Comprehensive Nursing Pharmacology Q 151

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Fluconazole (Diflucan) can be administered to a client with:

  

     A. Pneumococcal meningitis

     B. Oral thrush

     C. Cryptococcal meningitis

     D. Pneumococcal pneumonia

    

    

Correct Answer: C. Cryptococcal meningitis

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Fluconazole (Diflucan) is a drug given for the treatment of cryptococcal meningitis. The combination of amphotericin B and flucytosine has proved the most effective measure to clear the infection, and it showed a greater survival benefit over amphotericin alone. However, due to its cost, flucytosine is often unavailable in poor-resource settings where the disease burden is significant. A and D are incorrect because pneumococcal meningitis and pneumonia are not caused by fungal infections.

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Option A: Antibiotics and supportive care are critical in all cases of bacterial meningitis. The type of antibiotic is based on the presumed organism causing the infection. The clinician must take into account patient demographics and past medical history in order to provide the best antimicrobial coverage.

Option B: Oral thrush is treated with a more mild antifungal, such as nystatin. Oral candidiasis or thrush is an infection of the oral cavity by Candida albicans. It was first described in 1838 by pediatrician Francois Veilleux. Oral candidiasis is generally obtained secondary to immune suppression, whether a patient’s oral cavity has decreased immune function or if it is systemic.

Option D: Antibiotic treatment for invasive pneumococcal infections typically includes ‘broad-spectrum’ antibiotics until results of antibiotic sensitivity testing are available. Broad-spectrum antibiotics work against a wide range of bacteria. Once the sensitivity of the bacteria is known, a more targeted (or ‘narrow-spectrum’) antibiotic may be selected.

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