A 2 month old patient with current active infection. Being treated with Neomycin.

The nurse understands that neomycin may cause serious adverse effects such as 

___

and

___

.

A) Receiving excessive sunlight while on antibiotics:
While certain antibiotics, such as tetracyclines or fluoroquinolones, can cause photosensitivity and may lead to increased risk of sunburn when exposed to excessive sunlight, this does not directly contribute to bacterial resistance. Photosensitivity is a side effect, but it does not affect how bacteria respond to the antibiotic treatment. Therefore, this is not a factor in promoting bacterial resistance.

B) Discontinuing antibiotics once symptoms subside:
Discontinuing antibiotics prematurely when symptoms improve is a major contributor to antibiotic resistance. If the antibiotic course is not completed as prescribed, some bacteria may survive, particularly those that are less susceptible to the drug. These surviving bacteria can develop resistance to the antibiotic, making future infections harder to treat. It is essential for patients to complete the full course of antibiotics, even if they start feeling better, to ensure all bacteria are eradicated.

C) Performing frequent handwashing while taking antibiotics:
Handwashing is an essential practice in preventing the spread of infections, and it does not contribute to bacterial resistance. In fact, frequent handwashing can help reduce the transmission of pathogens, including bacteria, and minimize the need for antibiotics. Hand hygiene is an important preventive measure, especially for individuals taking antibiotics to avoid spreading infections to others. Therefore, this does not promote bacterial resistance.

D) Skipping dosages:
Skipping doses of antibiotics contributes to bacterial resistance because it leads to subtherapeutic levels of the antibiotic in the body. When the antibiotic concentration is not high enough to kill the bacteria, some bacteria may survive and adapt, potentially becoming resistant to the drug. It is critical to take antibiotics as prescribed, without skipping doses, to maintain the necessary drug levels to effectively kill the bacteria.

E) Treating viral infections with antibiotics:
Treating viral infections with antibiotics is a significant driver of antibiotic resistance. Antibiotics are only effective against bacterial infections, not viral ones. Using antibiotics unnecessarily for viral infections, such as the common cold, influenza, or viral sore throats, promotes the development of resistant bacteria. This overuse of antibiotics inappropriately increases selective pressure, allowing bacteria to evolve mechanisms to resist the effects of these drugs.

F) Frequent use of antibiotics:
Frequent use of antibiotics is a known contributor to bacterial resistance. Every time antibiotics are used, there is a chance that bacteria may develop resistance. This is especially true when antibiotics are used inappropriately or excessively. Overuse can lead to the emergence of antibiotic-resistant strains, making future infections harder to treat. This is why it's important to use antibiotics only when necessary and to follow appropriate guidelines for their use.

A) This medication may cause discoloration of the teeth:
Doxycycline is a tetracycline-class antibiotic, and like other drugs in this group, it can bind to calcium in developing teeth, leading to permanent discoloration if taken during childhood or by pregnant or breastfeeding women whose fetuses or infants are exposed to the drug. In adults, it can still cause temporary staining, especially with prolonged use. Patients should be informed about this potential side effect to prevent concern and encourage good oral hygiene.

B) This medication should not be taken if you are lactating:
Doxycycline is generally considered compatible with breastfeeding, although it should be used with caution. While doxycycline does pass into breast milk, the risk to an infant is minimal, particularly for short-term use. However, the safety profile may vary depending on the infant's age and health, and a healthcare provider should evaluate the risks and benefits in each case.

C) This medication should not be taken with antacids:
Antacids containing calcium, magnesium, or aluminum can interfere with the absorption of doxycycline. These minerals bind to the antibiotic in the gastrointestinal tract, decreasing its effectiveness. It is recommended to space the administration of doxycycline and antacids by at least 2 hours to ensure adequate absorption of the medication. This is a key consideration in managing patients taking doxycycline.

D) This medication can cause hyperglycemia:
Doxycycline is not typically associated with hyperglycemia. Hyperglycemia is not a common or expected side effect of this medication. Doxycycline's side effects more commonly involve gastrointestinal distress, photosensitivity, and potential effects on the liver or kidneys. Hyperglycemia would be more likely in a diabetic patient on steroids or other specific medications, not generally with doxycycline.

E) This medication should not be administered to anyone under the age of 20 years old:
Doxycycline is contraindicated in children under 8 years old due to the risk of tooth discoloration and impaired bone development, not generally in those under 20 years of age. While it may be used with caution in adolescents for specific infections, the drug is not recommended for younger children. However, there is no blanket restriction for those under 20, especially if the benefits outweigh the risks.

F) This medication may cause photosensitivity:
Doxycycline can increase the skin’s sensitivity to sunlight, resulting in an increased risk of sunburn or skin rash. This is a well-known side effect of tetracycline antibiotics, and patients taking doxycycline should be advised to avoid prolonged sun exposure, wear sunscreen, and protective clothing to reduce the risk of photosensitivity reactions.