Name of
Classification Dosage/Preparation
Drug
Clindamycin Antibiotic, Adults
(Dalacin C) Lincosamide drug Oral
class.
150–300 mg q 6 hr, up to
300–450 mg q 6 hr in more
severe infections.
Parenteral
600–2,700 mg/day in two to
four equal doses; up to 4.8
g/day IV or IM may be used
for life-threatening
situations.
Vaginal
One applicator (100 mg
clindamycin phosphate)
intravaginally, preferably at
bedtime for 7 consecutive
days; or insert vaginal
suppository, preferably at
Mechanism Indications and Nursing
of Action Contraindications Responsibilities
Inhibits protein Indication: Assessment
synthesis in  Systemic History:
susceptible administration: Allergy to clindamycin,
bacteria, causing Serious infections history of asthma or
cell death. caused by susceptible other allergies, allergy
strains of anaerobes, to tartrazine (in 75- and
streptococci, 150-mg capsules);
staphylococci, hepatic or renal
pneumococci; dysfunction; lactation;
reserve use for history of regional
penicillin-allergic enteritis or ulcerative
patients or when colitis; history of
penicillin is antibiotic associated
inappropriate; less colitis
toxic antibiotics Physical: Site of
(erythromycin) infection or acne; skin
should be considered color, lesions; BP; R,
 Parenteral: Treatment adventitious sounds;
of septicemia caused bowel sounds, output,
by staphylococci, liver evaluation; CBC,
streptococci; acute LFTs, renal function
bedtime for 7 consecutive
days; or insert vaginal
suppository, preferably at
bedtime for 3 days for
Cleocin Vaginal Ovules.
Topical
Apply a thin film to affected
area bid.
Pediatric
Oral
For clindamycin HCl, 8–20
mg/kg/day in three or four
equal doses. For
clindamycin palmitate HCl,
8–25 mg/kg/day in three or
four equal doses; for
children weighing < 10 kg,
use 37.5 mg tid as the
minimum dose.
Parenteral
Neonates: 15–20 mg/kg/day
in three or four equal doses.
hematogenous tests
osteomyelitis; Interventions
adjunct to surgical Systemic administration
treatment of chronic
bone and joint Culture infection before
infections due to therapy.
susceptible Administer oral drug
organisms; do not with a full glass of
use to treat water or with food to
meningitis; does not prevent esophageal
cross the blood–brain irritation.
barrier. Do not give IM
 Topical dermatologic injections of more than
solution: Treatment 600 mg; inject deep into
of acne vulgaris large muscle to avoid
 Vaginal preparation: serious problems.
Treatment of Do not use for minor
bacterial vaginosis bacterial or viral
infections.
Contraindication: BLACK BOX
 Hypersensitivity. WARNING: Be aware
that serious to fatal
colitis can occur;
reserve use, and monitor
patient closely.
> 1 mo: 15–40 mg/kg/day in
three or four equal doses or
350 mg/m2/day to 450
mg/m2/day.
Geriatric Patients or Patients
with Renal Failure
Reduce dose, and monitor
patient’s serum levels
carefully
Monitor LFTs and renal
function tests, and blood
counts with prolonged
therapy.
Topical dermatologic
administration
Keep solution away
from eyes, mouth and
abraded skin or mucous
membranes; alcohol
base will cause stinging.
Shake well before use.
Keep cool tap water
available to bathe eye,
mucous membranes,
abraded skin
inadvertently contacted
by drug solution.
Vaginal preparation
Give intravaginally,
preferably at bedtime.
Teaching points
Systemic administration
Take oral drug with a
full glass of water or
with food.
Take full prescribed
course of oral drug. Do
not stop taking without
notifying health care
provider.
You may experience
these side effects:
Nausea, vomiting (eat
frequent small meals);
superinfections in the
mouth, vagina (use
frequent hygiene
measures; request
treatment if severe).
Report severe or watery
diarrhea, abdominal
pain, inflamed mouth or
vagina, skin rash or
lesions.
Topical dermatologic
administration
Apply thin film of acne
solution to affected area
twice daily, being
careful to avoid eyes,
mucous membranes,
abraded skin; if solution
contacts one of these
areas, flush with lots of
cool water.
Report abdominal pain,
diarrhea.
Vaginal preparation

