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The Most Common Antibiotics are Used in Prescriptions

The Most Common Antibiotics are Used in Prescriptions

The Most Common Antibiotics Used in Prescriptions

Antibiotics

Within each prescription, there is a drug. Among these drugs, you may find antibiotics…

Antibiotic uses vary and vary, but there are some antibiotics found more common and repeated significantly.

Which called for the need to identify them in more detail and even shed light on them in a summary

In this article, you will read the following ten popular and commonly used Antibiotics:

10- Sulfamethoxazole and Trimethoprim 💊

Amoxicillin

Brand Names: Moxatag, Emox, Amoxicillin
Therapeutic Category: Beta-Lactam Antibiotics
Dosage Forms: oral (Tablet+ Suspension)
Use: Antibiotics
Labeled Indications: Ear, nose, and throat infections, Genitourinary tract infections, Lower respiratory tract infections, Skin and skin structure infections, Helicobacter pylori eradication
Off-Label Indications: Anthrax/ Actinomycosis/ Prophylaxis against bacterial infection in high-risk patients/ Lyme disease /Periodontitis/ Endocarditis, prophylaxis
Dosing:
Dosing Adult: 500 mg to 1 g every 8 to 12 hours
Geriatric: like adult dosing
Pediatric: Mild to moderate infection: 25 to 50 mg/kg/day in divided doses every 8 hours
Severe infection: 80 to 100 mg/kg/day in divided doses every 8 hours.

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Dose Adjustments
Renal Impairment: GFR ≥30 mL/minute: No dosage adjustment necessary.
GFR 10 to 30 mL/minute: 250 to 500 mg every 12 hours
GFR <10 mL/minute: 250 to 500 mg every 24 hours
Hepatic Impairment: Adult: no dosage adjustments
Adverse Drug Interaction:
Headache/ Diarrhea / Nausea / Vomiting / Vulvovaginal infection
Pharmacodynamics/Kinetics:
Time to peak: Capsule, oral suspension: 1 to 2 hours; Chewable tablet: 1 hour; Extended-release: 3.1 hours
Half-life elimination: Adults: Immediate-release: 61.3 minutes; Extended-release: 90 minutes
Excretion: Urine (60% as unchanged drug)
Important Notes:
Birth control pills and other hormone-based birth control may not work as well in preventing pregnancy. Use some different types of birth control when taking this drug.
Pregnancy & Lactation: Risk Factor B/ present in breast milk
Drug safety issue:

Amoxicillin may be confused with amoxapine, Augmentin

Amoxil may be confused with amoxapine

Azithromycin

Brand Names: Zithromax, Zmax, Zicrocin
Therapeutic Category: Antibiotics, Macrolide
Dosage Forms: oral (Capsule/ reconstituted susp)/ IV injection
Use: Antibiotics
Labeled Indications: Chancroid / Chronic obstructive pulmonary disease / Otitis media, acute / Pneumonia, community-acquired / Skin and skin structure infections/ Streptococcal pharyngitis
Off-Label Indications: Acne vulgaris/ Bronchiectasis (non-cystic fibrosis), prevention of pulmonary exacerbations/ Campylobacter infection/ Cesarean delivery (intrapartum or after rupture of membranes), preoperative prophylaxis/ Chlamydia trachomatis infection of the pharynx
Dosing:
Dosing Adult: Usual: Immediate release: 500 mg orally as a single dose on day 1, followed by 250 mg orally once a day on days 2 to 5
Extended-release: 2 g orally once as a single dose
Parenteral: 500 mg IV once a day as a single dose for at least two days, followed by 500 mg (immediate-release formulation) orally to complete a 7- to 10-day course of therapy
Geriatric: like adult dosing
Pediatric: Children ≥6 months: Oral: 10 mg/kg once daily for three days (maximum: 500 mg daily)
Dose Adjustments
Renal Impairment: Use with caution in patients with GFR <10 mL/minute
Hepatic Impairment: No dosage adjustments
Adverse Drug Interaction:
Loose stools/ vomiting/ diarrhea/ Skin rash
Pharmacodynamics/Kinetics:
Time to peak: Oral: Oral: Immediate release: 2 to 3 hours; Extended release: 3 to 5 hours
Half-life elimination: Infants and Children 4 months to 15 years: 54.5 hours
Adults: Immediate release: 68 to 72 hours; Extended release: 59 hours
Excretion: Oral, IV: Biliary (major route 50%, unchanged); urine (6% to 14% unchanged)
Important Notes:
Tablet may be administered with food to decrease GI effects.
extended-release suspension (Zmax) is not interchangeable with immediate-r
Oral suspension, extended-release, should be taken on an empty stomach release formulations
Pregnancy & Lactation: Risk Factor B/ present in breast milk
Drug safety issue:

