Medical Practice

Case: Antibacterial agents. Class

The basic principles for the selection of antibacterial therapy include consideration of factors such as the likelihood that the infection is bacterial and the identification of the likely infecting organism to support a rational selection of an antibiotic. Consideration of host and drug factors that could influence antibiotic selection include identification of the site of infection, which will influence the selection of the antibiotic and its route of administration; recognition of concomitant diseases such as AIDS; recognition of the likelihood of drug allergies; recognition of hepatic or renal dysfunction that could alter antibiotic clearance; and recognition of drug toxicity, drug-drug interactions, drug resistance, the patient’s age or pregnancy or maternal status; …

Case: Antibacterial agents

A 48-year-old man comes to your office with a 6-day history of worsening cough productive of green sputum. He has had fever and chills. He complains of pain in the right midback with deep breathing or coughing. Further history reveals that he has smoked one pack of cigarettes a day for 30 years. He has no other significant medical history. On examination, his temperature is 38.1°C (100.5°F); his respiratory rate is 24 breaths per minute; pulse, 98 beats per minute; blood pressure, 120/75 mm Hg; and saturation of oxygen, 96 percent on room air by pulse oximetry. Auscultation of his lungs reveals rales in the right lower-posterior lung field. The remainder …