Cholera: azithromycin & ceftriaxone

Generic Name: Azithromycin

Brand Name: Zithromax
Classification: Antibacterial macrolide
Dosage: 500mg
Route: TIV
Frequency: OD for 3 days

Mechanism of action
Binds to ribosomal receptor sites of susceptible organisms, inhibiting RNA dependent protein synthesis.
Therapeutic Effect: Bacteriostatic or bactericidal, depending on drug dosage.
Indication
used to treat many different types of infections caused by bacteria, such as respiratory infections, skin
infections, ear infections, eye infections, and sexually transmitted diseases. Findings state that it may also
be used as an adjunct to hydration treatment for cholera

Contraindication
 No contraindication indicated in the scenario but may include patients with:
- Renal dysfunction, hypokalemia, hypomagnesemia, bradycardia, dysrhythmias

Side Effect
 No side effects give in the scenario, but common are:
- Nausea
- Dizziness
- Abdominal cramp
- Fatigue
Nursing Consideration:
Before:
 Assess vital signs
 Check apical pulse
 Infuse slowly to avoid unnecessary pain (phlebitis)
 Assess for allergies by skin test
During:
 WOF: symptoms of hepatotoxicity
 Check IV site
After:
 Instruct patient to report adverse reactions promptly
 Monitor vital signs & urine output
 Monitor symptoms of high plasma potassium levels
 Monitor daily pattern of bowel activity and stool consistency

Reference: Centers for Disease Control and Prevention. (2020, October 2). Antibiotic treatment. Centers
for Disease Control and Prevention. Retrieved November 13, 2021, from
https://www.cdc.gov/cholera/treatment/antibiotic-treatment.html.
 Generic Name: Ceftriaxone
Classification: Third-generation cephalosporin
Dosage: 2g
Route: TIV
Frequency: OD

Mechanism of action
Binds to the bacterial cell wall membrane, causing cell death. Therapeutic Effect: Bactericidal action
against susceptible bacteria.
Indication
Used for treating otitis media, meningitis, gonorrhea, septicemia, UTI.
Also effective against Klebsiella, Haemophilus, Staphylococci and Escherichia coli

Contraindication
 No contraindication indicated in the scenario but may include patients with:
- Hypersensitivity to penicillin/cephalosporin
- Bleeding, Vit. K deficiency, Diabetes Mellitus

Side Effect
 No side effects given in the scenario, but common are:
- Anorexia
- Nausea
- Headache
- Dizziness
- Diarrhea
Nursing Consideration:
Before:
 Assess for allergies (by skin testing)
During:
 Instruct patient to increase fluid intake
 Check IV site (for signs of phlebitis)
 Observe stool consistency
After:
 Monitor patient for signs and symptoms of superinfection
 Monitor patient for bleeding
 Advise patient to report adverse reactions promptly
 WOF: seizure

Ceftriaxone. Ceftriaxone | Davis's Drug Guide for Rehabilitation Professionals | F.A. Davis PT Collection |
McGraw Hill Medical. (n.d.). Retrieved November 13, 2021, from
https://fadavispt.mhmedical.com/content.aspx?bookid=1873§ionid=139004956.
Generic Name: Ceftriaxone
Classification: Interkulin-6 receptor inhibitor
Dosage: 4mg
Frequency: OD

Mechanism of action
Binds to the bacterial cell wall membrane, causing cell death. Therapeutic Effect: Bactericidal action
against susceptible bacteria.
Indication
Used for treating otitis media, meningitis, gonorrhea, septicemia, UTI.
Also effective against Klebsiella, Haemophilus, Staphylococci and Escherichia coli

Contraindication
 No contraindication indicated in the scenario but may include patients with:
- Hypersensitivity to penicillin/cephalosporin
- Bleeding, Vit. K deficiency, Diabetes Mellitus

Side Effect
 No side effects given in the scenario, but common are:
- Anorexia
- Nausea
- Headache
- Dizziness
- Diarrhea
Nursing Consideration:
Before:
 Assess for allergies (by skin testing)
During:
 Instruct patient to increase fluid intake
 Check IV site (for signs of phlebitis)
 Observe stool consistency
After:
 Monitor patient for signs and symptoms of superinfection
 Monitor patient for bleeding
 Advise patient to report adverse reactions promptly
 WOF: seizure