Azithromycin may be confused with azathioprine, erythromycin

Zithromax may be confused with Fosamax, Zinacef, Zovirax

Cephalexin

Brand Names: Daxbia, Keflex, Ceporex
Therapeutic Category: Beta-Lactam antibiotic (1^st generation Cephalosporin)
Dosage Forms: oral (Tablet or Capsule+ Suspension)
Use: Antibiotics
Labeled Indications: Bone infections/ Genitourinary tract infections/ Otitis media/ Respiratory tract infections/ Skin and skin structure infections
Off-Label Indications: Community-acquired pneumonia/ Endocarditis, prophylaxis/ Prosthetic joint infection
Dosing:
Dosing Adult: 250 to 1000 mg every 6 hours or 500 mg every 12 hours
Geriatric: like adult dosing
Pediatric: 25 to 100 mg/kg/day in divided doses every 6 to 8 hours
Dose Adjustments
Renal Impairment: CrCl 15 to 29 mL/minute: 250 mg every 8 to 12 hours
CrCl 5 to 14 mL/minute (not yet on dialysis): 250 every 24 hours
CrCl 1 to 4 mL/minute (not yet on dialysis): 250 mg every 48 to 60 hours
Hepatic Impairment: Adult: no dosage adjustments
Adverse Drug Interaction:
Agitation, confusion, dizziness, fatigue
Pharmacodynamics/Kinetics:
Time to peak: 1 hour
Half-life elimination: Neonates: 5 hours; Children 3-12 months: 2.5 hours; Adults: 0.5 to 1.2 hours (prolonged with renal impairment)
Excretion: Urine (80% to 100% as unchanged drug) within 8 hours
Important Notes:
Administer without regard to food.
Pregnancy & Lactation: Risk Factor B/ present in breast milk
Drug safety issue:

Cephalexin may be confused with cefaclor, cefazolin, ciprofloxacin

Keflex may be confused with Keppra, Valtrex

Ciprofloxacin

Brand Names: Cipro, Cipro XR
Therapeutic Category: Fluoroquinolone antibiotics
Dosage Forms: oral/ IV
Use: Antibiotics
Labeled Indications: Treatment of complicated urinary tract infections and pyelonephritis due to E. coli/ acute uncomplicated cystitis in female
Off-Label Indications: Anthrax/ Bite wound infection/ Diabetic foot infections/ bacterial Meningitis / Chancroid/ Endocarditis
Dosing:
Dosing Adult: the usual dose is 500-750 mg every 12 hours
Geriatric: like adult dosing
Pediatric: Not routinely first-line therapy
Dose Adjustments
Renal Impairment: CrCl 10 to 50: Administer 50% to 75% of the usual dose every 12 hours
CrCl <10 mL/minute: Administer 50% of usual dose every 12 hours.
Hepatic Impairment: Adult: no dosage adjustments
Adverse Drug Interaction:
– Disabling, tendon rupture, peripheral neuropathy, and CNS effects. -Increase aortic dissections or ruptures should be avoided in patients at increased risk for developing an aortic aneurysm.

