Which adverse effect unique to vancomycin is caused by histamine release?

A. By assessing the temperature every 4 hours:

Monitoring temperature every 4 hours is a common practice in hospitalized patients to detect fever, which could indicate an infection or an inflammatory response. However, this method does not directly assess the therapeutic blood levels of vancomycin. Fever alone does not provide specific information about the effectiveness or concentration of the antibiotic in the bloodstream.

B. By repeating a culture and sensitivity test on day 3:

Culture and sensitivity tests involve taking a sample from the patient (such as blood, urine, or sputum) and growing the microorganisms in a laboratory to identify the causative organism and determine its susceptibility to antibiotics. While this test is essential for identifying the appropriate antibiotic therapy initially, repeating it on day 3 does not directly monitor therapeutic blood levels of vancomycin. It also doesn't provide real-time information about the concentration of vancomycin in the bloodstream.

C. By obtaining drug peak and trough levels:

This choice involves measuring the highest (peak) and lowest (trough) concentrations of vancomycin in the bloodstream. Peak levels are typically measured about 1 hour after the completion of a vancomycin infusion, while trough levels are measured just before the next dose is administered. These measurements allow healthcare providers to ensure that the drug concentration remains within the therapeutic range to effectively treat the infection while minimizing the risk of toxicity.

D. By assessing for breathlessness:

Assessing for breathlessness is important for monitoring respiratory status, particularly in patients receiving vancomycin, as rare side effects like red-man syndrome or anaphylaxis can cause respiratory distress. However, this method does not directly monitor therapeutic blood levels of vancomycin.

A. An infection that is difficult to treat:

This choice describes a challenging infection but does not specifically capture the concept of a superinfection. While superinfections can indeed be difficult to treat, they are defined more specifically as secondary infections that occur due to disruption of the normal microbial flora during the treatment of an initial infection.

B. An infection caused by a weakened immune system:

This choice describes an infection that occurs due to a compromised or weakened immune system, which can indeed increase the risk of developing infections, including superinfections. However, it does not fully encompass the definition of a superinfection, which specifically involves the overgrowth of opportunistic pathogens after the disruption of normal microbial flora by antimicrobial treatment.

C. A secondary infection that occurs when microorganisms normally present in the body are killed by the drug:

This choice accurately describes what a superinfection is. It highlights the key concept that a superinfection is a secondary infection that arises when antimicrobial treatment disrupts or kills the normal microbial flora of the body, allowing opportunistic pathogens to overgrow and cause infection.

D. A drug-resistant infection:

This choice describes an infection caused by microorganisms that are resistant to the effects of antimicrobial drugs. While drug resistance is a significant concern in healthcare, it does not specifically define a superinfection. Superinfections can involve drug-resistant microorganisms, but they are not solely characterized by drug resistance; rather, they are secondary infections resulting from the disruption of normal microbial flora during antimicrobial treatment.