Antibiotics

Class MOA Common

Contra- Monitoring
& & How Supplied Administration Adverse
indications Parameters
Categories & Examples Indications Effects
Penicillin Inhibits cell wall Oral (tablet, Time dependent Rash Allergy Efficacy
synthesis capsule, chewable, not concentration GI: N/V/D s/sx
Natural penicillins solutions, (scheduled time Generally well- improvement
penicillin (Veetids) Indications: suspensions) intervals necessary = tolerated
Aminopenicillins Gram (+) Parenteral (IM or less variation in Safety
amoxicillin (Amoxil) Gram (-) IV) peak & trough blood Allergic rxn
Extended spectrum Anaerobes levels) Rash
ticarcillin (Ticar) Oral: suspension can GI
Penicillinase-resistant be mixed w/other
dicloxacillin (Dynapen) liquids (formula,
milk, water, juice)
Oral: may be taken
with food
Cephalosporins Inhibits cell wall Oral (tab, capsule, Time dependent Rash Allergy Efficacy
(structurally & functionally synthesis chewable, not concentration GI: N/V/D Cross- s/sx
similar to penicillins) solutions, (scheduled time Generally well- reactivity improvement
Indications: suspensions) intervals necessary = tolerated (need to
1st generation Gram (+) Parenteral (IM or less variation in caution those Safety
cephalexin (Keflex) Gram (-) IV) peak & trough blood w/penicillin Allergic rxn
2nd generation Anaerobes levels) allergies of Rash
cefuroxime (Ceftin) Oral: suspension can very small GI
3rd generation be mixed w/other chance)
ceftriaxone liquids (formula,
(Rocephin) milk, water, juice)
4th generation (have Oral: may be taken
broader spectrum of with food
activity)
cefepime (Maxipime)

*each newer generation
tends to have greater Gram
(-) activity than preceding

L. Trotman, 1
 Antibiotics

Class MOA Common

Contra- Monitoring
& & How Supplied Administration Adverse
indications Parameters
Categories & Examples Indications Effects
Vancomycin Inhibits cell wall Oral: only for Oral: may be taken IV Renal Efficacy
synthesis Clostridium (only w/food Red man impairment Vanco levels
(Vancocin) works in gut) IV: infusion over at syndrome (NOT Concomitant s/sx improvement
Indications: IV least 60 mins allergy: occurs nephrotoxic
Narrow if infused too or ototoxic Safety
spectrum rapidly) meds Vanco levels
Gram (+) only Nephrotoxicity Renal fxn
Clostridium (C. Ototoxicity
dif)
Sulfonamides Blocks nutrient Oral (tab or Oral: take w/8oz Rash Allergy Efficacy
use suspension) water GI: Pregnancy s/sx management
sulfamethoxazole/ IV IV: must dilute & N/V/anorexia
trimethoprim (Bactrim, Indications: Topical infuse over 60-90 Safety
Septra) Gram (+) mins Allergic rxn
Enteric Gram Rash
(-) GI
Atypicals
Macrolides Inhibits protein Oral Oral: must check GI: N/V/D Allergy Efficacy
synthesis IV each if can be taken (direct irritant, Drug s/sx improvement
azithromycin (Zithromax) Topical (gel or w/food GI motility) interactions
clarithromycin (Biaxin) Indications: ointment) (CYP3A4) Safety
erythromycin (Ery-tab) Gram (+) QT Allergic rxn
Non-enteric prolongation GI
Gram (-) & ventricular
Atypicals arrhythmias
Tetracyclines Inhibits protein Oral Oral: take w/8oz GI: N/V/D Children 8 Efficacy
synthesis IV water & food Photosensitivity y/o s/sx
doxycycline (Doryx) IV: central line & slow Tooth Pregnancy improvement
Indications: b/c irritating to veins discoloration (in Allergies rare
Gram (+) children) Safety
Enteric Gram GI
(-)
Atypicals

L. Trotman, 2
 Antibiotics

Class MOA Common

Contra- Monitoring
& & How Supplied Administration Adverse
indications Parameters
Categories & Examples Indications Effects
Aminoglycosides Inhibits protein IV Topical: no contact Nephrotoxicity Renal Efficacy
synthesis Topical lenses Ototoxicity impairment Drug levels
gentamicin (Gentak) (ophthalmically) Inhalation: by (auditory or Concomitant (depends on size,
tobramycin (Tobrex) Indications: Inhalation nebulizer vestibular) neurotoxic or weight)
Narrow Not absorbed Neurotoxicity nephrotoxic s/sx
spectrum orally (vertigo, ataxia, meds improvement
Gram (+) gait instability)
Safety
Drug levels
Renal fxn
Hearing tests
(before, during &
after treatment
esp. for those on it
for >2 wks
Fluoroquinolones Interferes Oral Oral: avoid antacids, GI: N/D Children <18 Efficacy
w/DNA IV but take w/food for Insomnia y/o s/sx
ciprofloxacin (Cipro) Topical GI distress; separate Pregnancy improvement
Indications: from Ca2+, Fe, Zn Renal
Gram (-) IV: infuse over 60 impairment Safety
Atypicals mins (too rapid = QT GI
Some hypotension) prolongation Renal fxn
anerobes Topical: no contacts
Some Gram (if for eyes)
(+)
Metronidazole Interferes Oral Oral: avoid alcohol GI: nausea, Pregnancy Efficacy
w/DNA IV during & for 72 hrs metallic taste, (esp. 1st s/sx improvement
(Flagyl) Topical (vaginal) after completing abdominal trimester)
Indications: therapy, take w/food cramping Alcohol Safety
Anaerobes for GI distress (can Vaginal: GI
Protozoa cause intense irritation, Vaginal
vomiting, severe discharge,
flushing, HA, nausea) candidiasis
(yeast
infection)

L. Trotman, 3