Final answer:
In the event of an infection like cellulitis in a patient with adrenal insufficiency on chronic prednisone and fludrocortisone therapy, the corticosteroid dosage might need to be increased during the infection. Close monitoring is necessary, especially considering the potential need for treatments targeted at drug-resistant bacteria or fungi, and additional therapies if the patient develops sepsis.
Step-by-step explanation:
A patient with adrenal insufficiency on chronic prednisone and fludrocortisone therapy who develops a new infection such as cellulitis, in addition to treatment with antibiotics, may require an adjustment of their corticosteroid dosage. Infections can lead to an increased demand for corticosteroids because of the body's additional stress. Therefore, a doctor may consider prescribing a higher dose of corticosteroids during the period of infection to mimic the body's natural stress response. After the infection is resolved, the dosage can then be tapered back to the regular chronic therapy amount under medical supervision.
It is important to monitor the patient closely, as the use of antibiotics alongside increased corticosteroid dosage may contribute to increased susceptibility to certain pathogens like drug-resistant bacteria or fungi, necessitating the use of targeted treatments such as tigecycline for drug-resistant bacterial infections or antifungal agents for fungal infections. Also, if the infection is severe and leads to systemic involvement like sepsis, other therapies beyond antibiotics and corticosteroids might be necessary, such as intravenous fluids, medications to maintain blood pressure, or in some cases, aggressive treatments such as drotrecogin-a.