Patient Antiretroviral Therapy, Case Study Example

Considering the patient’s history with methamphetamine I would suggest stopping AZT (Zidovudine) and Lamivudine. This is further precipitated by the patient’s side effects such as SOB (Shortness of breath) and blurred vision. Further reasons for stopping Lamivudine is the fact that the patient’s tuberculin skin test elicited a weak PPD reaction. This indicates that the patient has not been exposed to Tuberculosis (TB) and therefore there is no need for continued use of Lamivudine

Considering the unprecedented increase in the Viral Load, i.e. an increase from HBV DNA of 100 copies/ml to 100,000 copies/ml, there is adequate proof to show increase in the Hepatitis C virus. The elevated levels of ALT suggest possible viral hepatitis and liver damage (Montaner, J., & British Columbia Centre for Excellence in HIV/AIDS, 2012). Owing to these test results, it is essential that the patient stops using AZT (Zidovudine) and Lamivudine as they are known to cause liver damage.

Owing to the patient showing evidence of carbapenem-resistant Klebsiella, there is need for combination drug therapy (Leavitt, 2010). This is because the normal drug therapy combinations would not work. The suggested combination drug therapy would be the use of Tygacil (Tigecycline) together with Polymixin (Leavitt, 2010). This drug therapy combination has been clinically proven to be effective against carbapenem-resistant Klebsiella.

Tigecycline will be administered through intravenous intrusions within a time frame of 30 to 60 minutes. The first dose will 100 mg and this will be accompanied by 50 mg after every 12 hours. This will be used with the regular dosage of Polymixin or Polymixin B while maintaining the use of Saquinavir.

References

Leavitt, A. (2010). Carbapenem resistance in Klebsiella pneumoniae. Thesis/Dissertation, Tel Aviv.

Montaner, J., & British Columbia Centre for Excellence in HIV/AIDS. (2012). Therapeutic guidelines: Antiretroviral treatment (ARV) of adult HIV infection, as of January 2011. Vancouver: British Columbia Centre for Excellence in HIV/AIDS.

Sax, P. E., Cohen, C. J., Kuritzkes, D. R., & UC Medical Humanities Consortium. (2012). HIV essentials. Burlington: Jones & Bartlett Learning.

Scheld, W. M. (2007). Emerging infections: 7. Washington: ASM.