Download Microbiology with Diseases by Body System, 3e

Microbiology with Diseases by Body System, 3e (Bauman)
Chapter 10 Controlling Microbial Growth in the Body: Antimicrobial Drugs
10.1 Multiple-Choice Questions
1) A large percentage of antibiotics and semisynthetic drugs are produced by members of the
genus
A) Cephalosporium.
B) Penicillium.
C) Bacillus.
D) Mycobacterium.
E) Streptomyces.
Answer: E
Bloom's Rank: Comprehension
Section: The History of Antimicrobial Agents
2) An antimicrobial that inhibits cell wall synthesis will result in which of the following?
A) Cells become more susceptible to osmotic pressure.
B) Cells cannot attach to their hosts.
C) Ribosomes lose their function.
D) The sterols in the cell wall become nonfunctional.
E) The replication of cells, including cancer cells, slows down.
Answer: A
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
3) Beta-lactam antibiotics have an effect on which of the following types of cells?
A) animal cells
B) bacterial cells
C) fungal cells
D) virus-infected cells
E) both animal and fungal cells
Answer: B
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
4) Which of the following is a primary advantage of semisynthetic drugs?
A) They are less stable and consequently have fewer side effects.
B) They work faster.
C) They have a broader spectrum of action.
D) They must be administered intravenously.
E) They are not readily absorbed, so they persist longer.
Answer: C
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
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5) Which of the following drugs specifically targets cell walls that contain arabinogalactanmycolic acid?
A) vancomycin
B) penicillin
C) methicillin
D) isoniazid
E) bacitracin
Answer: D
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
6) Which of the following antibiotics disrupts cytoplasmic membrane function?
A) streptomycin
B) erythromycin
C) tetracycline
D) penicillin
E) amphotericin B
Answer: E
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
7) Which of the following is NOT a target of drugs that inhibit protein synthesis?
A) the shape of the 30S ribosomal subunit
B) interference with alanine-alanine bridges
C) the enzymatic site of the 50S ribosomal subunit
D) movement of the ribosome from one codon to the next
E) the tRNA docking site
Answer: B
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
8) Which scientist coined the term antibiotic?
A) Fleming
B) Domagk
C) Kirby
D) Ehrlich
E) Waksman
Answer: E
Bloom's Rank: Knowledge
Section: The History of Antimicrobial Agents
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9) The most limited group of antimicrobial agents is the __________ drugs.
A) antibacterial
B) antifungal
C) anthelmintic
D) antiviral
E) antiprotozoan
Answer: D
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
10) Another term for the Kirby-Bauer test is the
A) minimum inhibitory concentration test.
B) E test.
C) diffusion susceptibility test.
D) minimum bactericidal concentration test.
E) broth dilution test.
Answer: C
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
11) Which of the following statements about the zone of inhibition is FALSE?
A) It is measured as a diameter.
B) The larger the zone, the more resistant the organism is.
C) It is a clearing zone with no growth.
D) It is a result of diffusion of the drug out of the paper disk.
E) It is measured after incubation.
Answer: B
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
12) Which of the following groups of drugs can become incorporated into the bones and teeth of
a fetus?
A) beta-lactams
B) aminoglycosides
C) quinolones
D) tetracyclines
E) sulfonamides
Answer: D
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
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13) Which of the following can result when antibiotic therapy disrupts the normal microbiota?
A) anaphylactic shock
B) black hairy tongue
C) pseudomembranous colitis
D) thrush
E) both pseudomembranous colitis and thrush
Answer: E
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
14) Which of the following statements concerning development of antibiotic resistance is
FALSE?
A) It is often mediated by R-plasmids.
B) Resistant cells are normally in the minority in a bacterial population.
C) Resistant cells grow more efficiently and quickly than susceptible cells.
D) New resistance genes can be gained through transformation, transduction, or conjugation.
E) Resistance can occur through mutation of existing bacterial genes.
Answer: C
Bloom's Rank: Comprehension
Section: Resistance to Antimicrobial Drugs
15) β-lactamase production is an example of which of the following types of resistance?
A) alteration of the target of the drug
B) inactivation of the drug
C) change in the permeability of the drug
D) overproduction of an enzyme in a key metabolic pathway
E) removal of the drug via a pump
Answer: B
Bloom's Rank: Comprehension
Section: Resistance to Antimicrobial Drugs
16) Probiotics
A) involve microbial antagonism.
B) are an alternative to the use of chemotherapy.
C) involve the use of extracts from microorganisms.
D) is a term for resistance to antibiotics.
E) are an alternative to the use of chemotherapy involving microbial antagonism.
