MEDizzy - A 70-year-old female resident in a nursing facility was

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BACTERIAL CELL WALL SYNTHESIS INHIBITORS

A 70-year-old female resident in a nursing facility was admitted to the hospital because of fever (101.4°F 38.6°C), diarrhea, and severe abdominal pain. Four days earlier, the patient had started antibiotic treatment because of acute tonsillitis due to β-hemolytic streptococci. Physical examination showed a critically ill patient with abdominal distention and absent bowel sounds. Colonoscopy revealed diffuse ulcerations and exudative plaques lining the colonic mucosa. Which of the following antibiotics most likely caused the patient’s disease?

ExplanationThe correct answer is D. The patient most likely developed antibiotic-associated pseudomembranous colitis (AAPC) due to Clostridium difficile. The disease has emerged as a major threat to elderly patients. Ampicillin, clindamycin, cephalosporins, and uoroquinolones are the most common antibiotics associated with the condition. Other causative agents are penicillins, erythromycin, trimethoprim-sulfamethoxazole, and tetracyclines. Ampicillin was most likely given to the patient to cure tonsillitis and therefore was the most plausible offending agent. A−C All of these antibiotics very rarely cause AAPC, and they are not used to treat streptococcal tonsillitis.