Question

Question A1 John has started on oral Ciprofloxacin for treatment of his acute bronchitis. He developed oral thrush (Candidiasis) three days later, which is confirmed to be caused by the antibiotic therapy.

(a) Identify the class of antibiotics of which Ciprofloxacin belongs to and briefly describe its mechanism of action.

(b) Explain why John would develop Candidiasis infection after commencing the antibiotic therapy.

Answer 1

Acute bronchitis is an infection of the lower respiratory tract that is generally an acute sequeta to an upper respiratory tract infections ( rhinitis)

? Cause and pathophysiology

Cause of acute bronchitis is viral ( influenza; rhinovirus)

Bacterial causes are common both in smokers ( streptococcus pneumoniae)

Non smokers ( mycoplasma pneumonia)

? Pathophysiology

⬇️Due to viral and bacterial causes

⬇️ decreased mucociliary function

⬇️ Airway become clayyed with mucous and irritated with increased mucus products

⬇️ Bronchitis

? Clinical manifestations

Persistent cough following URTI( most common symptom)

Productive cough - clear to purulent sptum.

Fever and headache ,malaise.

? Diagnostic evaluation

History collection

Physical examination- expiratory wheeze ,rhonchii.

Chest xray - no evidence of infiltrates and consolidation ( seen in pnemonia) in bronchitis

Sputum culture

?Mangement

Increased fluid intake

Rest

Anti-inflammatory agents

In case of bacterial infection- antibiotics therapy

Bronchodilator s for bronchospasm

Symptom mangement for cough ,fever

? nursing Mangement

Ineffective airway clearance related to sputum production .

(a) Ciprofloxacin may also be used to treat bronchitis , sinus infections,or urinary tract infections . 34 pateints with acute purulent exacerbations of chronic Bronchitis were treated with 500 mg Ciprofloxacin.

( Mechanism of action is already explained above ?)

(b) some circumstances such as taking a long course of antibiotics or having a weakened immune system can increase your risk of developing a candida infection. The most common candida infection such as vaginal and skin infections are localised and can be treated with with antifungal drugs.

Medications. Drugs such as prednisone, inhaled corticosteroids, or antibiotics that disturb the natural balance of microorganisms in your body can increase your risk of oral thrush.

Antibiotics can cause yeast infections in some people because they kill off beneficial bacteria that prevent the overgrowth of yeast in the vagina. But there are several things you can do to offset the negative effects of antibiotics and reduce your risk of developing a yeast infection.

But the white stuff is still there. It's time to call your primary care provider. Your provider will want to look at your mouth to rule out other causes, including: Burning mouth syndrome (a burning sensation in the mouth that has no obvious cause).

Mild infections can be treated by antifungal creams that need to be directly applied to the vagina. In addition, you may use vaginal pessaries containing clotrimazole as an active ingredient. Prescription medication. The doctor may prescribe strong antifungal agents for more serious cases of thrush.