Chapter 5 Drugs for Treating Infections

Case Study Although Violet, the athletic trainer working with the university’s intercollegiate wrestling team, has made sure the wrestling mats are cleaned on a regular basis, she also realizes that infections, especially skin infections, are expected during the wrestling season. Will, a 20-year-old, 149-pound wrestler on the team, comes to Violet in a panic. Will has noticed a large round area of redness on his leg and is afraid that he has Lyme disease. Violet inspects the lesion and notices that it has a very distinct circular pattern similar to a donut with a healed center. It is red, raised, and scaly. She knows that Will’s lesion is not Lyme disease but tinea corporis. Violet knows that Will must be seen by the physician to determine his contagion status for competition, but she also knows what can be done to resolve the problem. What kind of infection is this? What agents are used in the treatment of tinea corporis? What education should the athletic trainer provide regarding this infection?

Answer: Tinea corporis, also known as ringworm of the body, is a fungal infection of the skin. The infection typically occurs on the trunk and extremities. It is spread by direct contact with animals, humans, or inanimate objects infected with the fungus. Tinea corporis is typically treated using topical antifungals from the azole antifungal class. Examples include clotrimazole and miconazole. In some cases, oral antifungal therapy may be required. Terbinafine is an oral agent that is used in the treatment of tinea corporis. For athletes using a topical antifungal agent, the athletic trainer can provide education to help the athlete get the most benefit from the medication. Athletes should be educated on the importance of using the medication as directed. These infections usually take 2 to 4 weeks for effective treatment, so the athlete should continue using the medication until the infection is cured. There are also other interventions that can be done that do not involve drug therapy. For example, the athlete can decrease the risk of spreading the infection by not sharing towels and washing any contaminated towels in hot water.

Exam Questions 1. Which classes of should not be taken with dairy products or other calcium-containing products? a. Penicillins and cephalosporins. b. Macrolides and . c. Tetracyclines and fluoroquinolones. d. Cephalosporins and .

2. The athletic trainer is working with an athlete who has developed symptoms of tendonitis. He has now developed a respiratory infection and requires therapy. Which class of antibiotics would not be appropriate for this athlete? a. Fluoroquinolones. b. Sulfonamides. c. Tetracyclines. d. Penicillins.

3. What is the typical treatment duration for tinea pedis infections? a. 1 to 2 days. b. 1 to 2 weeks. c. 2 to 4 weeks. d. 4 to 8 weeks. 4. If an athlete has an allergic reaction to a penicillin, there is a possibility that he or she will also be allergic to: a. Aminoglycosides. b. Cephalosporins. c. Macrolides. d. Sulfonamides.

5. A cross-country runner is being started on a antibiotic for acne. What adverse effect would the athletic trainer be most concerned about? a. Tendonitis. b. Photosensitivity. c. Ototoxicity. d. Nausea.

6. Which class of antibiotics is not recommended for treatment of infections in most patients younger than 18 years? a. Fluoroquinolones. b. Tetracyclines. c. Sulfonamides. d. Penicillins.

7. A female athlete has been prescribed for treatment of trichomoniasis. The athlete should be educated to: a. Not take the medication at the same time as calcium supplements or antacids. b. Take the medication on an empty stomach. c. Stop taking the medication as soon as the symptoms resolve. d. Not drink any alcohol within 72 hours of taking the drug.

8. Which of the following classes of antibiotics are classified as bacteriostatic inhibitors of protein synthesis? a. Penicillins and sulfonamides. b. Macrolides and tetracyclines. c. Aminoglycosides and cephalosporins. d. Fluoroquinolones and carbapenems.

9. Which generation of cephalosporins would have the broadest antibacterial activity? a. First generation. b. Second generation. c. Third generation. d. Fourth generation.

10. Topical sulfonamides such as are used for: a. Treatment of acne. b. Prevention of infection following . c. Relief of symptoms of tinea corporis. d. Management of skin from penicillin use.