Antibioti

cs
Clas
s&
Categories &
Examples
Penicillin

MO
A
&
Inhibits
cell
Indicatio

wall synthesis

Natural penicillins
Indications:
penicillin (Veetids)
Gram (+)
Aminopenicillins
Gram (-)
amoxicillin (Amoxil)
Anaerobes
Extended spectrum
ticarcillin (Ticar)
Penicillinase-resistant
dicloxacillin (Dynapen)
Cephalosporins
(structurally &
functionally similar to
penicillins)

1st generation

generation

cefuroxime (Ceftin)

Indications:
Gram (+)
Gram (-)
Anaerobes

Oral (tablet,
capsule,
chewable,
solutions,
suspensions)
Parenteral (IM
or IV)

Administratio
n

Oral (tab,
capsule,
chewable,
solutions,
suspensions)
Parenteral (IM
or IV)

3rd generation

cephalexin (Keflex)

2nd

Inhibits cell
wall synthesis

How
Supplied

ceftriaxon
e
(Rocephin)

4th
generation
(have
broader
spectrum
of
activity)

Time dependent
not concentration
(scheduled time
intervals
necessary = less
variation in peak
& trough blood
levels)
Oral: suspension
can be mixed
w/other liquids
(formula, milk,
water, juice)
Time dependent
not concentration
(scheduled time
intervals
necessary = less
variation in peak
& trough blood
levels)
Oral: suspension
can be mixed
w/other liquids
(formula, milk,
water, juice)
Oral: may be
taken with food

Comm
on
Advers
e
Rash
GI: N/V/D
Generally

Contra
indicatio
Allergy

Monitori
ng
Paramete
Efficacy

well- tolerated

s/sx
improveme
nt

Safety
Allergic rxn

Rash
GI: N/V/D
Generally
well- tolerated

Allergy
Cross-
reactivity
(need to
caution
those
w/penicillin
allergies of
very small
chance)

Rash
GI

Efficacy
s/sx
improveme
nt
Safety
Allergic rxn

Rash
GI

L. Trotman,
1

Clas
s&
Categories &
Examples
Vancomycin
(Vancocin)

Sulfonamides
sulfamethoxazole/
trimethoprim
(Bactrim, Septra)

Macrolides
azithromycin
(Zithromax)

clarithromycin (Biaxin)
erythromycin (Ery-tab)
Tetracyclines
doxycycline (Doryx)

MO
A
&
Inhibits
cell
Indicatio

wall synthesis
Indication
s: Narrow
spectrum
Gram (+) only
Clostridium
(C. dif)
Blocks
nutrient use
Indications:
Gram (+)

Enteric
Gram (-)
Atypicals
Inhibits
protein
synthesis

How
Supplied

Indications:
Gram (+)

Oral: only for

Clostridium
(only works in
gut)
IV

Oral (tab
or
suspensio
n)
IV

Administratio
n

Oral: may be
taken w/food
IV: infusion over
at least 60 mins

Oral: take
w/8oz water
IV: must dilute
& infuse over
60-90 mins

IV

Comm
on
Advers
e
Red man
syndrome
(NOT allergy:
occurs if
infused too
rapidly)
Nephrotoxicity
Ototoxicity
Rash
GI:
N/V/anorexi
a

Indications:
Gram (+)

Enteric
Gram (-)

indicatio

Oral
IV

Topical (gel
or ointment)

Oral: must
check each if
can be taken
w/food

GI: N/V/D
(direct
irritant,
GI motility)

Oral

IV

Oral: take
w/8oz water &
food
IV: central line &
slow b/c irritating
to veins

GI: N/V/D
Photosensitivit

Tooth
discoloration
(in children)

Monitori
ng
Paramete
Efficacy

Vanco levels
s/sx
improvement

Safety
Vanco levels

Renal fxn

Efficacy
s/sx
management
Safety
Allergic rxn

Renal
impairme
nt
Concomita
nt
nephrotoxi
c or
ototoxic
meds
Allergy
Pregnancy

Topical

Non-
enteric
Inhibits
protein
synthesis

Contra

Allergy
Drug
interactio
ns
(CYP3A4)
QT
prolongatio
n&
Children
8 y/o
Pregnancy
Allergies
rare

Rash
GI
Efficacy
s/sx

improvement

Safety
Allergic rxn

GI

Efficacy
s/sx
improveme
nt
Safety
GI

Clas
s&
Categories &
Examples
Aminoglycosides
gentamicin (Gentak)
tobramycin (Tobrex)

Fluoroquinolones
ciprofloxacin (Cipro)

MO
A
&
Inhibits
Indicatio
protein
synthesis

Indication
s: Narrow
spectrum
Gram (+)

Interferes
w/DNA
Indications:
Gram (-)
Atypicals

How
Supplied

IV
Topical
(ophthalmicall
y)
Inhalation
Not
absorbed
orally

Oral

Metronidazole
(Flagyl)

Indications:
Anaerobes

Protozoa

nebulizer

IV
Topical

Some
anerob
es
Some
Interferes
w/DNA

Comm
Contra
Administratio
on
n
Advers
indicatio
e
Topical: no
Nephrotoxicity
Renal
contact lenses
impairme
Ototoxicit
nt
Inhalation:
y
Concomita
by
(auditory

Oral
IV
Topical (vaginal)

Oral: avoid
antacids, but
take w/food for
GI distress;
separate from
Ca2+, Fe, Zn
IV: infuse over
60 mins (too
rapid
=
hypotension)
Oral: avoid
alcohol during &
for 72 hrs after
completing
therapy, take
w/food for GI
distress (can
cause intense
vomiting, severe
flushing, HA,

nt
neurotoxic
or
nephrotoxi
c meds

or
vestibular
)
Neurotoxicity
(vertigo,
ataxia, gait
instability)

GI: N/D
Insomnia

GI: nausea,
metallic
taste,
abdominal
cramping
Vaginal:
irritation,
discharg
e,
candidias

Drug levels
(depends on
size, weight)
s/sx
improveme
nt

Safety
Drug levels

Renal fxn
Hearing tests

Monitori
ng
Paramete
Efficacy

Children
<18 y/o
Pregnancy
Renal
impairme
nt
QT
prolongati
on
Pregnan
cy (esp.
1st
trimeste
r)
Alcohol

(before, during
& after
Efficacy
s/sx
improveme
nt
Safety
GI

Renal fxn

Efficacy
s/sx
improvement
Safety
GI

Vaginal