Read The Case Study: 11.2 Go To The Hospital And Come Back
Read The Case Study 11 2go To The Hospital And Come Back
Read the Case Study 11-2: Go to the Hospital and Come Back with Four More Medications in Chapter 11 of the textbook. Once you have read the Case Study thoroughly, answer the following questions: What does the administration of antibiotics have to do with a Clostridium difficile (C. diff infection) infection? List all the inappropriate medications prescribed for K.L. and describe the reason why they are inappropriate. What kind of treatment regimen is utilized for a patient with a C. diff infection? Do any of these treatments regimens raise suspicion as being inappropriate for K.L.? List the therapy and if contraindicated, give a reason why it is inappropriate. Your paper should be: One (1) page or more. Use factual information from the textbook and/or appropriate articles and websites. Cite your sources – type references according to the APA Style Guide.
Paper For Above instruction
The case study titled "Go to the Hospital and Come Back with Four More Medications" provides a comprehensive context for understanding the implications of antibiotic administration and medication appropriateness in a patient with a Clostridium difficile (C. diff) infection. This discussion explores the relationship between antibiotic use and C. diff infection, identifies inappropriate medications prescribed to K.L., reviews treatment regimens for C. diff infections, and assesses the appropriateness of these treatments for the patient.
The administration of antibiotics is closely linked to C. diff infections because antibiotics disrupt normal gut flora, which usually maintain a balanced microbial community safeguarding against pathogenic bacteria. When antibiotics—particularly broad-spectrum agents—disturb this balance, C. diff spores can proliferate unchecked, leading to infection. According to the CDC (2020), antibiotic-induced dysbiosis significantly increases the risk of developing C. diff infection, especially with antibiotics such as clindamycin, fluoroquinolones, and cephalosporins (McDonald et al., 2018).
In the case of K.L., several medications prescribed were deemed inappropriate. These included unnecessary antibiotics, or medications that could exacerbate gastrointestinal disturbances or further suppress gut microbiota. For example, unnecessary broad-spectrum antibiotics not indicated for her condition, NSAIDs which can cause mucosal damage, and certain antidiarrheal agents that might complicate her clinical picture. These medications are inappropriate because they can worsen C. diff infection or delay recovery by further impairing gut flora recovery.
The standard treatment regimen for a C. diff infection generally involves targeted antibiotics such as vancomycin or fidaxomicin, which are specifically indicated to eradicate C. diff spores and vegetative cells. For mild to moderate cases, oral vancomycin or fidaxomicin is recommended, while severe cases may require additional supportive measures (Johnson & Gerding, 2019). Metronidazole, once common, is now considered less effective and is generally recommended only for mild cases or if the first-line agents are unavailable.
In reviewing K.L.'s treatment plan, certain therapy choices raise suspicion. For example, if she was prescribed contraindicated medications such as certain antidiarrheals or unnecessary antibiotics, these could exacerbate her condition or interfere with effective treatment. For instance, antidiarrheals like loperamide can be contraindicated in C. diff infections due to the risk of toxic megacolon. Furthermore, if antibiotics with broad activity not targeting C. diff were used unnecessarily, they might worsen the infection or delay recovery (Lessa et al., 2015).
In conclusion, careful medication management is vital in patients with C. diff infections. The appropriate use of antibiotics like vancomycin or fidaxomicin is essential, and medications that impair gut motility or microbiota should be avoided. Recognizing and avoiding inappropriate medications can significantly impact patient outcomes. Healthcare providers must adhere to evidence-based guidelines, ensuring targeted therapy and minimizing medications that could hinder recovery.
References
Johnson, S., & Gerding, D. N. (2019). Clinical Practice Guidelines for Clostridioides difficile Infection in Adults and Children. Infectious Disease Clinics of North America, 33(4), 781–842.
Lessa, F. C., Muñoz-Price, L. S., & McDonald, L. C. (2015). Other aspects of Clostridium difficile infection. Clinical Microbiology Reviews, 28(3), 469–477.
McDonald, L. C., Gerding, D. N., Johnson, S., et al. (2018). Clinical practice guidelines for Clostridioides difficile infection in adults and children. Infectious Diseases Society of America (IDSA). https://onlinelibrary.wiley.com/doi/full/10.1002/9781119465573.ch31
Centers for Disease Control and Prevention (CDC). (2020). Antibiotic Use in the United States, 2020. https://www.cdc.gov/healthysystems/healthcare/antibiotic-use.html