Use vaginal preparation

for 7 or 3 consecutive
days, preferably at
bedtime. Refrain from
sexual intercourse
during treatment with
this product.
Report vaginal
irritation, itching;
diarrhea, no
improvement in
 complaint being treated.
PO Uncomplicated UTI 125  Absorption:  Oral (cefuroxime  Culture infection,
mg twice daily. Respiratory Absorbed axetil) and arrange for
tract infections 250-500 mg from the GI Pharyngitis, tonsillitis sensitivity tests
twice daily. Uncomplicated tract with caused by Streptococcus before and during
gonorrhea W/ oral peak plasma pyogenes therapy if expected
probenecid: 1 g as a single concentration Otitis media caused by response is not
dose. IV Meningitis 3 g 8 s after 2-3 hr Streptococcus seen.
hrly. IM Gonorrhea W/ oral (oral); may pneumoniae, S. pyogenes,  Give oral drug with
probenecid: 1.5 g as a single be enhanced Haemophilus influenzae, food to decrease GI
Antibiotic, dose. IV/IM Surgical by the Moraxella catarrhalis upset and enhance
Cefuroxime Cephalosporin prophylaxis 1.5 g IV per-op, presence of Lower respiratory absorption.
(Zegen) (second generation) then 750 mg IM 8 hrly for food. infections caused by S.  Give oral drug to
up to 24-48 hr. Susceptible  Distribution: pneumoniae, children who can
infections750 mg 8 hrly, up Pleural and Haemophilus swallow tablets;
to 1.5 g 6-8 hrly for severe synovial parainfluenzae, H. crushing the drug
infections. fluid, influenzae results in a bitter,
sputum, bone UTIs caused by unpleasant taste.
and aqueous Escherichia coli,  Have vitamin K
fluids; CSF Klebsiella pneumoniae available in case
(therapeutic Uncomplicated gonorrhea hypoprothrombine
concentration (urethral and mia occurs.
s). Crosses endocervical)  Discontinue if
the placenta Dermatologic infections, hypersensitivity
and enters including impetigo reaction occurs.
 breast milk. caused by Streptococcus
Protein- aureus, S. pyogenes
binding: Up Treatment of early Lyme
to 50%. disease
 Metabolism:  Parenteral
Rapidly (cefuroxime sodium)
hydrolysed Lower respiratory
(intestinal infections caused by S.
mucosa and pneumoniae, S. aureus, E.
blood). coli, Klebsiella, H.
 Excretion: influenzae, S. pyogenes
Via the urine Dermatologic infections
by caused by S. aureus, S.
glomerular pyogenes, E. coli,
filtration and Klebsiella, Enterobacter
renal tubular UTIs caused by E. coli,
secretion (as Klebsiella
unchanged); Uncomplicated and
via bile disseminated gonorrhea
(small caused by N. gonorrhoeae
amounts); 70 Septicemia caused by S.
min pneumoniae, S. aureus, E.
(elimination coli, Klebsiella, H.
half-life); influenzae
prolonged in Meningitis caused by S.
 neonates and pneumoniae, H.
renal influenzae, S. aureus, N.
impairment. meningitidis
Bone and joint infections
caused by S. aureus
Perioperative prophylaxis
Treatment of acute
bacterial maxillary
sinusitis in patients 3 mo–
12 yr.

Contraindication:

