The term "virulence" refers to:

1. Do not have to demonstrate effectiveness:

This statement is generally true under DSHEA regulations. Unlike pharmaceutical drugs, dietary supplements are not required to undergo rigorous testing to demonstrate their effectiveness in treating, preventing, or curing specific health conditions before they are marketed. However, manufacturers are prohibited from making unsubstantiated claims about the effectiveness of their products.

B. Are determined to be safe before being placed on the market:

Under DSHEA regulations, dietary supplement manufacturers are responsible for ensuring the safety of their products before they are marketed. However, unlike pharmaceutical drugs, dietary supplements do not undergo premarket approval by the Food and Drug Administration (FDA) to verify their safety and efficacy. Instead, manufacturers are required to notify the FDA of their intent to market a new dietary ingredient (NDI) and provide evidence of the ingredient’s safety.

C. Are checked for label accuracy:

The FDA regulates dietary supplements to ensure that their labels are accurate and truthful. However, the extent of label accuracy checking varies, and the FDA does not routinely test every dietary supplement product on the market. Instead, the FDA relies on postmarket surveillance, consumer complaints, and other mechanisms to identify and address inaccuracies or violations of labeling regulations.

D. Are tested prior to marketing:

Unlike pharmaceutical drugs, dietary supplements are not required to undergo premarket testing to demonstrate their safety or efficacy before they are marketed. While manufacturers are responsible for ensuring the safety of their products, there is no formal premarket testing requirement under DSHEA regulations.

1. Abdominal surgery requires starting antibiotic therapy 4 days before surgery:

This statement is not accurate. While antibiotic prophylaxis is commonly administered before certain types of surgery to prevent surgical site infections, the timing and duration of antibiotic therapy vary depending on factors such as the type of surgery, the patient’s medical history, and institutional guidelines. However, starting antibiotic therapy four days before surgery would not be standard practice for most abdominal surgeries.

B. A reduction of intestinal bacteria lessens the possibility of postoperative infection:

This statement is correct. Neomycin, as well as other antibiotics used in bowel preparation regimens, help reduce the population of intestinal bacteria. By decreasing the bacterial load in the bowel before surgery, the risk of contaminating the surgical site with harmful bacteria during the procedure is reduced, thus lowering the likelihood of postoperative infections.

C. The bacteria found in the bowel cannot be destroyed after surgery:

This statement is incorrect. While it is true that the bowel contains a complex ecosystem of bacteria that play important roles in digestion and other physiological functions, the population of intestinal bacteria can be temporarily reduced through the use of antibiotics, such as neomycin, as part of a bowel preparation regimen before surgery.

D. Anesthesia makes the bowel resistant to an antibiotic after surgery:

This statement is not accurate. Anesthesia does not render the bowel resistant to antibiotics after surgery. However, the administration of antibiotics during surgery and postoperatively may be indicated in certain cases to prevent or treat infections, particularly if the surgical procedure involves contamination of the abdominal cavity or if the patient is at increased risk of infection.