Therapies+&+Treatments

====A 40 year old man suffering with Legionella Pneumophila is currently being treated with trimethoprim-Sultamethoxazole for his respiratory infection and abnormal liver and renal function. Because of the man’s age and abnormal liver and renal function, it would be better suited not to keep him on this course of antibiotics for too long a time as trimethoprim-Sultamethoxazole can cause severe liver damage and also renal impairment up to acute renal failure. (Cramer, 2003) So, the next class of antibiotics the patient will be put on is Macrolides; Azithromycin, Clarithromycin and Erythromycin. (Venkatesan, 1999) ====

====Azithromycin can be used to treat his bacterial infection, while Erythromycin can be given to him to treat his respiratory tract infection (is that not caused by bacteria?). And Clarithromycin will treat his mildly inflamed airways and pneumonia. The patient will also be given fluid and electrolytes intravenously administered through a drip and he will also be put on oxygen through a breathing machine or mask. (Equipment, 2008) ====

====If the patient builds a resistance to this class of antibiotics, or the symptoms persist or worsen, and become life-threatening to the patient, then they must be moved on to the class of antibiotics called the Quinolones, a group of potent synthetic antibiotics which are used to treat severe bacterial infections that have failed to respond to other antibiotics. Ciprofloxacin can be used to treat his respiratory tract infections and pneumonia, as can Moxifloxacin and Gatifloxacin, while Levofloxacin would be used to treat his bacterial infection. (Chemother, 2003), (Woodhead, 2001) ====

====While the patient is on this class of antibiotics, and as Levofloxacin is primarily eliminated by renal excretion, his renal function status must be taken into account and his serum levels must be monitored during therapy. This is to avoid an accumulation that may lead to a drug overdose. However, the antibiotic is also metabolised and partially cleared through the liver. This means that the dosage should be modified as he has impaired liver and renal functions. Duration or therapy and treatment will depend on his severity of the infection and the immunological competence of the patient. (Chemother, 2003) ====

**__References:__**
====Chemother, J. A. (2003). Legionnaires’ disease: a rational approach to therapy. //Journal of antimicrobial chemotheraphy//, 1119-1129. ====

====Equipment, I. W. (2008). //Chapter 1: Clinical Aspects of Legionnaires Disease//. Retrieved october 14, 2011, from Legionnaires Disease: http://www.legionnairesdisease.ie/legionnaires-chapter1.html#16 ====

====Woodhead, M. (2001). Treatment of Community-acquired Pneumonia. In T. J. Marrie, //Community Acquired Pneumonia// (pp. 163-175). New york: Kluwer Academic. ====

Good work, well written and well formatted list of reference. More depth on the treatment in term of mechanism of action would have greatly improved the work