Answer: E
Bloom's Rank: Comprehension
Section: Resistance to Antimicrobial Drugs
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17) Most drugs that inhibit the synthesis of the cell wall act by
A) preventing the cross-linkage of NAM subunits.
B) blocking the secretion of cell wall molecules from the cytoplasm.
C) preventing the formation of alanine-alanine bridges.
D) disrupting the formation of the mycolic acid layer of the cell wall.
E) preventing the formation of β-lactamases.
Answer: A
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
18) Most broad-spectrum antibiotics act by
A) inhibiting the synthesis of the cell wall.
B) inhibiting protein synthesis.
C) inhibiting nucleic acid synthesis.
D) inhibiting metabolic pathways.
E) disrupting the cytoplasmic membrane.
Answer: B
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
19) Which of the following antifungals works by inhibiting ergosterol synthesis?
A) fluconazole
B) turbinafine
C) amphotericin B
D) nystatin
E) both fluconazole and turbinafine
Answer: E
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
20) Sulfonamides
A) are antimetabolic drugs.
B) were the first widely used antimicrobial drugs.
C) indirectly inhibit the synthesis of nucleic acids.
D) are no longer widely used.
E) were the first widely used antimetabolic antimicrobial and indirectly inhibit nucleic acid
synthesis.
Answer: E
Bloom's Rank: Comprehension
Section: History of Antimicrobial Agents
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21) Which of the following pathways is specifically inhibited by sulfonamides?
A) the conversion of tetrahydrofolic acid to PABA
B) the conversion of PABA to dihydrofolic acid
C) the conversion of dihydrofolic acid to tetrahydrofolic acid
D) the conversion of PABA to tetrahydrofolic acid
E) the conversion of dihydrofolic acid to PABA
Answer: B
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
22) Which of the following drugs inhibits nucleic acid synthesis specifically in prokaryotes?
A) quinolones
B) actinomycin
C) rifampin
D) tetracycline
E) 5-fluorocytosine
Answer: A
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
23) The cooperative activity of drugs such as beta-lactam antibiotics and clavulanic acid, a βlactamase inhibitor, is known as
A) cross resistance.
B) antimetabolism.
C) synergism.
D) selective toxicity.
E) chemotherapy.
Answer: C
Bloom's Rank: Knowledge
Section: Resistance to Antimicrobial Drugs
24) Alterations in the structure of which of the following are an important aspect of Gramnegative bacterial resistance to antimicrobial drugs?
A) plasmids
B) porins
C) mitochondria
D) cytoplasmic membrane
E) ribosomes
Answer: B
Bloom's Rank: Knowledge
Section: Resistance to Antimicrobial Drugs
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25) It is inappropriate to prescribe antibacterial agents to treat colds or flu because
A) the microbes involved can develop resistance rapidly.
B) these diseases are transmitted by endospores, which are hard to kill.
C) these diseases exhibit cross resistance.
D) these diseases are caused by viruses.
E) these diseases can act synergistically with each other.
Answer: D
Bloom's Rank: Knowledge
Section: Resistance to Antimicrobial Drugs
26) Who discovered the first widely available antibiotic?
A) Domagk
B) Ehrlich
C) Fleming
D) Waksman
E) Ehrlich and Waksman
Answer: A
Bloom's Rank: Knowledge
Section: The History of Antimicrobial Agents
27) Which of the following statements is true of selective toxicity?
A) Selective toxicity takes advantage of structural differences between host and pathogen.
B) To be effective, an antimicrobial agent must be more toxic to the patient than the pathogen.
C) Selective toxicity takes advantage of metabolic differences between host and pathogen.
D) Antimicrobial agents must target structural differences between host and pathogen and be
more toxic to the patient than the pathogen.
E) Selective toxicity takes advantage of structural and/or metabolic differences between host and
pathogen.
Answer: E
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
28) Antimicrobials that block protein synthesis by binding to the mRNA are
A) aminoglycosides.
B) antisense nucleic acids.
C) macrolides.
D) beta-lactams.
E) nucleic acid analogs.
Answer: B
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
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29) The Etest determines which of the following?
A) susceptibility
B) MBC
C) MIC
D) both susceptibility and MIC
E) both MBC and MIC
Answer: D
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
30) Which of the following is NOT a criterion by which all antimicrobial agents can be
evaluated?
A) their spectrum of action
B) their efficacy
C) their activity against cell walls
D) their route of administration
E) their safety
Answer: C
Bloom's Rank: Knowledge
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
31) Which of the following interferes with cell wall synthesis by blocking alanine bridge
formation?
