[C2C]
Antibiotics
Drug class: Examples: MOA: Indications: Contraindication SEs: Interactions:
s:
Penicillins Amoxicillin. EXCRETED RENALLY. Sinusitis. Allergy. Diarrhoea. ↓ renal excretion of MTX
Uncomplicated CAP. Hypersensitivity. ↑ risk of toxicity.
Interfere with bacterial Salmonellosis. N&V.
cell wall synthesis. Oral infns. Skin reacs. Broad-spectrum penicillins
Acute bronchiectasis exacerbation. Thrombocytopenia. can enhance anticoag
Diffuse well into body Acute COPD exacerbation. effect of warfarin (kill N
tissues and Acute OM. gut flora that synthesis vit
fluid/penetration into Lyme disease (erythema migrans ± K).
CSF is poor (except non-focal Sx & affecting CNs/PNs).
when meninges are Acrodermatitis chronica atrophicans.
inflamed). Anthrax.
Dental abscess.
Excreted in urine in Listerial meningitis.
therapeutic concs. Endocarditis.
Lower UTI/CAUTI.
Part of H. pylori eradication.
Cephalospo Cefalexin. EXCRETED RENALLY. Susceptible infns due to sensitive Allergy. Abdo pain/diarrhoea. Enhance anticoag effect of
rins Gram +ve/-ve bacteria. Dizziness/HA/N&V. warfarin (kill N gut flora
Attach to PBPs to Acute pyelonephritis. Eosinophilia/neutropenia/ that synthesis vit K).
interrupt cell wall Lower UTI. leukopenia.
biosynthesis. CAUTI. Skin reacs. May ↑ nephrotoxicity of
Thrombocytopenia. aminoglycosides.
Broad spectrum. ↑ infn risk.
Tetracyclin Doxycycline EXCRETED RENALLY. Chlamydia. Pregnancy. Angioedema. Enhance anticoag effect of
es . Mycoplasma/anthrax/malaria. Breastfeeding. Diarrhoea. warfarin (kill N gut flora
Binds reversibly to 30S Acute sinusitis. < 12 yrs. HA/N&V. that synthesis vit K).
ribosomal subunit of Acute bronchiectasis exacerbation. HSP.
bacteria – prevents Acute COPD exacerbation. Hypersensitivity. Tetracyclines bind to
attachment of Acne vulgaris. Pericarditis. divalent cations – should
aminoacyl tRNA to RNA- Rosacea & papulopustular facial Photosensitivity reaction. not be given within 2 hrs
ribosome complex. rosacea. Skin reacs. of Ca, antacids, Fe
Early syphilis & late latent syphilis & SLE exacerbated. prevention of ABX
Broad spectrum against neurosyphilis. Discolouration/hypoplasia of absorption.
many Gram +ve & -ves. Non-gonococcal urethritis/PID. tooth enamel in children.
Lyme disease (erythema migrans ±
non-focal Sx & affecting CNs/PNs).
Acrodermatitis chronica atrophicans.
Periodontitis.
Recurrent aphthous ulceration.
Rocky Mountain spotted fever.
, [C2C]
Aminoglyco Gentamicin. EXCRETED RENALLY. Bacterial eye infns. Myasthenia gravis Skin reacs. Loop
sides Amikacin. Bacterial OE. (aminoglycosides Tinnitus. diuretics/vancomycin –
Neomycin. Binds reversibly to 30S Gram +ve bacterial may impair NM ototoxicity risk ↑.
ribosomal subunit of endocarditis/HACEK endocarditis. transmission).
bacteria – prevents Septicaemia. Ciclosporin/platinum
attachment of Meningitis & other CNS infns. chemo/cephalosporins/
aminoacyl tRNA to RNA- Biliary tract infn. vancomycin –
ribosome complex. HAP. nephrotoxicity risk ↑.
Prostatitis.
Activity against Gram - Acute pyelonephritis.
ve aerobic bacteria. CAUTI.
Inactive against Strep +
anaerobes.
Macrolides Erythromyci EXCRETED VIA BILE. RTIs incl. Legionellosis. Allergy. ↓ appetite. Erythro + clarithro (not
n. Skin infns. Diarrhoea/GI discomfort/N&V. azithro) inhibit CYP450
Binds reversibly to P site Oral infns. HA. ↑ plasma concs of drugs
on 50S ribosomal Campylobacter enteritis. Hearing impairment. e.g. warfarin (↑ bleed
subunit of bacteria – Acute OM. Insomnia. risk) & statins (↑
prevents Early syphilis. Pancreatitis. myopathy risk).
peptidyltransferase from Genital chlamydia. Paraesthesia.
adding the growing Non-gonococcal urethritis. Skin reacs. Macrolides prescribed with
peptide attached to Chronic prostatitis. Taste altered. caution in pts taking drugs
tRNA to next αα. Pertussis. Vasodilation. that prolong QT /cause
Rosacea. Vision disorders. arrhythmias e.g.
