Which of the following complaints by a man taking gentamycin would be most indicative that he is experiencing ototoxicity?

A. A Vitamin C deficiency:

While a Vitamin C deficiency can lead to oral health issues such as bleeding gums or scurvy, it is less likely to present with bright red oral mucous membranes and white patches. Vitamin C deficiency typically manifests with other symptoms such as fatigue, weakness, and joint pain.

B. Dehydration:

Dehydration can cause dry mouth and oral discomfort, but it is less likely to present with bright red oral mucous membranes and white patches. Dehydration may also result in a dry, sticky feeling in the mouth rather than soreness with white patches.

C. Poor oral hygiene:

Poor oral hygiene can lead to various oral health problems, including gingivitis and dental caries, but it is less likely to cause bright red oral mucous membranes with white patches. Poor oral hygiene typically results in plaque accumulation, gum inflammation, and dental decay rather than the specific symptoms described.

D. A superinfection:

This is the correct option. A superinfection occurs when opportunistic microorganisms, such as fungi or resistant bacteria, proliferate and cause infection following antibiotic therapy. Penicillin, like other antibiotics, can disrupt the normal balance of microorganisms in the mouth, allowing opportunistic pathogens to flourish and lead to conditions such as oral thrush (caused by Candida albicans) or oral candidiasis. The presence of bright red oral mucous membranes with white patches suggests the possibility of a superinfection, which warrants immediate attention from the primary care provider for further evaluation and management.

A. Sulfonamides:

Sulfonamides are a class of antibiotics that are structurally distinct from cephalosporins like cefazolin. Allergic reactions to sulfonamides do not necessarily indicate a risk of allergy to cefazolin. However, it's still important to assess for any previous allergic reactions to medications, including sulfonamides, as individuals can have multiple medication allergies.

B. Macrolides:

Macrolides are another class of antibiotics that are structurally different from cephalosporins. Allergic reactions to macrolides do not directly indicate an allergy to cefazolin. However, as with sulfonamides, it's crucial to assess for any history of allergic reactions to medications, including macrolides.

C. Yeast:

Yeast is not a class of antibiotics but rather a type of fungus. Allergic reactions to yeast are unrelated to cephalosporin antibiotics like cefazolin. Therefore, a history of allergic reactions to yeast does not suggest an allergy to cefazolin.

D. Penicillin:

This is the correct choice. Penicillins and cephalosporins share a similar beta-lactam ring structure. Individuals who have had allergic reactions to penicillin may have an increased risk of cross-reactivity with cephalosporins, including cefazolin. Therefore, it's crucial to assess for any previous allergic reactions to penicillin before administering cefazolin to avoid potential allergic reactions or adverse effects.