A child with an ear infection is not responding to treatment with amoxicillin (Amoxil). The nurse will expect the provider to order:
a. amoxicillin–clavulanic acid (Augmentin).
b. ampicillin.
c. nafcillin.
d. penicillin G (Benzylpenicillin).
ANS: A
Beta-lactamase inhibitors are drugs that inhibit bacterial beta-lactamases. These drugs are always given in combination with a penicillinase-sensitive penicillin. Augmentin contains amoxicillin and clavulanic acid and is often used when patients fail to respond to amoxicillin alone. Ampicillin is similar to amoxicillin, but amoxicillin is preferred and, if drug resistance occurs, ampicillin is equally ineffective. Pharmaceutical chemists have developed a group of penicillins that are resistant to inactivation by beta-lactamases (e.g., nafcillin), but these drugs are indicated only for penicillinase-producing strains of staphylococci. Penicillin G would be as ineffective as amoxicillin if beta-lactamase is present.
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