Clindamycin (Cleocin): for oral infections caused by bacteroides
Metronidazole (Flagyl): used to treat H. pylori infections of stomach
Vancomycin (Vancocin): effective for MRSA infections
Adverse effects : ototoxicity, nephrotoxicity, red man syndrome
Selection of an Antibiotic
Careful selection of correct antibiotic essential
Use of culture and sensitivity testing
For effective pharmacotherapy; to limit adverse effects
Effective for wide variety of bacteria
Effective for narrow group of bacteria
Affected by antagonism—combining two drugs may decrease efficacy of each
Use of multiple antibiotics increases risk of resistance.
Multidrug therapy can be used
When multi-organisms cause infection
For treatment of tuberculosis
For treatment of HIV
Occur when too many host flora are killed by an antibiotic
Pathogenic microorganisms have chance to multiply
Opportunistic—take advantage of suppressed immune system
Signs and symptoms include diarrhea, bladder pain, painful urination, or abnormal vaginal discharge
A 78-year-old nursing home patient with a history hypertension, type 2 DM, & COPD, is brought into the ED with a history of fever for 72 hrs & moist cough. The LTC nurse report states that he was very irritable last night, then was difficult to awaken this am. Assessment findings include:
TPR: 103-122-26 (labored) BP: 100/56
Lethargic-Confused, Crackles (rales) throughout lung fields, CXR: Lung consolidation.
IV fluids are running.
The following orders are written:
Admit: medical unit
Cefotetan 1gm IVPB Q12H
What are nursing responsibilities regarding these orders?
What type of antibiotic would you expect to be ordered and why?
The Culture & Sensitivity report just came in and is as follows. What should the nurse do? Antibiotic S=Sensitive R=Resistant Amikacin Amoxicillin Azithromycin Cefepime Cefotetan Levofloxacin Pipericillin Tobramycin R R S R R S R R
Adams, MP; Josephson, DL & Holland, LN (2008). Pharmacology for Nurses a Pathophysiologic Approach (2 nd ed). Upper Saddle River, NJ: Prentice Hall
Center for Disease Control (CDC – 2007). Recommended Immunization Schedules for Persons Aged 0-18 Years . Retrieved on January 21, 2007 from http://www.cdc.gov/nip/acip
Ignatavicius, DD & Workman, ML (2006) Medical Surgical Nursing critical Thinking for Collaborative Care 5 th Ed. St Louis, MO: Elsevier/Saunders
Hockenberry & Wilson (2007) Wong’s Nursing Care of Infants & Children 8 th Ed. St. Louis, MO: Mosby-Elsevier