Comprehensive Respiratory System Disorders Q 87 - Gyan Darpan : Learning Portal
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Thursday, 21 April 2022

Comprehensive Respiratory System Disorders Q 87

A male client comes to the emergency department complaining of sudden onset of diarrhea, anorexia, malaise, cough, headache, and recurrent chills. Based on the client’s history and physical findings, the physician suspects Legionnaires’ disease. While awaiting diagnostic test results, the client is admitted to the facility and started on antibiotic therapy. What is the drug of choice for treating Legionnaires’ disease?
     A. erythromycin (Erythrocin)
     B. rifampin (Rifadin)
     C. amantadine (Symmetrel)
     D. amphotericin B (Fungizone)

Correct Answer: A. Erythromycin (Erythrocin)

Erythromycin is the drug of choice for treating Legionnaires’ disease. Erythromycin has traditionally; it has been used for various respiratory infections (i.e., community-acquired pneumonia, Legionnaires disease), prophylaxis of neonatal conjunctivitis, and chlamydia. Erythromycin is a bacteriostatic antibiotic, which means it prevents the further growth of bacteria rather than directly destroying it. This action occurs by inhibiting protein synthesis.

Option B: Rifampin may be added to the regimen if erythromycin alone is ineffective; however, it isn’t administered first. Clinically, rifampin is recommended for infections where the disease-causing organisms are identified, their drug susceptibility determined, and it is used in combination with other antimicrobial agents to prevent the drug resistance.
Option C: Amantadine, an antiviral agent, is ineffective against Legionnaires’ disease, which is caused by bacterial infection. Amantadine is now used mostly for Parkinson disease. Clinical trials have shown that amantadine decreases symptoms of bradykinesia, rigidity, and tremor. Amantadine is an antiviral agent with mild antiparkinsonian activity. Amantadine was used in the early 2000s for Influenza A treatment. A 2006 meta-analysis showed that the drug decreased influenza symptoms by one day and decreased the severity of fever and other symptoms.
Option D: Amphotericin B, an antifungal agent, is ineffective against Legionnaires disease because it is caused by bacteria. Amphotericin B deoxycholate belongs to the polyene class of antifungals. It is also known by the name conventional amphotericin B and has been in use for the treatment of invasive fungal infections for more than 50 years. It was first isolated as a natural product of a soil actinomycete.

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