Questions 4 and 5 You are a doctor working at a local hospital. A few of your pa
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Questions 4 and 5 You are a doctor working at a local hospital. A few of your patients have been admitted for recur- ring infections and need treatment. The hospital pathologist has isolated and characterized the bacteria involved in each of the infections. Table 7-1 on the next page gives a list of commonly used antibiotics, the characteristics of bacteria that they work against, and how they work against the bacteria (mechanism of action). Broad-spectrum antibiotics work against both Gram-positive and Gram-negative bacteria. Narrow-spectrum antibiotics are only effective against specific families of bacteria. The pathologist's report of your patients is Table 7-2. Using both of these tables, which antibiotic would you prescribe for each patient and why? There is more than one correct answer for each patient. (2 points) 4.Explanation / Answer
Patient 1 - Gram (+), no cell wall, tetracycline resistant - Rifampin and trimethoprim-sulfa-methaxazole. Rationale - Since it is a gram positive bacteria without any cell wall, prescribing an antibiotic that tarrgets a cell wall will be futile. Hence, rifampin or rifampicin that blocks RNA synthesis of the bacteria or trimethoprim-sulfa-methaxazole that inhibits folic acid synthesis can be prescribed. Patient 2 - Gram (-), cell wall present; Amoxicillin and Gentamicin resistant - Cefazolin, polymixin B and trimethoprim-sulfa-methaxazole. Rationale - Since the bacteria is gram negative and resistant to amoxicillin and gentamicin, cefazolin which targets the thin peptidoglycan layer of the gram negative bacteria, polumixin B which destructs the cell membrane and trimethoprim-sulfa-methaxazole which inhibits folic acid synthesis can be prescribed. Patient 3 - Gram (+) cell wall present, penecillin resistant, patient allergic to tetracycline - Amoxicillin-calvulanic acid, Vanomycin, Rifampin, trimethoprim-sulfa-methaxazole and cefazolin. Rationale - Since the bacteria is gram positive, has a cell wall and penecillin resistant, Amoxicillin-calvulanic acid that inhibits peptidoglycan formation in cell wall, Rifampin that blocks RNA synthesis, trimethoprim-sulfa-methaxazole that blocks folic acid synthesis and cefazolin that again blocks peptidoglycan can be prescribed.
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