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22 | INFECTIOUS DISEASES I: BACKGROUND & ANTIBACTERIALS BY DRUG CLASS PATIENT COUNSELING ALL ANTIBIOTICS Antibiotics only treat bacterial infections. They do not treat viral infections, such as the common cold. Skipping doses or not completing the full course of treatment can i the effects, cause...

22 | INFECTIOUS DISEASES I: BACKGROUND & ANTIBACTERIALS BY DRUG CLASS PATIENT COUNSELING ALL ANTIBIOTICS Antibiotics only treat bacterial infections. They do not treat viral infections, such as the common cold. Skipping doses or not completing the full course of treatment can i the effects, cause the infection to return, and increase the likelihood that this medication will not work for you in the future. If your symptoms worsen , contact your healthcare provider. Many antibiotics can cause rash. If you experience a rash, contact your healthcare provider. Many antibiotics can cause GI upset. Taking the medication with food can help, but some antibiotics need to be taken on an empty stomach. Measure liquid doses carefully using the measuring device /syringe that comes with the medication. Ask your pharmacist if you do not have one. Household spoons should not be used, as they often do not deliver the correct dose. Contact your healthcare provider if you have watery diarrhea several times a day, with or without abdominal cramping. This can occur during treatment, or weeks after the antibiotic treatment has finished. You should not self treat with anti -diarrheal medication. Some oral liquid and chewable dosage forms contain phenylalanine. Let your healthcare provider know if you have phenylketonuria (inability to metabolize phenylalanine). BETA- LACTAM ANTIBIOTICS Amoxicillin Products Amoxicillin can be taken with or without food. Amoxicillin ER is taken within 1 hour of finishing a meal. Augmentin is taken with food to T what your body absorbs and 1 stomach upset. Suspensions should be refrigerated (especially important for Augmentin ). Cephalexin ( Keflex ) , Cefuroxime, Cefdinir (formerly Omnicef ) Cephalexin: take this medication by mouth , with or without food , every six hours. The suspension should be refrigerated . Cefuroxime: take this medication by mouth, with food, every 12 hours. The suspension should be refrigerated. Cefdinir: can be taken with or without food. The suspension should not be refrigerated. Penicillin VK Take this medication by mouth one hour before or two hours after a meal , usually every six hours. The suspension should be refrigerated. QUINOLONES Antacids, didanosine (Videx ) , sucralfate ( Carafate ) , bile acid resins, magnesium, aluminum, calcium, iron , zinc and multivitamins can bind to quinolones and prevent them from working properly. Take: - i Ciprofloxacin two hours before or six hours after these drugs. J Levofloxacin two hours before or two hours after these drugs. J Moxifloxacin four hours before or eight hours after these drugs. Dairy products can decrease how well these antibiotics work. Avoid consuming calcium - rich foods (dairy products) with the dose. Drink plenty of fluids to prevent crystals from forming in the urine. This medication can cause tendon inflammation ( tendinitis) or tendon rupture. It is rare, but if you hear or feel a pop, or notice pain /swelling in the back of the ankle (Achilles) , shoulder, hand or other site, stop the medication and contact your healthcare provider immediately. This occurs more frequently if you are age > 60 years, have had an organ transplant, or use steroid medications, such as prednisone. This medication can increase your risk for seizures. This is rare, but you should not take this medication if you have a history of seizures. Other effects include restlessness, anxiousness, trouble sleeping/ nightmares, lightheadedness, dizziness, headaches or depression. This medication can make your skin more sensitive to the sun, and you can burn more easily. Use sunscreen, wear protective clothing and avoid sun exposure. Do not take this medication if you have myasthenia gravis. Breathing problems can occur. This medication can cause weakness or tingling/ painful sensations in the arms and legs. If this occurs, contact your healthcare provider immediately. If you use blood sugar - lowering medications, your blood sugar may get unusually low. Check your blood sugar level more frequently and treat low blood sugar if it occurs. . RxPrep Course Book | RxPrep 02019 RxPrep © 2020 Ciprofloxacin (Cipro) Do not use this medication if you take a different medication called tizanidine ( Zanaflex ). The liquid suspension should not be refrigerated. Levofloxacin ( Levaquin ) Take this medication once daily, with or without food. The suspension is taken one hour before or two hours after eating. The liquid formulation should not be refrigerated . MACROLIDES Azithromycin (Zithromax ) Common dosing is two tablets on day 1, followed by one tablet daily on days 2 - 5. The tablets and immediate release oral suspension can be taken with or without food. The suspension should be stored at room temperature and should not be refrigerated. Clarithromycin ( Biaxin ) Common side effects include abnormal ( metallic) taste, diarrhea and GI upset. The tablets and oral suspension are taken twice daily, with or without food or with milk. Biaxin XL tablets should be taken with food. The liquid suspension should not be refrigerated. TETRACYCLINES Doxycycline (Vibramycin , Others) This medication can make your skin more sensitive to the sun , and you can burn more easily. Use sunscreen , wear protective clothing and avoid the sun. Take with a full glass of water and stay upright for 30 minutes to avoid GI irritation. Minocycline ( Minocin, Solodyn ) Take this medication with or without food, 1- 2 times daily. Swallow the tablet or capsule whole with a full glass of water to decrease GI irritation. Do not use this medication if you are pregnant, if you could become pregnant, or if you are breastfeeding. SULFAMETHOXAZOLE AND TRIMETHOPRIM ( BACTRIM ) Do not use this medication if you have an allergy to sulfa. Take with a full glass of water to prevent crystal formation in the urine. Take with or without food. If stomach upset occurs, take with food or milk. Do not use this medication if you are pregnant, if you could become pregnant, or if you are breastfeeding. This medication can make your skin more sensitive to the sun, and you can burn more easily. Use sunscreen , wear protective clothing, and avoid the sun. Shake the suspension prior to use. The suspension should not be refrigerated and it should be protected from light. CLINDAMYCIN (CLEOCIN ) Take by mouth, with or without food, 3 - 4 times a day. Take with a full glass of water to avoid GI irritation. The liquid suspension should not be refrigerated. METRONIDAZOLE ( FLAGYL ) Common side effects include nausea and an unusual ( metallic) taste in the mouth. Do not use any alcohol products while using this medication , and for at least three days afterward. Immediate- release tablets and capsules may be taken with food to minimize stomach upset. This medication should be taken twice daily, 1 - 2 hours before, or 4 - 6 hours after antacids, vitamins, magnesium, calcium, iron , zinc, dairy products, or bismuth subsalicylate. Oracea should be taken on an empty stomach (one hour before or two hours after meals) . Do not use this medication if you are pregnant, if you could become pregnant, or if you are breastfeeding. The liquid suspension should not be refrigerated. T7** 22 | INFECTIOUS DISEASES I. BACKGROUND & ANTIBACTERIALS BY DRUG CLASS NITROFURANTOIN ( MACRODANTIN , MACROBID ) Take this medication with food to help it get into the body and i side effects. Swallow the medication whole. Nausea and headache may occur. This medication can cause your urine to turn dark yellow or brown in color. This is a harmless, temporary effect and will disappear when the medication is stopped. Dark brown urine can be a sign of liver damage. Seek immediate medical attention if you notice dark urine with any of the following: persistent nausea or vomiting, pale stools, unusual fatigue or if your skin and whites of your eyes become yellow. This medication can cause very serious ( possibly fatal ) lung problems. This is rare, but can occur within the first month of treatment or after long-term use of the drug (generally for 6 months or longer ). Seek immediate medical attention if you develop symptoms of lung problems, including: persistent cough, chest pain, shortness of breath / trouble breathing, joint /muscle pain or bluish/ purplish skin. 774 MUPIROCIN OINTMENT ( BACTROBAN NASAL ) 1 GRAM TUBE Place Vi the ointment from the tube into one nostril and the other V2 into the other nostril. Press the nostrils at the same time and let go; do this many times (for about 1 minute) to spread the ointment into the nose. Wash your hands after use. The most common side effects are burning and itching. Select Guidelines/References Guidelines available at the Infectious Diseases Society of America website (www.idsociety.org)

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