

    What is a consideration for antibiotic dosing in the elderly?

    <p>Lower dose required due to kidney decline in function</p> Signup and view all the answers

    What are two broad classes of antibiotics that people are commonly allergic to?

    <p>Penicillins and Sulfonamides</p> Signup and view all the answers

    What is the mechanism of action of Sulfonamides?

    <p>Bacteriostatic</p> Signup and view all the answers

    What is a common indication for the use of SMX-TMP?

    <p>Urinary tract infections</p> Signup and view all the answers

    What is a side effect of Sulfonamides?

    <p>Photosensitivity</p> Signup and view all the answers

    What is the mechanism of action of Penicillins?

    <p>Inhibit cell wall synthesis</p> Signup and view all the answers

    What is a contraindication for the use of Penicillins?

    <p>Known drug allergy</p> Signup and view all the answers

    What is a type of adverse reaction that can occur with Penicillins?

    <p>All of the above</p> Signup and view all the answers

    What is a characteristic of Carbapenems?

    <p>Extended spectrum of activity</p> Signup and view all the answers

    What is an example of a Combination Agent?

    <p>Ampicillin/sulbactam</p> Signup and view all the answers

    What is essential to ask a patient about when prescribing antibiotics?

    <p>What kind of reaction occurred with an antibiotic</p> Signup and view all the answers

    What is a common adverse effect of cephalosporins?

    <p>Nausea, vomiting, and diarrhea</p> Signup and view all the answers

    Which generation of cephalosporins has the most potent activity against gram-negative bacteria?

    <p>Third generation</p> Signup and view all the answers

    What is the main purpose of carbapenems?

    <p>To treat complicated body cavity and connective tissue infections</p> Signup and view all the answers

    What is the main characteristic of fifth-generation cephalosporins?

    <p>Broader spectrum of antibacterial activity than third generation</p> Signup and view all the answers

    What should patients taking cephalosporins be advised to do regarding oral contraceptives?

    <p>Use a barrier method</p> Signup and view all the answers

    What is a potential adverse effect of carbapenems?

    <p>Seizure activity</p> Signup and view all the answers

    Which antibiotic is used to treat bacterial endocarditis caused by S. aureus?

    <p>Imipenem/cilastatin (Primaxin)</p> Signup and view all the answers

    What is the main difference between fourth-generation and fifth-generation cephalosporins?

    <p>Fifth generation has a broader spectrum of antibacterial activity</p> Signup and view all the answers

    Why should patients with a history of throat swelling or hives from penicillin not receive cephalosporins?

    <p>Due to potential allergic reactions</p> Signup and view all the answers

    Which of the following antibiotics is the only carbapenem currently indicated for treatment of bacterial meningitis?

    <p>Meropenem (Merrem)</p> Signup and view all the answers

    What is the mechanism of action of macrolides?

    <p>Prevent protein synthesis within bacterial cells</p> Signup and view all the answers

    Which macrolide is indicated only for the treatment of C. difficile–associated diarrhea?

    <p>Fidaxomicin (Dificid)</p> Signup and view all the answers

    What is a common adverse effect of macrolides?

    <p>Gastrointestinal bleeding</p> Signup and view all the answers

    Which of the following drugs interacts with macrolides through competition for hepatic metabolism?

    <p>All of the above</p> Signup and view all the answers

    Which of the following statements about doripenem is true?

    <p>It is indicated for intraabdominal infections, pyelonephritis, and UTIs</p> Signup and view all the answers

    What is the primary mechanism of action of aztreonam?

    <p>Inhibiting cell wall synthesis</p> Signup and view all the answers

    Which of the following macrolides has minimal effects on the cytochrome P-450 enzymes?

    <p>Azithromycin (Zithromax)</p> Signup and view all the answers

    What is the spectrum of activity of ertapenem?

    <p>Comparable to that of imipenem/cilastatin, but not active against Enterococcus or Pseudomonas species</p> Signup and view all the answers

    Why should macrolides be used with caution when administered with statins?

    <p>To avoid increased risk of myopathy</p> Signup and view all the answers

    What is the primary reason for avoiding milk products, iron preparations, antacids, and other dairy products when taking tetracyclines?

    <p>Due to the chelation and drug-binding that occur</p> Signup and view all the answers

    What is the recommended time for monitoring patients after administration of penicillin for an allergic reaction?

    <p>At least 30 minutes</p> Signup and view all the answers

    What is the reason for taking oral administered cephalosporins with food?

    <p>To reduce GI upset</p> Signup and view all the answers

    What is the effect of taking macrolides on an empty stomach?

    <p>It enhances the absorption of the medication</p> Signup and view all the answers

    What is a sign of therapeutic effect of antibiotics?

    <p>Return to normal vital signs</p> Signup and view all the answers

    What is a potential interaction between certain cephalosporins and alcohol?

    <p>A disulfiram (Antabuse)-like reaction</p> Signup and view all the answers

    What is the primary mechanism of action of tetracyclines?

    <p>Inhibiting protein synthesis</p> Signup and view all the answers

    What is a common adverse effect of tetracyclines in children and pregnant or lactating women?

    <p>Tooth discoloration</p> Signup and view all the answers

    Which of the following can reduce the oral absorption of tetracyclines?

    <p>Antacids and dairy products</p> Signup and view all the answers

    What is a unique indication for demeclocycline?

    <p>Syndrome of inappropriate antidiuretic hormone secretion</p> Signup and view all the answers

    What is a potential consequence of tetracycline use during pregnancy?

    <p>Fetal skeletal development retardation</p> Signup and view all the answers

    What is a common interaction between tetracyclines and other medications?

    <p>All of the above</p> Signup and view all the answers

    What is a common adverse effect of tetracyclines on the gastrointestinal system?

    <p>All of the above</p> Signup and view all the answers

    What is an important nursing implication for patients taking tetracyclines?

    <p>All of the above</p> Signup and view all the answers

    What is a characteristic of tetracyclines in relation to their interaction with calcium ions?

    <p>They bind to calcium ions, forming insoluble complexes</p> Signup and view all the answers

    What is a potential consequence of altering the normal intestinal flora with tetracyclines?

    <p>Superinfection with Candida spp.</p> Signup and view all the answers

    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.

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