How to write a nursing essay on Empiric therapy (Solved)

Empiric therapy refers to the administration of treatment based on experience rather than knowledge of the exact cause of a disease. Differentiating the potential cause of cellulitis before initiating empiric therapy is important because of the emergence of bacterial resistance to antibiotics. Studies show that the emergence of methicillin-resistant Staphylococcus aureus (MRSA) and macrolide- or erythromycin-resistant Streptococcus pyogenes make it difficult to manage cellulitis (Sullivan & de Barra, 2018). Empiric treatment may only be beneficial to nonsevere cases that do not require hospitalization.

The most common cause of cellulitis is staphylococcus aureus making the selection of empiric therapy easy for non-complicated cases (Rosenthal & Burchum, 2020). The drug I would consider in this case is Flucloxacillin 500 mg PO qds. If the patient is allergic to penicillins, I would prescribe cephalexin 500 mg PO qds. These drugs are effective for the treatment of skin infections caused by gram-positive bacteria (Sullivan & de Barra, 2018). Because there are no signs of sepsis or necrotizing infection mentioned, the oral formulations will be preferred over parenteral therapy.

The monitoring parameters for this drug will include signs of penicillin allergy like anaphylaxis, stridor, angioedema, and immediate onset urticaria (Rosenthal & Burchum, 2020). If these are noticed, I would consider changing medication to second or third-generation cephalosporins. Side effects to monitor will include nausea, vomiting, diarrhea, boating, and indigestion (Rosenthal & Burchum, 2020). For drug efficacy, the patient should be able to respond to treatment within five days. The development of an abscess will indicate a worsening disease and this will require a change of medication and potential inpatient admission.

Medications like penicillins and cephalosporins are associated with diarrhea characterized by watery or loose stool three or more times a day while taking antibiotics. Clostridium defficile diarrhea is different because it is more severe, lasts for more than one day, and is associated with abdominal cramping, fever, and tenderness (Czepiel et al., 2018). Treatment may involve the use of antibiotics like vancomycin for at least 10 days and oral rehydration. In some cases, if there is severe damage, surgery may be recommended to remove affected sections of the intestines.

References

Czepiel, J., Dróżdż, M., Pituch, H., Kuijper, E. J., Perucki, W., Mielimonka, A., Goldman, S., Wultańska, D., Garlicki, A., & Biesiada, G. (2019). Clostridium difficile infection: review. European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology, 38(7), 1211–1221. https://doi.org/10.1007/s10096-019-03539-6

Rosenthal, L., & Burchum, J. (2020). Lehne’s Pharmacotherapeutics for Advanced Practice Nurses and Physician Assistants-E-Book. Elsevier Health Sciences.

Sullivan, T., & de Barra, E. (2018). Diagnosis and management of cellulitis. Clinical Medicine (London, England), 18(2), 160–163.

https://doi.org/10.7861/clinmedicine.18-2-160

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