Hypersensitivity to
cephalosporins.
 PO Resp tract Azithromycin Indication:  Culture site of
infections; Skin and soft blocks  Treatment of lower infection before
tissue infections 500 mg transpeptidation respiratory therapy.
once daily for 3 days. by binding to 50s infections: Acute  Administer on an
Uncomplicated genital ribosomal subunit bacterial empty stomach 1 hr
chlamydial infections 1 of susceptible exacerbations of before or 2–3 hr
g as a single dose. organisms and COPD due to after meals. Food
Uncomplicated disrupting RNA- Haemophilus affects the
gonorrhoea 2 g as a dependent protein influenzae, absorption of this
Azithromycin Macrolide single dose. Prophylaxis synthesis at the Moraxella drug.
(Zithromax) of disseminated MAC chain elongation catarrhalis,  Prepare Zmax by
infections 1.2 g once step. Streptococcus adding 60 mL water
wkly. Treatment or pneumoniae; to bottle, shake
secondary prophylaxis: community-acquired well.
W/ other pneumonia due to S.  Counsel patients
antimycobacterials: 500 pneumoniae, H. being treated for
mg once daily. Typhoid influenzae STDs about
500 mg once daily for 7  Treatment of lower appropriate
days. Granuloma respiratory precautions and
inguinale Initial: 1 g, infections: additional therapy.
then 500 mg/day until Streptococcal
all lesions has healed pharyngitis and
completely. tonsillitis due to
Streptococcus
pyogenes in those
who cannot take
penicillins
 Treatment of
uncomplicated skin
infections due to
Staphylococcus
aureus, S. pyogenes,
Streptococcus
agalactiae
 Treatment of
 nongonococcal
urethritis and
cervicitis due to
Chlamydia
trachomatis;
treatment of PID
 Treatment of acute
sinusitis
 Treatment of otitis
media caused by H.
influenzae, M.
catarrhalis, S.
pneumoniae in
children > 6 mo
 Treatment of
pharyngitis and
tonsillitis in children
> 2 yr who cannot
use first-line therapy
 Prevention and
treatment of
disseminated
Mycobacterium
avium complex
(MAC) in patients
 with advanced AIDS
 Treatment of patients
with mild to
moderate acute
bacterial sinusitis
caused by H.
influenzae,
Moracellis
catarrhalis, S.
pneumoniae (Zmax)
 Treatment of mild to
moderate community
acquired pneumonia
caused by
Chlamydophila
pneumoniae, H.
influenzae,
Mycoplasma
pneumoniae, S.
pneumoniae (Zmax)
 Unlabeled uses:
Uncomplicated
gonococcal
infections caused by
N. gonorrhoeae;
 gonococcal
pharyngitis caused by
N. gonorrhoeae;
chlamydial infections
caused by C.
trachomatis;
prophylaxis after
sexual attack.

Contraindication:
 Contraindicated with
hypersensitivity to
azithromycin,
erythromycin, or any
macrolide antibiotic.
 Use cautiously with
gonorrhea or
syphilis, pseudo
membranous colitis,
hepatic or renal
impairment,
lactation.

Linezolid is an Indication:  Always wash hands

 oxazolidinone thoroughly and
antibacterial  Linezolid is indicated disinfect equipment
agent that in adults and children (whirlpools,
selectively for the treatment of electrotherapeutic
inhibits the infections caused by devices, treatment
bacterial protein susceptible Gram- tables, and so forth)
synthesis by positive bacteria, to help prevent the
Linezolid Antibiotics, Other, Oral and IV binding to the including nosocomial spread of infection.
(Zyvox) Oxazolidinones 23S ribosomal pneumonia,  Use universal
ribonucleic acid community-acquired precautions or
(RNA) of the 50S pneumonia, skin and isolation procedures
subunit of the skin structure as indicated for
bacteria. infections, and specific patients.
vancomycin-resistant
Enterococcus
faecium infections.9
Examples of
susceptible bacteria
include
Staphylococcus
aureus, Streptococcus
pneumoniae,
Streptococcus
pyogenes, and
Streptococcus
 agalactiae.9

 Linezolid is not
indicated for the
treatment of Gram-
negative infections,
nor has it been
evaluated for use
longer than 28 days.

Contraindication:

 Do not use within

two weeks of MAO
inhibitors, e.g.,
phenelzine.
 Avoid tyramine-
containing foods and
serotonergic drugs,
as these may
precipitate a
hypertensive crisis.
 Use caution with
serotonergic and
adrenergic drugs,

