MEDICATIONS FOR INFECTION

Antibiotics Affecting the Bacterial Cell Wall

Overview

Bactericidal Penicillin Cephalosporin Carbapenems Monobactams

PENICILLIN G POTASSIUMOTHER

NARROW SPECTRUMPCN G BENZATHINEPCN V

BROAD SPECTRUMAMOXICILLIN-CLAVULANATE

ANTISTAPHYLOCOCCALNAFCILLIN

ANTIPSEUDOMONASTICARCILLIN-CLAVULANATEPIPERACILLIN TAZOBACTAM

Penicillins

Purpose

Expected Action Destroy bacteria by

weakening the bacterial cell wall

Therapeutic Use Gram positive cocci Gram negative cocci Syphilis Extended spectrum

pcn prophylaxis

Complications

Allergies/anaphylaxisRenal impairmentHyperkalemia/dysrhythmiasHypernatremia

Contraindications/Precautions Contraindicated - severe history of allergies to pcn,

cephalosporin &/or imipenem Caution – at risk for kidney dysfunction If allergic to one pcn should be considered cross allergic

to other pcn & at risk for allergy to cephalosporin

Interactions

AminoglycosidesProbenecid

CEPHALEXINOTHER

1 S T GENERATION – CEFAZOLIN2 N D GENERATION – CEFACLOR3 R D GENERATION – CEFTRIAXONE4 T H GENERATION - CEFEPIME

Cephalosporins

Purpose

Expected Action Beta lactam antibiotics Destroy bacterial cell

walls Four generations

Therapeutic Use Urinary tract

infections Postoperative

infections Pelvic infections meningitis

Complications

Allergic/hypersensitivity/anaphylaxisPossible cross sensitivityBleeding tendenciesThrombophlebitisPainAntibiotic associated pseudomembranous colitis

Contraindications/Precautions Contraindications – history of severe allergic reactions to

pcn Caution – renal impairment or bleeding tendencies

Interactions

Disulfiram reactionProbenecid

IMIPENEM-CILASTATINOTHER

MEROPENEM

Carbapenems

Purpose

Expected Action Beta lactam antibiotic Destroy bacterial cell

wall

Therapeutic Use Serious infections

Pneumonia Peritonitis UTI

Combine with antipseudomonal medications to avoid resistance when treating pseudomonas aeruginosa

Complications

Allergy/hypersensitivityPossible cross sensitivityGISupra-infection

Contraindications/Precautions Pregnancy risk C Caution – renal impairment

VANCOMYCINAZTREONAMFOSFOMYCIN

Other inhibitors

Purpose

Expected Action Destroys bacterial cell

walls

Therapeutic Use MRSA E.coli Staphylococcus

epidermidis

Complications

OtotoxicityInfusion reactionsThrombophlebitisRenal toxicity

Contraindications/Precautions Contraindicated – allergy to corn/corn products or

previous allergy to vancomycin Caution – renal impairment, hearing impairment,

geriatrics

Interactions

Increased risk for ototoxicity When vancomycin used with other ototoxic

medications