A) beta-lactams
B) cycloserine
C) bacitracin
D) vancomycin
E) both cycloserine and vancomycin
Answer: E
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
32) Antimicrobial sugar analogs are effective for
A) preventing bacterial protein synthesis.
B) preventing cell membrane synthesis.
C) preventing virus attachment.
D) preventing nucleic acid synthesis.
E) blocking a metabolic pathway.
Answer: C
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
8
Copyright © 2012 Pearson Education, Inc.
33) Which of the following is a measurement associated with the broth dilution test?
A) the zone of inhibition
B) lack of turbidity
C) cell lysis
D) lack of turbidity and zone of inhibition
E) presence of turbidity and cell lysis
Answer: B
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
34) Infection of the __________ would be the hardest to treat with antimicrobial drugs.
A) heart
B) kidneys
C) liver
D) brain
E) colon
Answer: D
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
35) Disruption of the normal microbiota can result in infections caused by which of the
following microbes?
A) Mycobacterium
B) Candida albicans
C) Clostridium difficile
D) both Mycobacterium and Clostridium difficile
E) Candida albicans, Mycobacterium, and Clostridium difficile
Answer: E
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
36) The antimicrobials called quinolones act by
A) disrupting cytoplasmic membranes.
B) inhibiting cell wall synthesis.
C) inhibiting nucleic acid synthesis.
D) inhibiting a metabolic pathway.
E) inhibiting protein synthesis.
Answer: C
Bloom's Rank: Knowledge
Section: Mechanisms of Antimicrobial Action
9
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37) Amphotericin B is an antifungal drug that
A) inhibits protein synthesis.
B) inhibits nucleic acid synthesis.
C) blocks a metabolic pathway.
D) disrupts cytoplasmic membranes.
E) inhibits cell wall synthesis.
Answer: D
Bloom's Rank: Knowledge
Section: Mechanisms of Antimicrobial Action
38) The mechanism of action of the antibiotic vancomycin is
A) inhibition of protein synthesis.
B) inhibition of cell wall synthesis.
C) inhibition of nucleic acid synthesis.
D) inhibition of a metabolic pathway.
E) disruption of cytoplasmic membranes.
Answer: B
Bloom's Rank: Knowledge
Section: Mechanisms of Antimicrobial Action
39) The tetracyclines interfere with
A) protein synthesis.
B) cell wall synthesis.
C) cell membrane component synthesis.
D) nucleic acid synthesis.
E) folic acid synthesis.
Answer: A
Bloom's Rank: Knowledge
Section: Mechanisms of Antimicrobial Action
40) Trimethoprim is an example of antimicrobials that
A) disrupt cytoplasmic membranes.
B) inhibit cell wall synthesis.
C) inhibit nucleic acid synthesis.
D) inhibit metabolic pathways.
E) inhibit protein synthesis.
Answer: D
Bloom's Rank: Knowledge
Section: Mechanisms of Antimicrobial Action
10
Copyright © 2012 Pearson Education, Inc.
41) The mechanism of action of erythromycin is
A) inhibition of protein synthesis.
B) inhibition of cell wall synthesis.
C) inhibition of nucleic acid synthesis.
D) inhibition of a metabolic pathway.
E) disruption of cytoplasmic membranes.
Answer: A
Bloom's Rank: Knowledge
Section: Mechanisms of Antimicrobial Action
42) Methicillin is an example of the beta-lactam class of drugs that
A) disrupt cytoplasmic membranes.
B) inhibit cell wall synthesis.
C) inhibit nucleic acid synthesis.
D) inhibit metabolic pathways.
E) inhibit protein synthesis.
Answer: B
Bloom's Rank: Knowledge
Section: Mechanisms of Antimicrobial Action
43) Ribavirin is an antiviral that interferes with
A) protein synthesis.
B) cell wall synthesis.
C) cell membrane component synthesis.
D) nucleic acid synthesis.
E) viral attachment.
Answer: D
Bloom's Rank: Knowledge
Section: Mechanisms of Antimicrobial Action
44) The antimicrobial polymyxin
A) inhibits protein synthesis.
B) inhibits nucleic acid synthesis.
C) blocks a metabolic pathway.
D) disrupts cytoplasmic membranes.
E) inhibits cell wall synthesis.
Answer: D
Bloom's Rank: Knowledge
Section: Mechanisms of Antimicrobial Action
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Copyright © 2012 Pearson Education, Inc.
45) The mechanism of action of sulfonamides is
A) inhibition of metabolic pathways.
B) inhibition of cell wall synthesis.
C) inhibition of nucleic acid synthesis.
D) disruption of cytoplasmic membranes.
