A 73-year-old male smoker with moderate to severe chronic obstructive pulmonary disease (COPD) (FEV1 50% predicted) was admitted to A & E Department with an acute exacerbation of COPD for the fifth time this year. He presented to A & E doctor with fever, increased productive cough and shortness of breath. Upon admission to the ward, chest x-ray revealed an infiltrates. From his previous medical record, the doctor noticed the detection of Pseudomonas aeruginosa in his prior exacerbations.

a) Which class of antibiotics is the drug of choice to be given to the patient? Name the antibiotic and state the route of administration. (3 marks)

b) What is the mechanism of action for this antibiotic? (5 marks)

c) List FOUR common adverse effects. (2 marks)

d) Name TWO potential drug-drug interactions associated with this class of antibiotics and explain the mechanism of such drug-drug interaction involved. (4 marks)

e) State the mechanism of resistance which may develop with the antibiotic used? (4 marks)

f) State FOUR reasons for the increase in prevalence of antibiotic resistance over the years. (2 marks)