Co-Amoxiclav Broad-spectrum Adult & childn >12 yr Mild
(Augmentin) penicillin to moderate infections 375
mg 8 hrly or 625 mg 12 hrly.
Dental abscess 375 mg 8
hrly for 5 days. Severe
infections including chronic
& recurrent UTI & lower
resp tract infections 625 mg
8 hrly or 1 g 12 hrly.
Hemodialysis 375 or 625 mg
24 hrly. Renal impairment
CrCl 10-30 mL/min 375 or
625 mg 12 hrly, CrCl <10
mL/min 375 mg 12 hrly.
e.g., imipramine.
An antibiotic that Indication:
combines
amoxicillin and  It's used in adults and
clavulanic acid. It children to treat:
destroys bacteria middle ear and sinus
by disrupting infections. throat or
their ability to lung respiratory tract
form cell walls. - infections. urinary
Clavulanic acid tract infections.
blocks the
chemical defence, Contraindication:
known as beta-
lactamase, that  Patients with a
some bacteria history of
have against hypersensitivity to
penicillins penicillin and in
patients who are
sensitive to
amoxicillin &
potassium injection-
associated cholestatic
jaundice or hepatic
dysfunction.
 Be sure the patient
understands all
medications,
including dosage,
route, action, and
adverse effects.
 Monitor for S&S of
an urticarial rash
(usually occurring
within a few days
after start of drug)
suggestive of a
hypersensitivity
reaction. If it
occurs, look for
other signs of
hypersensitivity
(fever, wheezing,
generalized itching,
dyspnea), and
report to physician
immediately
Co- Co-trimoxazole Adult doses of 6 to 8 tablets
trimoxazole belongs to a class of daily for up to 3 months
(Bactrim) drugs called sulfur have been used (one tablet
or sulfonamides contains 400 mg
drugs. It contains sulfamethoxazole and 80 mg
two antibiotics, trimethoprim),Adults (>18
trimethoprim and years old):
sulfamethoxazole,
which work together STANDARD DOSAGE
in the treatment of
infections caused by Age Tablets
bacteria
>18 years old 2 tablets every
12 hours
Children over 12 years old
(>12 to <18 years old):
The standard dosage for
children is equivalent to
approximately 6 mg
trimethoprim and 30 mg
sulfamethoxazole per kg
body weight per day, given
in two equally divided
Co-trimoxazole Indication Patients should be
acts by  Co-trimoxazole is monitored carefully for
sequentially used to treat certain adverse effects
inhibiting bacterial infections, including delayed
enzymes of the such as pneumonia (a hypersensitivity
folic acid lung infection), reactions. Sulfonamide
pathway; bronchitis (infection medications increase the
sulfamethoxazole of the tubes leading risk of crystalluria
inhibits the to the lungs), and which can cause kidney
formation of infections of the stones or decreased
dihydrofolic acid urinary tract, ears, kidney function.
from p- and intestines. It also Patients should increase
aminobenzoic is used to treat their water intake while
acid and, by 'travelers' diarrhea taking these medications
inhibiting
dihydrofolate Contraindication
reductase,
trimethoprim  In patients with a
inhibits the known
formation of hypersensitivity to
tetrahydrofolic trimethoprim or
acid from sulfonamides and in
dihydrofolic acid patients with
documented
megaloblastic anemia
 doses. The schedules for due to folate
children are according to the deficiency.
child’s age and weight and
provided in the table below:

