A mother brings her 4-year-old son to see you because he has been experiencing decreased appetite, fever, and right-sided ear discharge for the past 24 hours. His past medical history is significant for three episodes of otitis media over the last year. You prescribe amoxicillin. Adding clavulanic acid to this treatment regimen would serve which of the following purposes?

Question

A mother brings her 4-year-old son to see you because he has been experiencing decreased appetite, fever, and right-sided ear discharge for the past 24 hours.  His past medical history is significant for three episodes of otitis media over the last year.  You prescribe amoxicillin.  Adding clavulanic acid to this treatment regimen would serve which of the following purposes?

Quizplus · Accepted Answer

Certain strains of bacteria produce the beta-lactamase enzyme, which hydrolyzes the beta-lactam ring of penicillin family antibiotics rendering them ineffective. To help prevent this effect, beta-lactamase inhibiting compounds have been developed. The beta-lactamase inhibitors include clavulanic acid, sulbactam and tazobactam. Concurrent administration of a beta-lactamase inhibitor with a beta-lactamase susceptible antibiotic allows that antibiotic to retain its efficacy against the offending bacterium. For example, giving clavulanate together with amoxicillin expands amoxicillin's spectrum of activity to include strains of beta-lactamase synthesizing bacteria which would otherwise have been resistant to amoxicillin alone. (Choice A) Clavulanic acid has negligible intrinsic antibacterial activity. (Choice B) Immune cells do not produce beta-lactamases. (Choice D) Clavulanic acid has no effect on the biotransformation of amoxicillin in the liver. Moreover amoxicillin undergoes enterohepatic recirculation and is excreted primarily in unchanged form in the urine. (Choice E) Probenecid is a compound that decreases the renal clearance of penicillins by inhibiting the tubular organic acid secretion system. This agent has been utilized to prolong the action of penicillin in some settings. Educational Objective: Clavulanic acid, sulbactam and tazobactam are beta-lactamase inhibitors. Concurrent administration of clavulanate with amoxicillin expands amoxicillin's spectrum of activity to include strains of β-lactamase synthesizing bacteria that are resistant to amoxicillin alone.

A Mother Brings Her 4-Year-Old Son to See You Because