A nurse is providing an Inservice to newly graduated nurses. Which of the following vaccines would the nurse label as "live vaccines" and should be avoided by immunocompromised clients?
Select All that Apply

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

pseudomembranous colitis.

i. Ototoxicity: Neomycin is part of the aminoglycoside class of antibiotics, which are known to cause ototoxicity, potentially leading to hearing loss, tinnitus, or balance issues. The risk is particularly high in young children or when administered at high doses over long periods.

Rationale for other options:

• Constipation: This is not a known serious adverse effect of neomycin.
• Hypercalcemia: Elevated calcium levels (hypercalcemia) are not typically associated with neomycin use.
• Thrombocytopenia: While aminoglycosides can occasionally cause hematologic effects, thrombocytopenia (low platelet count) is not a common adverse effect of neomycin.

ii. Pseudomembranous colitis: Neomycin, like other antibiotics, can disrupt the normal balance of gut flora, leading to an overgrowth of Clostridioides difficile, which can cause pseudomembranous colitis, a severe inflammatory condition of the colon.

Rationale for other options:

• Hypotrichosis: This refers to reduced hair growth and is not related to neomycin. It can cause hypertrichosis instead.
• Photosensitivity: Neomycin is not known to cause photosensitivity reactions.
• Hyperpigmentation: Neomycin typically causes hypopigmentation.

A. Amoxicillin/clavulanate (Augmentin): Amoxicillin/clavulanate is a broad-spectrum antibiotic but not the preferred choice for anthrax exposure.

B. Nystatin (Mycostatin): Nystatin is an antifungal medication used for treating fungal infections, such as oral thrush or cutaneous candidiasis. It is not effective against anthrax, which is a bacterial infection.

C. Ciprofloxacin (Cipro): Ciprofloxacin, a fluoroquinolone, is the recommended first-line antibiotic for treating anthrax exposure due to its efficacy against Bacillus anthracis, the bacteria causing anthrax.

D. Tamoxifen: Tamoxifen is a selective estrogen receptor modulator (SERM) used primarily in the treatment of breast cancer. It has no role in treating bacterial infections like anthrax.