05-22-2009, 12:36 PM
45. A 2-year-old girl has had fever and bloody
diarrhea for 10 days.
A stool culture obtained 7 days ago grew Salmonella
species sensitive
to amoxicillin. A blood culture was negative.
Despite beginning oral
amoxicillin therapy 4 days ago, her diarrhea has
persisted. Current
examination shows no other abnormalities except for a
temperature of 38.6 C
(101.5 F). Which of the following is the most likely
explanation for
the failure of amoxicillin to improve her symptoms?
A
) Amoxicillin does not alter the course of
Salmonella enteritidis
B
) Amoxicillin has caused pseudomembranous colitis
C
) Amoxicillin is absorbed at the level of the
jejunum, leaving no
drug to be delivered to the colon
D
) Oral amoxicillin is not absorbed into the
systemic circulation in
the presence of diarrhea
E
) Salmonella has expressed an inducible ß-lactamase
that inactivates
amoxicillin
diarrhea for 10 days.
A stool culture obtained 7 days ago grew Salmonella
species sensitive
to amoxicillin. A blood culture was negative.
Despite beginning oral
amoxicillin therapy 4 days ago, her diarrhea has
persisted. Current
examination shows no other abnormalities except for a
temperature of 38.6 C
(101.5 F). Which of the following is the most likely
explanation for
the failure of amoxicillin to improve her symptoms?
A
) Amoxicillin does not alter the course of
Salmonella enteritidis
B
) Amoxicillin has caused pseudomembranous colitis
C
) Amoxicillin is absorbed at the level of the
jejunum, leaving no
drug to be delivered to the colon
D
) Oral amoxicillin is not absorbed into the
systemic circulation in
the presence of diarrhea
E
) Salmonella has expressed an inducible ß-lactamase
that inactivates
amoxicillin