Inhibit ribosomal Acne. amiodarone,
translation. GI stasis. antipsychotics, quinine,
ABX, SSRIs.
Broad spectrum against
Gram +ve & -ves.
Quinolones Ciprofloxaci EXCRETED RENALLY. Superficial bacterial eye infn. Hx of tendon ↓ appetite. Drugs containing divalent
n. Corneal ulcer. disorders related to Arthralgia. cations (e.g. Ca,
Inhibit bacterial DNA Acute OE. quinolone use. Asthenia. antacids) ↓ absorption
gyrase/topoisomerase IV Fistulating CD. Constipation/diarrhoea/GI and efficacy of quinolones.
inhibition of DNA RTIs. discomfort/N&V.
replication + UTIs. Dizziness. Cipro inhibits certain
transcription. Acute prostatitis. Dyspnoea. CYP450 ↑ toxicity risk,
Gonorrhoea. Eye discomfort/disorders. esp theophylline.
Broad spectrum, esp Anthrax. Fever.
against Gram -ves. Acute pyelonephritis. HA. NSAIDs – ↑ seizure risk.
CAUTI. Muscle complaints.
OT-interval prolongation. Prednisolone – ↑ tendon
Skin reacs. rupture risk.
Sleep disorders.
Taste altered. Quinolones prescribed
, [C2C]
Tinnitus. with caution in pts taking
Vision disorders. other drugs that prolong
QT /cause arrhythmias
e.g. amiodarone,
antipsychotics, quinine,
ABX, SSRIs.
Anaerobic Metronidaz EXCRETED RENALLY. Anaerobic infns. Alcohol should not Dry mouth. Metronidazole has some
antimicrobi ole. Part of H. pylori eradication. be taken whilst Myalgia. inhibitory effect on CYP
als In anaerobic bacteria, Fistulating CD. taking N&V. enzymes, ↓ metabolism of
reduction of Leg ulcers. metronidazole Oral disorders. warfarin (↑ bleeding risk)
metronidazole Pressure sores. disulfiram-like reac Taste metallic. & phenytoin (↑ toxicity
generates a nitroso free Bacterial vaginosis (Gardnerella – flushing, HA, risk, incl impaired
radical. vaginalis). N&V. cerebellar fn).
PID.
This binds to DNA, ↓ Acute ulcerative gingivitis. Li – ↑ toxicity risk.
synthesis and causing Acute oral infns.
widespread damage Invasive intestinal amoebiasis.
(bactericidal). Extra-intestinal amoebiasis.
Urogenital trichomoniasis.
Giardiasis.
Tetanus.
Glycopepti Vancomycin EXCRETED RENALLY. C. diff infn. IV – prev hearing Agranulocytosis. Aminoglycoside/loop
des . Complicated SSTIs. loss. Dizziness/nausea. diuretics/ciclosporin – ↑
Bactericidal activity Bone + jt infns. Drug fever. risk of ototoxicity ±
against aerobic + CAP, HAP, VAP. Eosinophilia/neutropenia. nephrotoxicity.
anaerobic Gram +ve Infective endocarditis. Hypersensitivity.
incl. MRSA. CSF Acute bacterial meningitis. Nephritis tubulointersititial.
penetration poor. Peritonitis assoc with peritoneal Renal F.
dialysis. SCARs.
Skin reacs.
Thrombocytopenia.
Tinnitus.
Vasculitis.
Vertigo.
Trimethopri EXCRETED RENALLY. RTIs. 1st trimester of Diarrhoea. Enhance anticoag effect of
m. PCP in pts who cannot tolerate co- pregnancy – NTDs, Electrolyte imbalance. warfarin (kill N gut flora
Inhibits bacterial folate trimoxazole. cleft lip/palate. Fungal overgrowth. that synthesis vit K).
synthesis. Shigellosis. Blood dyscrasias. HA/N&V.
Invasive salmonella infn. Skin reacs. K+-elevating drugs (e.g.
Broad activity against Acute prostatitis. aldosterone
many Gram +ve and -ve CAUTI. antagonists, ACEis,
bacteria. Lower UTI. ARBs) – predisposes to
hyperK.
