What is the best method of monitoring therapeutic blood levels of vancomycin during therapy?
By assessing the temperature every 4 hours
By repeating a culture and sensitivity test on day 3
By obtaining drug peak and trough levels
By assessing for breathlessness
The Correct Answer is C
A. By assessing the temperature every 4 hours:
Monitoring temperature every 4 hours is a common practice in hospitalized patients to detect fever, which could indicate an infection or an inflammatory response. However, this method does not directly assess the therapeutic blood levels of vancomycin. Fever alone does not provide specific information about the effectiveness or concentration of the antibiotic in the bloodstream.
B. By repeating a culture and sensitivity test on day 3:
Culture and sensitivity tests involve taking a sample from the patient (such as blood, urine, or sputum) and growing the microorganisms in a laboratory to identify the causative organism and determine its susceptibility to antibiotics. While this test is essential for identifying the appropriate antibiotic therapy initially, repeating it on day 3 does not directly monitor therapeutic blood levels of vancomycin. It also doesn't provide real-time information about the concentration of vancomycin in the bloodstream.
C. By obtaining drug peak and trough levels:
This choice involves measuring the highest (peak) and lowest (trough) concentrations of vancomycin in the bloodstream. Peak levels are typically measured about 1 hour after the completion of a vancomycin infusion, while trough levels are measured just before the next dose is administered. These measurements allow healthcare providers to ensure that the drug concentration remains within the therapeutic range to effectively treat the infection while minimizing the risk of toxicity.
D. By assessing for breathlessness:
Assessing for breathlessness is important for monitoring respiratory status, particularly in patients receiving vancomycin, as rare side effects like red-man syndrome or anaphylaxis can cause respiratory distress. However, this method does not directly monitor therapeutic blood levels of vancomycin.
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Correct Answer is D
Explanation
A.Goldenseal:
Goldenseal is a plant commonly used in herbal medicine, but it is not a drug that specifically inhibits bacterial beta-lactamase. While goldenseal may have antimicrobial properties, it is not typically used as a beta-lactamase inhibitor in the treatment of bacterial infections.
B. Ceftriaxone (Rocephin):
Ceftriaxone is a third-generation cephalosporin antibiotic. While it is an effective antibiotic for treating a wide range of bacterial infections, it does not have beta-lactamase inhibitor properties. Instead, ceftriaxone is susceptible to degradation by beta-lactamase enzymes produced by certain bacteria.
C. Penicillin:
Penicillin is one of the earliest discovered and most widely used beta-lactam antibiotics. However, many bacteria have developed resistance to penicillin by producing beta-lactamase enzymes. Penicillin itself does not inhibit beta-lactamase; instead, it is often combined with beta-lactamase inhibitors to enhance its effectiveness against beta-lactamase-producing bacteria.
D. Zosyn (piperacillin/tazobactam):
Zosyn is a combination antibiotic containing piperacillin, a broad-spectrum penicillin antibiotic, and tazobactam, a beta-lactamase inhibitor. Tazobactam inhibits the action of beta-lactamase enzymes produced by bacteria, allowing piperacillin to exert its antibacterial effects without being degraded by beta-lactamase. Therefore, Zosyn is the correct answer as it contains a drug that inhibits bacterial beta-lactamase.
Correct Answer is A
Explanation
A. Refers to an infection that is resistant to conventional antibiotics:
This statement is partially correct. Acquired resistance does indeed refer to bacteria becoming resistant to antibiotics, but it is not specific to conventional antibiotics. Bacteria can develop resistance to various types of antibiotics, including conventional antibiotics and newer antimicrobial agents.
B. Superinfection that has significant antifungal resistance:
This statement is incorrect. Acquired resistance specifically pertains to bacteria and their ability to resist antibiotics. It does not involve antifungal resistance or superinfections.
C. Refers to a term used for antibiotic coverage:
This statement is incorrect. Acquired resistance is not a term used to describe antibiotic coverage. It describes the phenomenon of bacteria becoming resistant to antibiotics.
D. There is no such phenomenon of acquired resistance:
This statement is incorrect. Acquired resistance is a well-documented phenomenon in microbiology and is a significant challenge in the treatment of bacterial infections. Ignoring or denying the existence of acquired resistance would overlook a critical aspect of antibiotic stewardship and management of bacterial infections.
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