Antibiotics: Penicillin- penicillin G potassium, amoxicillin, ampicillin, piperacillin and tazobactam. Cephalosporins - cefadroxil, cefazolin, cephalexin, cefdinir, cefepime. Tetracyclines - tetracycline, doxycycline, minocycline. Macrolides - azithromycin, erythromycin. Aminoglycosides - gentamicin, neomycin, tobramycin. Fluoroquinolones - ciprofloxacin, levofloxacin. Sulfonamides - trimethoprim-sulfamethoxazole, sulfadazine. Urinary aseptics - nitrofurantoin.
Mechanism of action: Penicillins - Kill bacteria by disrupting their cell walls. Gram-positive bacteria.
Mechanism of action: Cephalosporins - Largest antibacterial class. 1st generation: gram-positive infections 2nd/3rd and the rest of the generations more effective at treating gram negative infections. Inhibit bacterial cell wall synthesis.
Mechanism of action: Tetracyclines - very broad spectrum, against both gram positive and negative infections. Inhibit bacterial protein synthesis.
Mechanism of action: Macrolides - Inhibit protein synthesis by binding to the bacterial ribosome. Effective against most gram positive and many gram negative bacteria.
Mechanism of action: Aminoglycosides - treats aerobic gram-negative bacteria, mycobacteria and some protozoans. Inhibit bacterial protein synthesis.
Mechanism of action: Fluoroquinolones - broad spectrum, gram-negative, newer generations also against gram positive. Affect DNA synthesis by inhibiting enzymes.
Side effects: Penicillins - rash, puritus, diarrhea, nausea, fever, nephrotoxicity, anaphylaxis.
Side effects: Cephalosporins - diarrhea, abdominal cramping, nausea, fatigue, rash, pruritus, oral or vaginal candidiasis, anaphylaxis, nephrotoxicity.
Side effects: Tetracyclines - nausea, vomiting, abdominal cramping, flatulence, mild phototoxicity, rash dizziness, hepatotoxicity, anaphylaxis.
Side effects: Macrolides - nausea, vomiting, diarrhea, abdominal cramping, ototoxicity, hepatotoxicity, dysrhythmias, anemia and anaphylaxis.
Side effects: Aminoglycosides - pain/inflammation at injection site, rash, fever, nausea, diarrhea, dizziness, tinnitus, ototoxicity, nephrotoxicity, anaphylaxis.
Side effects: Fluroquinolones - nausea, diarrhea, vomiting, rash, headache, restlessness, tendon rupture, photosensitivity, seizure, hepatotoxicity, anaphylaxis.
Nursing Interventions: Penicillins - Do not mix penicillin and aminoglycosides in the same IV solution. Allergic reaction is usually seen within the first 30 minutes of administration so monitor closely.
Nursing Interventions: Cephalosporins - Monitor kidney function (BUN/Creatinine, I/O) d/t nephrotoxicity especially if mixed with other nephrotoxic medications.
Nursing Interventions: Tetracyclines - given PO, short half life so frequent doses. Advise patients d/t photosensitivity they should avoid sunlight, tanning beds and use sunscreen. Should not be used in children 8 years or younger. Advise to take with full glass of water to reduce GI adverse effects.
Nursing Interventions: Macrolides - Administer on an empty stomach with a full glass of water. Do not give immediately before or after fruit juices. Monitor for dysrhythmias.
Nursing Interventions: Fluroquinolones - Do not take with antacids or mineral supplements. Advise to use sunscreen and avoid sun exposure while taking.
Nursing Interventions: Aminoglycosides - Monitor for ototoxicity (headache, tinnitus, vertigo). Monitor for nephrotoxicity (BUN, Creatinine, I/O)
All antibiotics: Assess for allergies prior to administration. Monitor for anaphylaxis (angioedema, cardiac arrest, shortness of breath.) Advise patients to take ALL antibiotics as prescribed even if they begin to feel better. Obtain a culture and sensitivity sample prior to starting antibiotics. (Blood, swab, UA etc). If patient has a history of adverse reactions (not anaphylaxis) then tylenol, benadryl, and even prednisone can be given prior to antibiotic to reduce the adverse reaction.