Antibiotics
Drug class: Examples: MOA: Indications: Contraindication SEs: Interactions:
s:
Penicillins Amoxicillin. EXCRETED RENALLY. Sinusitis. Allergy. Diarrhoea. ↓ renal excretion of MTX
Uncomplicated CAP. Hypersensitivity. ↑ risk of toxicity.
Interfere with bacterial Salmonellosis. N&V.
cell wall synthesis. Oral infns. Skin reacs. Broad-spectrum penicillins
Acute bronchiectasis exacerbation. Thrombocytopenia. can enhance anticoag
Diffuse well into body Acute COPD exacerbation. effect of warfarin (kill N
tissues and Acute OM. gut flora that synthesis vit
fluid/penetration into Lyme disease (erythema migrans ± K).
CSF is poor (except non-focal Sx & affecting CNs/PNs).
when meninges are Acrodermatitis chronica atrophicans.
inflamed). Anthrax.
Dental abscess.
Excreted in urine in Listerial meningitis.
therapeutic concs. Endocarditis.
Lower UTI/CAUTI.
Part of H. pylori eradication.
Cephalospo Cefalexin. EXCRETED RENALLY. Susceptible infns due to sensitive Allergy. Abdo pain/diarrhoea. Enhance anticoag effect of
rins Gram +ve/-ve bacteria. Dizziness/HA/N&V. warfarin (kill N gut flora
Attach to PBPs to Acute pyelonephritis. Eosinophilia/neutropenia/ that synthesis vit K).
interrupt cell wall Lower UTI. leukopenia.
biosynthesis. CAUTI. Skin reacs. May ↑ nephrotoxicity of
Thrombocytopenia. aminoglycosides.
Broad spectrum. ↑ infn risk.
Tetracyclin Doxycycline EXCRETED RENALLY. Chlamydia. Pregnancy. Angioedema. Enhance anticoag effect of
es . Mycoplasma/anthrax/malaria. Breastfeeding. Diarrhoea. warfarin (kill N gut flora
Binds reversibly to 30S Acute sinusitis. < 12 yrs. HA/N&V. that synthesis vit K).
ribosomal subunit of Acute bronchiectasis exacerbation. HSP.
bacteria – prevents Acute COPD exacerbation. Hypersensitivity. Tetracyclines bind to
attachment of Acne vulgaris. Pericarditis. divalent cations – should
aminoacyl tRNA to RNA- Rosacea & papulopustular facial Photosensitivity reaction. not be given within 2 hrs
ribosome complex. rosacea. Skin reacs. of Ca, antacids, Fe
Early syphilis & late latent syphilis & SLE exacerbated. prevention of ABX
Broad spectrum against neurosyphilis. Discolouration/hypoplasia of absorption.
many Gram +ve & -ves. Non-gonococcal urethritis/PID. tooth enamel in children.
Lyme disease (erythema migrans ±
non-focal Sx & affecting CNs/PNs).
Acrodermatitis chronica atrophicans.
Periodontitis.
Recurrent aphthous ulceration.
Rocky Mountain spotted fever.
, [C2C]
Aminoglyco Gentamicin. EXCRETED RENALLY. Bacterial eye infns. Myasthenia gravis Skin reacs. Loop
sides Amikacin. Bacterial OE. (aminoglycosides Tinnitus. diuretics/vancomycin –
Neomycin. Binds reversibly to 30S Gram +ve bacterial may impair NM ototoxicity risk ↑.
ribosomal subunit of endocarditis/HACEK endocarditis. transmission).
bacteria – prevents Septicaemia. Ciclosporin/platinum
attachment of Meningitis & other CNS infns. chemo/cephalosporins/
aminoacyl tRNA to RNA- Biliary tract infn. vancomycin –
ribosome complex. HAP. nephrotoxicity risk ↑.
Prostatitis.
Activity against Gram - Acute pyelonephritis.
ve aerobic bacteria. CAUTI.
Inactive against Strep +
anaerobes.
Macrolides Erythromyci EXCRETED VIA BILE. RTIs incl. Legionellosis. Allergy. ↓ appetite. Erythro + clarithro (not
n. Skin infns. Diarrhoea/GI discomfort/N&V. azithro) inhibit CYP450
Binds reversibly to P site Oral infns. HA. ↑ plasma concs of drugs
on 50S ribosomal Campylobacter enteritis. Hearing impairment. e.g. warfarin (↑ bleed
subunit of bacteria – Acute OM. Insomnia. risk) & statins (↑
prevents Early syphilis. Pancreatitis. myopathy risk).
peptidyltransferase from Genital chlamydia. Paraesthesia.
adding the growing Non-gonococcal urethritis. Skin reacs. Macrolides prescribed with
peptide attached to Chronic prostatitis. Taste altered. caution in pts taking drugs
tRNA to next αα. Pertussis. Vasodilation. that prolong QT /cause
Rosacea. Vision disorders. arrhythmias e.g.