Age Tablets

>12 to <18 years old 2

tablets every 12 hours

Body weight Tablets

>27 kg 1 tablet every 12

hours

>53 kg 2 tablets every 12

hours

Co-Trimoxazole should be
taken for at least five days.
Make sure that you finish
the course of Co-
Trimoxazole which your
doctor has prescribed.
Piperacillin Piperacillin Sodium Piperacillin Sodium + Piperacillin Indication Obtain history of
Na, + Tazobactam Tazobactam Sodium sodium is hypersensitivity to
Tazobactam Sodium (VIGOCID) (VIGOCID) is given bactericidal in  Piperacillin and penicillins,
(Vigocid) is indicated for the intravenously in a ratio of action by tazobactam cephalosporins, or other
treatment of Piperacillin (as the sodium inhibiting septum combination drugs prior to
infections caused by salt) 8 parts to 1 part of formulation and injection is used to administration. Lab
Pseudomonas Tazobactam (as the sodium cell wall treat bacterial tests: C&S prior to first
aeruginosa, and also salt). May be administered synthesis of infections in many dose of the drug; start
infections due to by slow intravenous susceptible different parts of the drug pending results.
other susceptible injection over 3 to 5 minutes
bacteria. In vitro, body (eg, stomach or Periodic CBC with
bacteria: by intravenous infusion overpiperacillin is bowel, lungs, skin, differential, platelet
Immunocompromise 20 to 40 minutes. Doses active against a female reproductive count, Hgb and Hct, and
d patients should generally be reduced variety of gram- organs) serum electrolytes
(neutropenic in moderate to severe positive and
patients) in impairment. gram-negative Monitor signs of
combination with an For the treatment of seriousaerobic and Contraindication allergic reactions and
aminoglycoside. or complicated infections: anaerobic bacteria anaphylaxis, including
Biliary tract with an extended  Piperacillin and pulmonary symptoms
infections Adults: Piperacillin Sodium spectrum of tazobactam (tightness in the throat
(cholangitis) + Tazobactam (VIGOCID) activity against combination and chest, wheezing,
200 to 300 mg per kg body – gram-negative injection is used to cough dyspnea) or skin
weight daily in divided bacteria. treat bacterial reactions (rash, pruritus,
doses may be given infections in many urticaria). Notify
intravenously. The usual different parts of the physician or nursing
dose is 4 g every 6 to 8 body (eg, stomach or staff immediately if
hours. bowel, lungs, skin, these reactions occur.
 female reproductive
organs) Use this medicine for
the full prescribed
length of time, even if
your symptoms quickly
improve. Skipping
doses can increase your
risk of infection that is
resistant to medication.
Piperacillin and
tazobactam will not
treat a viral infection
such as the flu or a
common cold. You may
need frequent blood
tests.

Ciprofloxacin Ciprofloxacin is in a For oral dosage form Ciprofloxacin Indication Use of ciprofloxacin is
(Ciprobay) class of antibiotics (extended-release tablets): acts on bacterial acceptable in nursing
called For acute uncomplicated topoisomerase II  Ciprofloxacin is used mothers with
fluoroquinolones. It pyelonephritis: (DNA gyrase) to treat or prevent monitoring of the infant
works by killing Adults—1000 milligrams and certain infections for possible effects on
bacteria that cause (mg) once a day. topoisomerase caused by bacteria the gastrointestinal
infections. Children—Use and dose IV. such as pneumonia; flora, such as diarrhea
Antibiotics such as must be determined by your Ciprofloxacin's gonorrhea (a sexually or candidiasis (thrush,
ciprofloxacin will doctor.
not work for colds, For complicated urinary
flu, or other viral tract infections:
infections. Adults—1000 milligrams
(mg) once a day.
Children—Use and dose
must be determined by your
doctor.
For uncomplicated urinary
tract infections (acute
cystitis):
Adults—500 milligrams
(mg) once a day for 3 days.
Children—Use and dose
must be determined by your
doctor.
targeting of the transmitted disease); diaper rash). Avoiding
alpha subunits of typhoid fever (a breastfeeding for 3 to 4
DNA gyrase serious infection that hours after a dose
prevents it from is common in should decrease the
supercoiling the developing exposure of the infant to
bacterial DNA countries); infectious ciprofloxacin in
which prevents diarrhea (infections breastmilk.
DNA replication. that cause severe
diarrhea); and
infections of the skin,
bone, joint, abdomen
(stomach area), and
prostate (male
reproductive gland),
Ciprofloxacin is also
used to treat or
prevent plague (a
serious infection that
may be spread on
purpose as part of a
bioterror attack) and
inhalation anthrax (a
serious infection that
may be spread by
anthrax germs in the
 air on purpose as part
of a bioterror attack)

