Antibiotics and Antifungals

Antibiotics

Substance that destroys or inhibits the growth of other microorganisms

Bactericidial

Kills bacteria

Bacteriostatic

Slows the growth

General Information about Antibiotics

M- monitor for superinfections

E- evaluate renal and liver function

D- diarrhea (eat yogurt)

I- inform the provider of allergies

C- cultures before initial dose

A- no alcohol

T- take full course

E- evaluate cultures, WBC, and temp

Penicillin (PCN)

Used for pneumonia or meningitis, endocarditis, and GYN infections

-effective against a variety of bacteria

-Low toxicity

-Weakens bacterial cell wall

-Most common cause of drug allergy

Rash + Anaphylaxis

Penicillin Examples

-Amoxicillin-Clavulanic Acid (Augmentin)

-Ampicillin

-Penicillin V or G

Extended Spectrum:

-Pipercillin/tazobactam

-Ampicillin/sulbactam

Cephalosporin

Used for urinary infections, post-op infections, and prophylaxis

Nursing implementation:

-Cannot take with PCN

-Take on an empty stomach

-Monitor for a superinfection

Cephalosporin Examples

-Cefazolin (Ancef)

-Cephalexin (Keflex)

-Ceftriaxone (Rocephin)

Macrolide

Used to treat Legionnaires' disease, pertussis (whooping cough), H. pylori

Nursing implementation:

-Can be used if the patient has a PCN allergy

G- GI disturbance

I- IV site irritation

R- Reduces med activity if given with fruit juices and acid foods

L- Liver function tests needed

Macrolide Examples

-Erythromycin (E-mycin)

-Azithromycin (Zithromax)

Legionnaire's disease

Severe, often fatal, bacterial infection characterized by pneumonia and liver + kidney damage

Sulfonamides

Used to treat UTIs (E.coli caused), PCP (pneumonia r/t impaired immune systems)

Nursing Implementation:

-Crystalluria: encourage fluids (2-3L/day)

-Photosensitivity

-Monitor for Stevens-Johnson Syndrome

-Avoid alcohol: risk of a disulfiram-like reaction

S- Sunlight sensitivity

U- Undesirable effects: rash, renal toxicity

L- Look at urine output, fever, sore throat, and bleeding

F- Fluids

A- Anorexia and anemia

Sulfonamides Examples

-Trimethoprim-sulfamethoxazole (Bactrim)

-Co-trimaxozole (Septra)

Tetracycline

Used for severe acne, Lyme disease (Rickettsia), Anthrax, and STIs

Nursing implementation:

-Do not give to young children or pregnant women (stains teeth)

S- Sunlight sensitivity

T- Take with full glass of water

O- Avoid antacid, iron, milk

P- Put on an empty stomach

Tetracycline Examples

-Tetracycline hydrochloride (Sumycin)

-Doxycycline (Vibramycin)

Fluoroquinolones

Used as a broad-spectrum antibiotic

Nursing implementation:

Nervous system: tingling, dizziness, weakness, psychosis

-Caution with seizure disorders

Musculoskeletal: tendon rupture, joint swelling

CV: chest pain, tachycardia, prolonged QT interval, SOB

Fluoroquinolones Examples

Ciprofloxacin (Cipro)

Ofloxacin (Floxin)

Levofloxacin (Levaquin)

Aminoglycosides

Used for gram - bacteria, serious infections, and GI pre-op

Nursing implementation:

Neurological disorders:

-neuromuscular blockade

Ototoxicity:

-Tinnitus

Nephrotoxicity:

-monitor BUN/CR

-monitor peak and troughs

Aminoglycosides Examples

-Gentamicin (Garamycin)

-Tobramycin sulfate (Nebcin)

-Neomycin

Glycopeptides

-Multigenerational

Used to treat serious infections like MRSA and Pseudomembranous colitis (caused by C. diff)

Nursing Implementation:

Ototoxicity

Nephrotoxicity- Monitor BUN/CR

Infusion reaction- Red Man Syndrome

-Caution in Renal failure patients and monitor peak and troughs

Gylcopeptide Examples

-Vancomycin (Vancocin)

Red man syndrome

Rash on the upper body, pruritis, and hypotension caused by certain anti-infectives

-may occur when administered too fast

"Zole" Antifungals

Used to treat candidiasis, ringworm, yeast, athlete's foot, and thrush

Nursing Implementation:

-Itching

-Rash

-Contraindicated in pregnancy (decreases folic acid)

-Take with food

-Do not take with antacids

"ZOLE" Antifungal Examples

-Miconazole (Monistat)

-Clotrimazole (Lotrimin)

-Fluconazole (Diflucan)

-Ketoconazole (Nizoral)

-Nystatin (Mycostatin)

Amphotericin B

Used to treat systemic fungal infections

Nursing Implementation:

-Heart irregularities

-Nephrotoxicity

-Hypokalemia

-Thrombocytopenia

Antivirals

Used to treat Herpes and HIV

Nursing Implementation:

-Nephrotoxicity

-Thrombocytopenia

Antiviral Examples

-Acyclovir (Zovirax)

-Valacyclovir (Valtrex)

-Zidovudine (AZT)

Drug-resistant organisms

-MRSA

-VRE

MRSA

Methicillin-resistant Staphylococcus aureus

-most common drug-resistant organism

Treated using:

-Sulfamethoxazole/trimethoprim (Bactrim)

-Bactroban

-Nozin

-CHG Baths

-Vancomycin

VRE

Vancomycin-resistant enterococcus

Treated using:

-Linezolid (Zyvox)

Multi-drug resistant organisms (MDRO)

-VISA

-VRSA

VISA

Vancomycin Intermediate Staphylococcus aureus

Treated using:

-Linezolid (Zyvox)

VRSA

Vancomycin-resistant Staphylococcus aureus

-Contact the CDC

Treated using:

-Linezolid (Zyvox)