Inhibit ribosomal Acne. amiodarone,
translation. GI stasis. antipsychotics, quinine,
ABX, SSRIs.
Broad spectrum against
Gram +ve & -ves.
Quinolones Ciprofloxaci EXCRETED RENALLY. Superficial bacterial eye infn. Hx of tendon ↓ appetite. Drugs containing divalent
n. Corneal ulcer. disorders related to Arthralgia. cations (e.g. Ca,
Inhibit bacterial DNA Acute OE. quinolone use. Asthenia. antacids) ↓ absorption
gyrase/topoisomerase IV Fistulating CD. Constipation/diarrhoea/GI and efficacy of quinolones.
inhibition of DNA RTIs. discomfort/N&V.
replication + UTIs. Dizziness. Cipro inhibits certain
transcription. Acute prostatitis. Dyspnoea. CYP450 ↑ toxicity risk,
Gonorrhoea. Eye discomfort/disorders. esp theophylline.
Broad spectrum, esp Anthrax. Fever.
against Gram -ves. Acute pyelonephritis. HA. NSAIDs – ↑ seizure risk.
CAUTI. Muscle complaints.
OT-interval prolongation. Prednisolone – ↑ tendon
Skin reacs. rupture risk.
Sleep disorders.
Taste altered. Quinolones prescribed
, [C2C]
Tinnitus. with caution in pts taking
Vision disorders. other drugs that prolong
QT /cause arrhythmias
e.g. amiodarone,
antipsychotics, quinine,
ABX, SSRIs.
Anaerobic Metronidaz EXCRETED RENALLY. Anaerobic infns. Alcohol should not Dry mouth. Metronidazole has some
antimicrobi ole. Part of H. pylori eradication. be taken whilst Myalgia. inhibitory effect on CYP
als In anaerobic bacteria, Fistulating CD. taking N&V. enzymes, ↓ metabolism of
reduction of Leg ulcers. metronidazole Oral disorders. warfarin (↑ bleeding risk)
metronidazole Pressure sores. disulfiram-like reac Taste metallic. & phenytoin (↑ toxicity
generates a nitroso free Bacterial vaginosis (Gardnerella – flushing, HA, risk, incl impaired
radical. vaginalis). N&V. cerebellar fn).
PID.
This binds to DNA, ↓ Acute ulcerative gingivitis. Li – ↑ toxicity risk.
synthesis and causing Acute oral infns.
widespread damage Invasive intestinal amoebiasis.
(bactericidal). Extra-intestinal amoebiasis.
Urogenital trichomoniasis.
Giardiasis.
Tetanus.
Glycopepti Vancomycin EXCRETED RENALLY. C. diff infn. IV – prev hearing Agranulocytosis. Aminoglycoside/loop
des . Complicated SSTIs. loss. Dizziness/nausea. diuretics/ciclosporin – ↑
Bactericidal activity Bone + jt infns. Drug fever. risk of ototoxicity ±
against aerobic + CAP, HAP, VAP. Eosinophilia/neutropenia. nephrotoxicity.
anaerobic Gram +ve Infective endocarditis. Hypersensitivity.
incl. MRSA. CSF Acute bacterial meningitis. Nephritis tubulointersititial.
penetration poor. Peritonitis assoc with peritoneal Renal F.
dialysis. SCARs.
Skin reacs.
Thrombocytopenia.
Tinnitus.
Vasculitis.
Vertigo.
Trimethopri EXCRETED RENALLY. RTIs. 1st trimester of Diarrhoea. Enhance anticoag effect of
m. PCP in pts who cannot tolerate co- pregnancy – NTDs, Electrolyte imbalance. warfarin (kill N gut flora
Inhibits bacterial folate trimoxazole. cleft lip/palate. Fungal overgrowth. that synthesis vit K).
synthesis. Shigellosis. Blood dyscrasias. HA/N&V.
Invasive salmonella infn. Skin reacs. K+-elevating drugs (e.g.
Broad activity against Acute prostatitis. aldosterone
many Gram +ve and -ve CAUTI. antagonists, ACEis,
bacteria. Lower UTI. ARBs) – predisposes to
hyperK.
