DCA Anti- Infective 11-20

cephalexin brand name

Keflex

cephalexin therapeutic class

First generation cephalosporin

cephalexin dosage forms

Oral suspension, Oral tablet, Oral capsule

cephalexin indications

Infection of skin and/or subcutaneous tissue
Osteomyelititis
Urinary tract infection
Impetigo

cephalexin mechanism of action

Cephalexin is a 1st-generation cephalosporin that inhibits bacterial wall synthesis by binding to penicillin-binding proteins. Primarily active against gram-positive bacteria

cephalexin counseling

• Complete full course of therapy

cephalexin adverse effects

"Common (>10%): Nausea, diarrhea

Rare but Serious (<1%): anemia, neutropenia, hypersensitivity"

cephalexin toxicity

Severe diarrhea, rash Hypersensitivity

cephalexin dosing

250 - 500 mg q 6 -12 hr

cephalexin pharmacology

Dose Adjustment RENAL: CrCl

cephalexin pearls

Approximately 3-5% of patients allergic to penicillins are also allergic to cephalosporins use with caution in patients with severe penicillin allergy"

cefuroxime brand name

Ceftin

cefuroxime therapeutic class

Second generation cephalosporin

cefuroxime dosage form

Oral tablet

cefuroxime indications

"Acute infective exacerbation of COPD
Sinusitis
Acute otitis media
Bronchitis Community Acquired Pneumonia
Pharyngitis, tonsillitis
Urinary tract infection (alternative agent)"

cefuroxime mechanism of action

"Cefuroxime is a 2nd generation cephalosporin who has activity against H.influenzae, including beta-lactamase producing strains
Its activity against anaerobes is poor, similar to the 1st-generation cephalosporins"

cefuroxime counseling

- Complete full curse of therapy

cefuroxime adverse effects

"Common (>10%): Nausea, Diarrhea
Rare but Serious (

cefuroxime toxicity

Severe diarrhea, rash

cefuroxime drug interaction

- Estrogen-based birth control products: Decreased efficacy of birth control

cefuroxime dosing

250 - 500 mg po BID

cefuroxime pharmacology

Dose Adjustment RENAL: CrCl < 30 mL/min

cefuroxime pearls

Approximately 3-5% of patients allergic to penicillins are also allergic to cephalosporins use with caution in patients with severe penicillin allergy"

cefdinir brand name

Omnicef

cefdinir therapeutic class

Third generation cephalosporin

cefdinir dosage

Oral suspension, Oral capsule

cefdinir indications

"Acute otitis media
Bronchitis
Community-acquired pneumonia
Acute infective exacerbation of COPD"

cefdinir mechanism of action

Cefdinir is a 3rd-generation cephalosporin with activity against a number of gram-positive and gram-negative bacteria, including beta-lactamase producing strains

cefdinir counseling

"- Complete full curse of therapy
- Separate from antacids, iron and vitamin products by at least 2 hours"

cefdinir adverse effects

"Common (>10%): Nausea, Diarrhea
Rare but Serious (

cefdinir toxicity

Severe diarrhea, rash

cefdinir drug interactions

- Antacids, iron, vitamins: decreased absorption

cefdinir dosing

300 mg po BID

cefdinir pharmacology

Dose Adjustment RENAL: CrCl

cefdinir pearls

Approximately 3-5% of patients allergic to penicillins are also allergic to cephalosporins use with caution in patients with severe penicillin allergy"

trimethoprim/sulfamethoxazole brand name

Bactrim, Septra

trimethoprim/sulfamethoxazole therapeutic class

Sulfonamide antibiotic

trimethoprim/sulfamethoxazole dosage forms

Oral tablet, Oral suspension, Injectable

trimethoprim/sulfamethoxazole indications

"Staphylococcal infection of skin
Pneumocystis pneumonia
Urinary tract infection"

trimethoprim/sulfamethoxazole efficacy

"Resolution of clinical signs of infection
Decreased episodes of Pneumocystis pneumonia"

trimethoprim/sulfamethoxazole mechanism of action

SMZ competitively inhibits the synthesis of folic acid precursors in microorganisms. TMP inhibits the enzymatic reduction of dihydrofolic acid to tetrahydrofolic acid.

trimethoprim/sulfamethoxazole counseling

"- Complete full course of therapy

• May cause photosensitivity

• Maintain adequate hydration during therapy to prevent kidney complications"

trimethoprim/sulfamethoxazole adverse effects

"Common (>10%): Diarrhea, nausea
Rare but Serious (

trimethoprim/sulfamethoxazole toxicity monitoring

"Monitor potassium in those taking concurrent ACEIs
Monitor glucose with concurrent sulfonylureas
CBC monthly if using for PCP prophylaxis"

trimethoprim/sulfamethoxazole drug interactions

"- Antiarrhythmic agents: Increased risk of QTc prolongation
- Methotrexate: increased toxicity of methotrexate through synergistic antifolate effects of TMP"

trimethoprim/sulfamethoxazole counterindications

"Hypersensitivity
Children < 2 months
Pregnant patients at term
Megaloblastic anemia due to folate deficiency
Marked hepatic or renal disease"

trimethoprim/sulfamethoxazole dosing

800 - 1600 mg SMZ and 160 - 320 mg TMP po BID

trimethoprim/sulfamethoxazole pharmacology

Dose Adjustment RNEAL: CrCl < 30 mL/min

trimethoprim/sulfamethoxazole pearls

Avoid use in patients with G6PD deficiency due to increased risk of hemolytic anemia

doxycycline brand name

Vibramycin

doxycycline therapeutic class

Tetracycline antibiotic

doxycycline dosage forms

Oral tablet, Oral capsule, Injectable

doxycycline indications

"Staphylococcal infection of skin
Community-acquired pneumonia Chlamydia infections Tick-borne diseases"

doxycycline mechanism of action

Doxycycline is a broad-spectrum bacteriostatic compound that inhibits protein synthesis at the 30S ribosomal subunit. Activity inclues gram-positive, gram-negative, aerobic, anaerobic, and "atypical" bacteria.