E) inhibition of protein synthesis.
Answer: A
Bloom's Rank: Knowledge
Section: Mechanisms of Antimicrobial Action
10.2 True/False Questions
1) Paul Erhlich coined the term antibiotics for the "magic bullet" antimicrobials he pursued.
Answer: FALSE
Bloom's Rank: Knowledge
Section: The History of Antimicrobial Agents
2) Antisense nucleic acids are designed to have no side effects against humans.
Answer: TRUE
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
3) Beta-lactam drugs act by inhibiting formation of the cytoplasmic membrane.
Answer: FALSE
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
4) Because all cells engage in protein synthesis, there are few antimicrobial drugs that selectively
inhibit this process.
Answer: FALSE
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
5) Many antimicrobial drugs that affect the cytoplasmic membrane are used only externally
because they can be toxic to humans.
Answer: TRUE
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
6) Some bacterial cells are resistant to a variety of antimicrobials because they actively pump the
drugs out of the cell.
Answer: TRUE
Bloom's Rank: Comprehension
Section: Resistance to Antimicrobial Drugs
12
Copyright © 2012 Pearson Education, Inc.
7) The outer membrane of Gram-negative bacteria enables many antimicrobial drugs to enter the
cell more easily.
Answer: FALSE
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
8) If a subculture of an MIC test grows in an MBC test, the concentration of the drug was
bactericidal.
Answer: FALSE
Bloom's Rank: Application
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
9) Brain and spinal cord infections are difficult to treat because most antimicrobial drugs cannot
diffuse out of the blood into these organs.
Answer: TRUE
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
10) Organs that are commonly affected by drug toxicity include the kidneys and the liver.
Answer: TRUE
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
10.3 Short Answer Questions
1) Any drug that acts against a disease is called a(n) __________ agent.
Answer: chemotherapeutic
Bloom's Rank: Knowledge
Section: The History of Antimicrobial Agents
2) Selective __________ means that a given antimicrobial agent is more toxic to a pathogen than
to the host being treated.
Answer: toxicity
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
3) Nucleotide or nucleoside __________are antimicrobial agents that mimic the chemical
structure of DNA building blocks.
Answer: analogs
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
4) A broad-spectrum __________ is effective against a wide variety of pathogens.
Answer: drug
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
13
Copyright © 2012 Pearson Education, Inc.
5) Secondary infections that result from the killing of the normal microbiota are called
__________.
Answer: Superinfections
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
6) Competition between beneficial microbes and potential pathogens is called microbial
__________.
Answer: antagonism
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
7) A(n) __________ concentration of a drug is one at which microbes survive but are not able to
grow and reproduce.
Answer: bacteriostatic
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
8) R-plasmids are __________ pieces of DNA that promote horizontal transfer of genes among
bacteria and contribute to the spread of antimicrobial resistance.
Answer: extrachromosomal
Bloom's Rank: Knowledge
Section: Resistance to Antimicrobial Drugs
9) Some bacteria develop resistance to groups of drugs because the drugs are all structurally
similar to each other; this is a phenomenon known as __________ resistance.
Answer: cross
Bloom's Rank: Comprehension
Section: Resistance to Antimicrobial Drugs
10) Second-generation drugs are semisynthetic drugs developed to combat __________ against
an existing drug.
Answer: resistance
Bloom's Rank: Comprehension
Section: Resistance to Antimicrobial Drugs
11) Drugs that slow down bacterial growth would be __________ to penicillin.
Answer: antagonistic
Bloom's Rank: Comprehension
Section: Resistance to Antimicrobial Drugs
12) External infections can be treated by __________ administration, in which a drug is applied
directly to the site of infection.
Answer: topical
Bloom's Rank: Comprehension
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
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13) The abbreviation __________ stands for the smallest amount of a drug that will inhibit the
growth and reproduction of a pathogen. (Be sure to use all capital letters.)
Answer: MIC
Bloom's Rank: Knowledge
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
14) Antiviral medications frequently block unique __________ to prevent production of new
virus.
Answer: enzymes
Bloom's Rank: Comprehension
Section: Mechanisms of Antimicrobial Action
15) Praziquantel alters the cytoplasmic membrane permeability of __________ worms.
Answer: parasitic
Bloom's Rank: Knowledge
Section: Mechanisms of Antimicrobial Action
10.4 Essay Questions
1) Why can microbial resistance to antibiotics and other drugs be considered a primarily genetic
phenomenon?