Pharmacodynamics/Kinetics:
Time to peak, serum: Immediate release tablet: 0.5 to 2 hours/ Extended-release tablet: Cipro XR: 1 to 2.5 hours
Half-life elimination: Children: 4 to 5 hours; Adults: Normal renal function: 3 to 5 hours
In case of renal function impairment: The half-life is prolonged.
Important Notes:
Tablets may be taken without regard to meals
Avoid concurrent administration of quinolones and antacids as they may decrease the absorption of Quinolones.
Pregnancy & Lactation: Risk Factor C/ present in breast milk
Drug safety issue:
Ciprofloxacin may be confused with cephalexin
Cipro may be confused with Ceftin

Clindamycin

Brand Names: Cleocin, Clindam, Dalacin C
Therapeutic Category: Antibiotics
Dosage Forms: oral (Capsule/ reconstituted solution)/ IV.IM injection
Use:
Labeled Indications: Bone infections/ Gynecological infections / Intra-abdominal infections / Lower respiratory tract infections/ Skin and skin structure infections
Off-Label Indications: Acute otitis media / Community-acquired pneumonia / Group B streptococci, maternal prophylaxis for prevention of neonatal disease / Pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA)
Dosing:
Dosing Adult: Oral: 600 to 1,800 mg/day in 2 to 4 divided doses
IM, IV: 600 to 2,700 mg/day in 2 to 4 divided doses
Geriatric: like adult dosing
Pediatric: Neonates: IM, IV: 15 to 20 mg/kg/day divided every 6 to 8 hours.
Infants, Children, and Adolescents: Oral:8 to 40 mg/kg/day in 3 to 4 divided doses
IM, IV: 20 to 40 mg/kg/day in 3 to 4 divided doses
Dose Adjustments
Renal Impairment: No dosage adjustment
Hepatic Impairment: No dosage adjustments
Adverse Drug Interaction:
Metallic taste/ Abdominal pain/ antibiotic-associated colitis/ diarrhea/ vomiting
Pharmacodynamics/Kinetics:
Time to peak: Oral: Within 60 minutes; IM: 1 to 3 hours
Half-life elimination: Neonates: Premature: 8.7 hours, Full-term: 3.6 hours/ Infants 1 month to 1 year: 3 hours/ Children: 2.5 hours/ Adults: 3 hours
Excretion: Urine (10%) and faeces (3.6%) as active drugs and metabolites
Important Notes:
Clindamycin injection contains benzyl alcohol as a preservative, which can cross the placenta and is associated with the potentially fatal “gasping syndrome” in pediatric patients
It is common to have diarrhoea when taking antibiotics. Rarely a severe form of diarrhoea called Clostridium diff–associated diarrhoea (CDAD) may happen.
Pregnancy & Lactation: Risk Factor B/ present in breast milk
Drug safety issue:

Cleocin may be confused with bleomycin, Clinoril, Cubicin, Lincocin

Clindamycin may be confused with clarithromycin, Claritin, vancomycin, lincomycin

Doxycycline

Brand Names: Avidoxy, Doxy 100, Vibramycin
Therapeutic Category: Antibiotic, Tetracycline
Dosage Forms: oral (Capsule/ reconstituted susp)/ IV injection
Use: Antibiotics
Labeled Indications: Acne/ Actinomycosis / Acute intestinal amebiasis/ Clostridium / Gram-negative infections / Gram-positive infections / Sexually transmitted infections
Off-Label Indications: Cellulitis, mild to moderate/ Surgical prophylaxis, uterine evacuation (induced abortion or pregnancy loss)/ Pelvic inflammatory disease / Rhinosinusitis, acute bacterial
Dosing:
Dosing Adult: oral: 100 to 200 mg/day in 1 to 2 divided doses
IV: 100 mg every 12 hours. Note: IV form may cause phlebitis.
Geriatric: like adult dosing
Pediatric: Children >8 years and Adolescents (<45 kg): Oral, IV: 2 to 4 mg/kg/day in 1 to 2 divided doses
Children >8 years and Adolescents (≥45 kg): Oral, IV: Refer to adult dosing.