doxycycline counseling

"- Sit upright for 30 minutes after taking oral doses to prevent esophageal injury -May take with food that does not contain calcium

• Complete full course of therapy

• May cause photosensitivity

wear sunscreen and avoid prolonged exposure to sunlight -Take with plenty of water"

doxycycline adverse effect

"Common (>10%): Esophageal injury, photosensitivity, tooth discoloration in children

doxycycline toxicity

Burning or pain in esophagus, tooth discoloration "

doxycycline drug interactions

- Retinoic acid derivatives: risk of increased intracranial pressure
- Antacids and calcium products: decreased absorption"

doxycycline counterindications

"Hypersensitivity Concurrent use with retinoic acid derivatives Use in the 2nd and 3rd trimesters of pregnancy"

doxycycline dosing

100 mg po QD-BID

doxycycline pharmacology

No dose adjustments necessary

doxycycline pearls

Not for use in children < 8 years of age due to tooth discoloration

minocycline brand name

Minocin

minocycline therapeutic class

Tetracycline antibiotic

minocycline dosage forms

Oral tablet, Oral capsule, Oral tablet (ER), Oral capsule (ER, 24-hr), Injectable

minocycline indications

Acne vulgaris Staphylococcal infection of skin

minocycline efficacy

"Decreased acne
Resolution of clinical signs of infection"

minocycline mechanism of action

Minocycline is a broad-spectrum bacteriostatic compound that inhibits protein synthesis at the 30S ribosomal subunit. Activity includes gram-positive, gram-negative, aeorbic, anaerobic, and "atypical" bacteria.

minocycline counseling

"- May take with food that does not contain calcium (dairy)
- Complete full course of therapy
- Warn patients (both male and female) to avoid pregnancy"

minocycline adverse effects

"Common (>10%): Dizziness and vertigo, tooth discoloration in children

minocycline toxicity

Extreme headache, tooth or skin darkening

minocycline drug interactions

"- Retinoic acid derivatives: risk of increased intracranial pressure
- Antacids and calcium products: decreased absorption"

minocycline counterindications

"Hypersensitivity
Use in the 2nd and 3rd trimesters of pregnancy"

minocycline dosing

100 mg po BID

minocycline pharmacology

No dose adjustment necessary, but do not exceed 200 mg daily

minocycline pearls

"Dizziness occurs more frequently in women than men
Not for use in children < 8 years of age due to tooth discoloration"

mupirocin (topical) brand name

Bactroban

mupirocin (topical) therapeutic class

Topical Antibacterial

mupirocin (topical) dosage forms

Topical ointment, Topical cream, Nasal ointment

mupirocin (topical) indications

"Impetigo
Eradication of nasal colonization of MRSA"

mupirocin (topical) efficacy

"Eradication of nasal colonization of MRSA
Resolution of clinical signs of infection"

mupirocin (topical) mechanism of action

Mupirocin is an antibacterial agent active against a wide range of gram-positive bacteria including MRSA

mupirocin (topical) counseling

"- Instruct patients on proper application technique
- Avoid drug exposure to open wounds, burns, or eyes"

mupirocin (topical) adverse effects

"Common (>10%): None known
Rare but Serious (

mupirocin (topical) toxicity

Monitor for local adverse effects

mupirocin (topical) drug interactions

None known

mupirocin (topical) dosing

Apply topically TID x 3-5 days

mupirocin (topical) pharmacology

No dose adjustment necessary

mupirocin (topical) pearls

The area treatment may be covered with gauze dressing if desired

acyclovir brand name

Zovirax

acyclovir therapeutic class

Viral DNA polymerase inhibitor

acyclovir dosage forms

Oral tablet, Oral capsule, Oral suspension, Injectable

acyclovir indications

"Genital herpes
Herpes zoster (shingles)
Varicella (chickenpox)
Cold sores (orolabial HSV)"

acyclovir efficacy

Resolution of clinical signs of infection (lesions) within 2-3 days

acyclovir counseling

"- Complete full course of therapy
- Ensure adequate hydration
- Initiate treatment as soon as possible at first sign of herpes lesions or varicella rash"

acyclovir adverse effects

"Common (>10%): Malaise
Rare but Serious (

acyclovir toxicity

Decreased urination, confusion, lethargy

acyclovir drug interactions

- Nephrotoxic drugs: additive adverse effects

acyclovir dosing

400 mg TID to 800 mg BID (may see higher doses)

acyclovir pharmacology

Dose Adjustment RENAL: CrCl < 25 mL/min "