Answer: Microbial resistance is considered a genetic phenomenon because there are two major
ways that bacteria acquire resistance: through mutations of chromosomal genes or through
acquisition of new genes carried on R-plasmids. In both cases, the cell gains the ability to resist
the activity of a particular drug through the modified structure or activity of proteins that are
coded for by the genes in question. For example, some of these altered proteins can be
cytoplasmic membrane proteins or porin proteins that no longer allow a drug such as penicillin to
enter the cell. Also, some of the proteins coded for by these genes may be enzymes of various
sorts that serve to inactivate a particular drug, such as the inactivation of beta-lactam antibiotics
by β-lactamases.
Furthermore, these altered genes and proteins are then heritable by the offspring of the cell that
acquired the resistance, leading quickly to entire populations of bacteria or other microbes that
are resistant to a drug. When selective pressure is then brought to bear (through the
administration of a particular drug) on a population that contains both susceptible and resistant
cells, the result is that the susceptible cells die off, leaving the resistant cells to grow and
flourish.
Bloom's Rank: Application
Section: Resistance to Antimicrobial Drugs
15
Copyright © 2012 Pearson Education, Inc.
2) Discuss the cellular factors that might make a drug's spectrum of action narrow rather than
broad.
Answer: When a drug is labeled "narrow-spectrum," meaning that it has activity against only a
limited number of microbes, generally the reason is that many microbes possess some form of
natural resistance against the drug. For example, many drugs work better against Gram-positive
organisms than Gram-negative ones because Gram-negative cells possess an outer membrane
that does not allow these drugs to enter the cell as readily as they enter Gram-positive cells.
Other cellular factors that can have an effect on the spectrum of action of a particular drug
include the presence of R-plasmids in the cell that carries resistance genes, the presence of
altered cytoplasmic membrane or cell wall proteins that prevent the passage of some types of
drugs, and alterations in a cell's metabolic pathways, which can make the cell more resistant to
certain types of drugs.
Other antimicrobials have a narrow spectrum of action because they target a metabolic or
structural feature unique to a single pathogen or small group of pathogens. One example of this
type of narrow-spectrum antimicrobial is antisense RNA, which complements a specific
nucleotide sequence that may be present in only one pathogen. Another example is isonizid
which blocks the synthesis of a cell wall component unique to the Mycoplasmas.
Bloom's Rank: Application
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
3) Explain the concept of selective toxicity.
Answer: Selective toxicity is the underlying principle supporting Ehrlich's idea of the "magic
bullet." This simply means that the most effective antimicrobial drugs are those that target some
difference in a cellular structure or metabolic process between the host/patient cell and the target
microbe. Conversely, the more similar the host cell and the microbe are, the harder it is to
selectively attack just the microbe. Drugs that do not differentiate very well between types of
cells are generally more toxic to the host than those that are more selective. This is most striking
in the case of antiviral drugs, which are generally poor magic bullets because the virus is
dependent on the host cell for all aspects of its growth. Those drugs that successfully inactivate
the virus sometimes also end up damaging or even killing the cell.
Bloom's Rank: Application
Section: Mechanisms of Antimicrobial Action
4) Examine the diffusion susceptibility plate results shown in Figure 10.9. Propose an
explanation for the appearance of the zone around the AM/10 disk, and discuss the implications
for therapeutic use of this antibiotic for the pathogen tested.
Answer: The ring of colonies within the outermost limit of the zone of inhibition indicates that
there are some cells in the population that are less susceptible to the antibiotic than the rest. If
this antibiotic were used to treat an infection with this population, the growth of bacteria with
some resistance would be promoted at the expense of the more susceptible cells, potentially
giving rise to a new variant that is fully resistant. If this were to occur in a patient being treated,
the antibiotic therapy would fail, putting the patient's health at risk. Therefore drug AM would be
a poor choice, perhaps the poorest choice, for chemotherapy against this bacterial species.
Bloom's Rank: Application
Section: Clinical Considerations in Prescribing Antimicrobial Drugs
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5) Explain why many antibiotics are effective only against cells that are actively growing and
reproducing.
Answer: When cells are not actively growing and reproducing, they are not synthesizing many
of their component molecules or structures. Because many antimicrobial drugs inhibit the
synthesis of structures such as the cell wall or interfere with various metabolic pathways, cells
that are not actively doing one or both of these activities will be naturally more resistant to these
drugs. For example, as bacterial cells age or become dormant, they cease to synthesize molecules
such as peptidoglycan; therefore, drugs such as penicillin, which act by inhibiting peptidoglycan
synthesis, have no effect on these cells. Additionally, as cells age, they may modify or cease
certain metabolic pathways. Drugs that target these pathways will thus lose their effectiveness.
Bloom's Rank: Application
Section: Mechanisms of Antimicrobial Action
17
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