Antibiotic amoxicillin -rocephin

Amoxicillin

Aminopenicillin; beta-lactam antibiotic.

Amoxicillin mechanism of action

Inhibits bacterial cell wall synthesis by binding to PBPs; bactericidal.

Amoxicillin adult dosing

250–500 mg PO q8h OR 500–875 mg PO q12h (max 4 g/day).

Amoxicillin pediatric dosing

20–40 mg/kg/day PO divided q8h OR 25–45 mg/kg/day PO divided q12h.

Indications for Amoxicillin

Otitis media, sinusitis, pharyngitis, RTIs, UTIs, H. pylori, Lyme disease, skin infections.

Common side effects of Amoxicillin

Diarrhea, N/V, rash, headache, oral/vaginal candidiasis.

Severe side effects of Amoxicillin

Anaphylaxis, SJS/TEN, C. diff colitis, hemolytic anemia, hepatitis, seizures.

Drug interactions with Amoxicillin

↓ effectiveness of oral contraceptives, ↑ INR with warfarin, ↑ methotrexate toxicity, reduced clearance with probenecid.

Monitoring for Amoxicillin

Allergy check, renal function, LFTs, CBC with prolonged use.

Amoxicillin pregnancy category

Category B.

Augmentin

Amoxicillin + Clavulanate; aminopenicillin + beta-lactamase inhibitor.

Augmentin mechanism of action

Amoxicillin inhibits cell wall synthesis; clavulanate inhibits beta-lactamase.

Augmentin adult dosing

500/125 mg PO q8h OR 875/125 mg PO q12h; XR: 2 g PO q12h.

Augmentin pediatric dosing

25–45 mg/kg/day PO divided q12h (max 90 mg/kg/day).

Indications for Augmentin

Otitis media, sinusitis, CAP, bronchitis, UTI, SSTI, bite wounds.

Common side effects of Augmentin

Diarrhea (esp. clavulanate), N/V, rash, candidiasis, ↑ LFTs.

Severe side effects of Augmentin

Anaphylaxis, hepatotoxicity, C. diff colitis, SJS/TEN, cholestatic jaundice.

Drug interactions with Augmentin

↓ OCP effectiveness, ↑ INR with warfarin, ↑ methotrexate toxicity, probenecid ↑ levels.

Monitoring for Augmentin

LFTs, renal function, CBC, signs of hypersensitivity or diarrhea.

Augmentin pregnancy category

Category B.

Keflex (Cephalexin)

First-generation cephalosporin; oral beta-lactam antibiotic.

Keflex mechanism of action

Inhibits bacterial cell wall synthesis; bactericidal.

Keflex adult dosing

250–500 mg PO q6h (max 4 g/day).

Keflex pediatric dosing

25–50 mg/kg/day PO divided q6–8h (max 4 g/day).

Indications for Keflex

Skin infections, strep throat, UTI, bone/joint infections, endocarditis prophylaxis.

Common side effects of Keflex

Diarrhea, N/V, rash, dyspepsia, headache, dizziness.

Severe side effects of Keflex

Anaphylaxis, SJS/TEN, C. diff, hemolytic anemia, interstitial nephritis, seizures.

Drug interactions with Keflex

↑ INR with warfarin, ↑ nephrotoxicity with aminoglycosides/loops, ↑ levels with probenecid.

Monitoring for Keflex

Allergy check, renal function, CBC if prolonged therapy, monitor for diarrhea/rash.

Keflex pregnancy category

Category B.

Septra DS (SMX/TMP)

Sulfonamide antibiotic + folate synthesis inhibitor.

Septra DS mechanism of action

SMX inhibits dihydropteroate synthase; TMP inhibits dihydrofolate reductase; synergistic bactericidal effect.

Septra DS adult dosing

1 DS tab (800/160 mg) PO q12h; IV 8–10 mg/kg/day (TMP component) divided q6–12h.

Septra DS pediatric dosing

8–12 mg/kg/day (TMP component) PO divided q12h.

Indications for Septra DS

UTI, MRSA SSTI, PCP prophylaxis/treatment, shigellosis, traveler’s diarrhea, otitis media, bronchitis.

Common side effects of Septra DS

Rash, photosensitivity, N/V/D, hyperkalemia, ↑ creatinine, anorexia.

Severe side effects of Septra DS

SJS/TEN, agranulocytosis, aplastic anemia, hepatitis, renal failure, hemolysis (G6PD), aseptic meningitis.

Drug interactions with Septra DS

↑ INR with warfarin, ↑ phenytoin levels, ↑ methotrexate toxicity, ↑ risk hyperkalemia with ACEI/ARB, ↓ cyclosporine levels.

Monitoring for Septra DS

CBC, renal function, electrolytes (esp. K+), monitor for rash or hematologic toxicity.

Septra DS pregnancy category

Category D (avoid near term).

What type/classification is Rocephin (Ceftriaxone)?

Third-generation cephalosporin; IV/IM beta-lactam antibiotic.

: What is Rocephin’s mechanism of action?

Inhibits bacterial cell wall synthesis via PBPs; broad spectrum, bactericidal.

: What is Rocephin’s adult dosing?

1–2 g IV/IM q12–24h (max 4 g/day); meningitis: 2 g q12h; gonorrhea: 500 mg IM once

What is Rocephin’s pediatric dosing?

50–100 mg/kg/day IV/IM q12–24h (max 4 g/day); meningitis: 100 mg/kg/day divided q12h.

What are indications for Rocephin?

Meningitis, CAP, pyelonephritis, PID, gonorrhea, sepsis, Lyme disease, bone/joint infection.

What are common side effects of Rocephin?

Diarrhea, injection site pain, rash, ↑ LFTs, eosinophilia, thrombocytosis.

What are severe side effects of Rocephin?

Anaphylaxis, C. diff, biliary sludging, hemolytic anemia, seizures, SJS; contraindicated with calcium in neonates.

What are Rocephin’s drug interactions?

↑ INR with warfarin, ↑ levels with probenecid; do NOT mix with calcium solutions (neonates risk death).

What monitoring is required for Rocephin?

Allergy check, CBC, LFTs, PT/INR, renal function, monitor for biliary sludging.

: What is Rocephin’s pregnancy category?

Category B.