Contraindication

 in persons with a
history of
hypersensitivity to
ciprofloxacin or any
of the quinolones.
Concomitant
administration with
tizanidine is
contraindicated.
Ciprofloxacin should
be used in pediatric
patients only for
infections listed
above.
Nystatin Nystatin belongs to Intestinal or Esophageal Nystatin acts by Indication History: Allergy to
(Afunginal) the group of Candidiasis: Adults: 500,000 binding to sterols  Treatment of nystatin or components
medicines called iu (5 mL) or 1,000,000 iu in the cell candidiasis in the used in preparation,
antifungals. The dry (10 mL) 3 or 4 times a day. membrane of the oral cavity. pregnancy, lactation
powder, lozenge Children: ≥100,000 iu (1 fungus which Physical: Skin color,
(pastille), and liquid mL) may be given 4 times interferes in the Contraindication lesions, area around
forms of this daily.
medicine are used to Lesions of the Mouth:
treat fungus 100,000 iu (1 mL) 4 times
infections in the daily.
mouth. Infants Born to Mothers
with Vaginal Candidiasis:
100,000 iu (1 mL) daily.
The preparation should be
retained in the mouth as long
as possible before
swallowing and patients
should avoid taking food or
drink earlier than 1 hr after a
dose.
membrane lesions; bowel sounds;
permeability. It  Patients with a culture of area involved
exhibits no history of
appreciable hypersensitivity to Take the full course of
activity against nystatin. drug therapy even if
bacteria or  Hypersensitivity to symptoms improve.
trichomonads. nystatin is a Continue during
contraindication for menstrual period if
its use. Some nystatin vaginal route is being
oral suspension used. Long-term use of
preparations contain the drug may be needed;
sugar and are beneficial effects may
unsuitable for not be seen for several
children with weeks. Vaginal
disaccharide suppositories should be
intolerance. inserted high into the
vagina.
Use appropriate hygiene
measures to prevent
reinfection or spread of
infection.
This drug is for the
fungus being treated; do
not self-medicate other
problems.
 Refrain from sexual
intercourse or advise
partner to use a condom
to avoid reinfection; use
a sanitary napkin to
prevent staining of
clothing with vaginal
use.
You may experience
these side effects:
Nausea, vomiting,
diarrhea (oral use);
irritation, burning,
stinging (local use).
Report worsening of
condition; local
irritation, burning
(topical application);
rash, irritation, pelvic
pain (vaginal use);
nausea, GI distress (oral
administration).

Metronidazole Metronidazole is in Capsule 375mg Metronidazole Indications Watch for seizures;

(Flagyl) a class of Tablet diffuses into the notify physician
medications called 250mg organism, inhibits  Indicated in the immediately if patient
nitroimidazole 500mg protein synthesis treatment of acute develops or increases
antimicrobials. It tablet, extended-release by interacting intestinal amebiasis seizure activity.
works by stopping 750mg with DNA, and (amebic dysentery)
the growth of infusion solution causes a loss of and amebic liver Monitor signs of
bacteria 500mg/100mL helical DNA abscess. In amebic peripheral neuropathy
Loading dose: 15 mg/kg IV; structure and liver abscess, (numbness, tingling).
not to exceed 4 g/day strand breakage. FLAGYL 375 Perform objective tests
Therefore, it capsules therapy does (nerve conduction,
Maintenance dose: 7.5 causes cell death not obviate the need monofilaments) to
mg/kg PO/IV (over 1 h) in susceptible for aspiration or document any
q6hr x 7-10 days (or 2-3 organisms. drainage of pus. neuropathic changes.
weeks if severe) Anaerobic Bacterial
Infections. Monitor signs of
disulfiram-like reaction
Contraindication (i.e., toxicity occurring
when this drug is taken
 contraindicated in with alcohol). Signs
patients with a prior include throbbing
history of headache, difficulty
hypersensitivity to breathing, nausea,
metronidazole or vomiting, sweating,
other nitroimidazole thirst, chest pain,
derivatives. In palpitations,
patients with tachycardia,
 trichomoniasis, hypotension, syncope,
FLAGYL 375 agitation, confusion,
capsules are weakness, vertigo, and
contraindicated blurred vision. Report
during the first these signs to the
trimester of physician immediately.
pregnancy (see
PRECAUTIONS). Assess dizziness that
might affect gait,
 Do not take balance, and other
metronidazole if you functional activities (see
have taken disulfiram Appendix C). Report
(Antabuse®) within balance problems and
the last 2 weeks. functional limitations to
Using these the physician and
medicines together nursing staff, and
may cause serious caution the patient and
unwanted effects. family/caregivers to
Drinking alcoholic guard against falls and
beverages while trauma.
using this medicine
may cause stomach Be alert for confusion,
pain, nausea, agitation, headache, or
vomiting, headache, other alterations in
or flushing or redness mental status. Notify the
of the face. physician promptly if
these symptoms
develop.

Monitor IV injection
site for pain, swelling,
and irritation. Report
prolonged or excessive
injection site reactions
to the physician.