Dose Adjustments

Renal Impairment: No dosage adjustments
Hepatic Impairment: No dosage adjustments
Adverse Drug Interaction:
Hypertension/ Anxiety/ Increased lactate dehydrogenase/ Diarrhea/ Nasopharyngitis/ sinusitis
Pharmacodynamics/Kinetics:
Time to peak: Immediate release: 1.5 to 4 hours; delayed release: 2.8 to 3 hours
Half-life elimination: 18 to 22 hours
Excretion: Feces (30%); urine (23% to 40%)
Important Notes:
Take on an empty stomach 1 hour or 2 hours after meals.
Of currently available tetracyclines, doxycycline has the least affinity for calcium
Pediatric: May cause tissue hyperpigmentation, tooth enamel hypoplasia, or permanent tooth discolouration
Pregnancy & Lactation: Risk Factor D/ present in breast milk
Drug safety issue:

Doxycycline may be confused with dicyclomine, doxepin, doxylamine

Doxy100 may be confused with Doxil

Vibramycin may be confused with vancomycin, Vibativ.

Levofloxacin

Brand Names: Levaquin, Levanic, Tavacin
Therapeutic Category: Fluoroquinolone Antibiotics
Dosage Forms: oral/ IV
Use: Antibiotics
Labeled Indications: Treatment of community-acquired pneumonia, MDR Streptococcus pneumoniae (MDRSP), UTI (uncomplicated or complicated)
Off-Label Indications: Anthrax/ Diabetic foot infections/ Cervicitis or urethritis due to Chlamydia trachomatis infection/ H.pylori eradication
Dosing:
Dosing Adult: the usual dose is 500-750 mg every 24 hours
Geriatric: like adult dosing
Pediatric: Oral, IV: 10 to 20 mg/kg/day divided every 12 to 24 hours. Recommended in type I penicillin allergy, after the failure of initial therapy o
Dose Adjustments
Renal Impairment: Clearance is reduced; the half-life is prolonged in patients with CrCl less than 50 mL/minute.
Hepatic Impairment: Adult: no dosage adjustments
Adverse Drug Interaction:
– Common: diarrhoea and insomnia
– Disabling, tendon rupture, peripheral neuropathy, and CNS effects.
Increase aortic dissections or ruptures should be avoided in patients at increased risk for developing an aortic aneurysm.
Stopped immediately if a patient reports any blood glucose disturbances; or side effects involving tendons, muscles, or joints.
Pharmacodynamics/Kinetics:
Time to peak, serum: Oral: 1 to 2 hours
Half-life elimination: Adults: 6 to 8 hours
In case of renal function impairment: The half-life is prolonged.
Important Notes:
Tablets may be taken without regard to meals
Avoid concurrent administration of quinolones and antacids as they may decrease the absorption of Quinolones.
Pregnancy & Lactation: Risk Factor C/ present in breast milk
Drug safety issue:
Levaquin may be confused with Levoxyl, Levsin/SL, Lovenox
LevoFLOXacin may be confused with levETIRAcetam, levodopa, Levophed, or levothyroxine.

