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34.8Penicillins, which kill bacteria by disrupting the cell wall, are most effective against gram-positive bacteria. Allergies occur most frequently with the penicillins.34.9The cephalosporins are similar in structure and function to the penicillins and are one of the most widely prescribed anti-infective classes. Cross sensitivity may exist with the penicillins in some patients.34.10Tetracyclines have some of the broadest spectrums of any antibiotic class. They are drugs of choice for Rocky Mountain spotted fever, typhus, cholera, Lyme disease, peptic ulcers caused by Helicobacter pylori, and chlamydial infections.34.11The macrolides are safe alternatives to penicillin. They are effective against most gram-positive bacteria and many gram-negative species.34.12The aminoglycosides are narrow-spectrum drugs, most commonly prescribed for infections by aerobic, gramnegative bacteria. They have the potential to cause serious adverse effects such as ototoxicity, nephrotoxicity, and neuromuscular blockade.34.13The use of fluoroquinolones has expanded far beyond their initial role in treating urinary tract infections. All fluoroquinolones have activity against gram-negative pathogens, and newer drugs in the class have activity against gram-positive microbes.34.14Resistance has limited the usefulness of once widely prescribed sulfonamides to urinary tract infections and a few other specific infections.
34.15A number of miscellaneous antibacterials have specific indications, distinct antibacterial mechanisms, and related nursing care.34.16Multiple drug therapies are needed in the treatment of tuberculosis, since the complex microbes are slow growing and commonly develop drug resistance.The nurse is administering an anti-infective that is considered to be a bacteriocidal. Before beginning therapy, the nurse should assess the client for: The client asks the nurse why thephysician didn't prescribe the same antibiotic that he always takes for an infection. The best response by the nurse would be: