Question

The patient has a staphylococcal infection of the blood, a septicemia--very serious and possibly deadly. As the doctor, you would like to prescribe a relatively non-toxic and inexpensive drug out of the cephalosporin family. However, if the patient harbors a strain of Staphylococcus that is resistant to a variety of antibiotics, you would prefer to use vancomycin-- which is highly effective against Staphylococcus. Which of the following explains why the cephalosporin drug is preferred for use over the vancomycin?

A. You would rather give an inexpensive drug to save the family money.
B. You really do not know that much about vancomycin, so you would rather go with a drug that you can find out more about.
C. Vancomycin is very toxic, and the Staphylococcus strain could become resistant leaving no back-up drugs with which to treat the infection.
D. Vancomycin is one of the most selectively toxic drugs there is, so you would prefer one that has a more broad-spectrum effect.

Answer 1

The cephalosporin drug is preferred for treating a staphylococcal infection of the blood over vancomycin to avoid potential toxicity and the risk of promoting antibiotic resistance. Cephalosporins, being broad-spectrum and low in toxicity, are effective against both Gram-positive and Gram-negative bacteria, whereas vancomycin is a last-line treatment reserved for resistant infections to prevent the emergence of vancomycin-resistant strains.

Step-by-step explanation:

The preference for a cephalosporin drug over vancomycin for a patient with a staphylococcal infection of the blood is based on controlling antibiotic resistance and avoiding toxicity issues. While cephalosporins are broad-spectrum antibiotics with low toxicity, vancomycin is reserved as a last-line treatment for resistant infections due to its potential to promote resistance if overused and because it is considered a high-alert medication. The concern is that overusing vancomycin could lead to an increase in the number of vancomycin-resistant strains of bacteria, leaving fewer treatment options available for future infections.

Cephalosporins have a similar structure and mode of action to penicillin, interfering with bacterial cell wall synthesis, and are effective against both Gram-positive and Gram-negative bacteria, making them a versatile treatment option. When faced with a serious condition like septicemia, it is crucial to initiate treatment promptly using an antibiotic that offers a balance between effectiveness and safety while preserving stronger antibiotics for cases where resistance to other drugs is confirmed.

The emergence of antibiotic-resistant bacteria, such as MRSA (methicillin-resistant Staphylococcus aureus) and VRSA (vancomycin-resistant S. aureus), highlights the importance of antimicrobial stewardship. Proper use of antibiotics, such as preferring a cephalosporin when effective, is part of this approach to hinder the development of further resistance and maintain the efficacy of powerful antibiotics like vancomycin.