Nitrofurantoin

Brand Names: Furadantin, Macrobid, Macrofuran
Therapeutic Category: Antibiotic, Miscellaneous
Dosage Forms: oral capsule/ suspension
Use: Antibiotics
Labeled Indications: Acute uncomplicated cystitis, Recurrent cystitis prophylaxis
Off-Label Indications: None
Dosing:
Dosing Adult: Nitrofurantoin monohydrate/macrocrystals: Oral: 100 mg twice daily; treat females for five days and males for seven days
Nitrofurantoin microcrystals: oral: 50 to 100 mg every 6 hours; treat females for five days and males for seven days
Geriatric: Avoid use
Pediatric: Infants, Children, and Adolescents: Nitrofurantoin macrocrystals: Oral: 5 to 7 mg/kg/day in divided doses every 6 hours (maximum: 400 mg daily). Administer for seven days or at least three days after obtaining sterile urine.
Adolescents: Nitrofurantoin monohydrate/macrocrystals :Oral: 100 mg twice daily for seven days
Dose Adjustments
Renal Impairment: CrCl ≥60 mL/minute: No dosage adjustments
CrCl <60 mL/minute: Limited data suggest nitrofurantoin is safe and effective for short-term treatment
Hepatic Impairment: Adult: no dosage adjustments
Adverse Drug Interaction:
– ECG changes/ Bulging fontanel (infants)/ chills/ confusion/ depression/ dizziness/ drowsiness/ headache/ Alopecia/ erythema multiforme/ exfoliative dermatitis/ pruritus/ skin rash/ Urine discoloration (brown) / Acute pulmonary reaction
Pharmacodynamics/Kinetics:
Bioavailability: Increased with food by 40%
Half-life elimination: 20 to 60 minutes; prolonged with renal impairment
Excretion: Macrocrystals: Urine (20% to 25% as unchanged drug)
Important Notes:
Take meals to improve absorption and decrease adverse effects.
Use caution in patients with G6PD deficiency; they may be at increased risk for hemolytic anaemia. Discontinue therapy if it occurs.
Avoided in patients 65 years and older (independent of diagnosis or condition) due to its potential for pulmonary toxicity, hepatotoxicity and peripheral neuropathy, particularly when given long-term.
Pregnancy & Lactation: Risk Factor B (contraindicated at term)/ present in breast milk
Drug safety issue:

Macrobid may be confused with micro K, Nitro-Bid.

Nitrofurantoin may be confused with Neurontin and nitroglycerin.

Polymyxin B

Brand Names: Polymyxin B/ Maxitrol/ Neobacigrin
Therapeutic Category: Antibiotics, Miscellaneous
Dosage Forms: Solution Reconstituted, Injection/ ophthalmic drops
Use: Antibiotics
Labeled Indications: Infections, acute: Treatment of infections of the urinary tract, meninges, and bloodstream caused by susceptible strains of Pseudomonas aeruginosa
Serious infections: When less potentially toxic drugs are ineffective or contraindicated: H. influenzae, specifically meningeal infections; Escherichia coli, specifically urinary tract infections; Aerobacter aerogenes, specifically bacteremia; Klebsiella pneumonia, specifical bacteremia
Off-Label Indications: Selective gastrointestinal tract decontamination
Dosing:
Dosing Adult: Ocular infections: A concentration of 0.1% to 0.25% (10,000 to 25,000 units/mL) is administered as 1 to 3 drops every hour, then increasing the interval as response indicates
Systemic infections: 15,000 to 25,000 units/kg/day IV divided every 12 hours
Geriatric: Refer to adult dosing
Pediatric: Severe, life-threatening, multidrug-resistant infection:
Dose Adjustments: IV: 15,000 to 40,000 units/kg/day divided every 12 hours (Routine IM administration not recommended due to severe pain at the injection site)
Renal Impairment: reduce to dose to <15,000 units/kg/day
Hepatic Impairment: Adult: no dosage adjustments
Adverse Drug Interaction:
- – Neurotoxicity (includes ataxia, blurred vision, drowsiness, irritability, numbness of extremities)/ Urticaria/ Hypocalcemia, hypochloremia, hypokalemia, hyponatremia
Pharmacodynamics/Kinetics:
Time to peak, serum: IM: Within 2 hours
Half-life elimination: 6 hours, increased with reduced renal function
Excretion: Urine (<1% as unchanged drug within first 12 hours)
Important Notes:
- -avoid concurrent or sequential use of other nephrotoxic drugs
- – Avoid concurrent or sequential use of other neurotoxic drugs

Pregnancy & Lactation: Safety in pregnant women has not been established/ not known if polymyxin b is excreted in human milk
Drug safety issue:

The Institute for Safe Medication Practices (ISMP) includes this medication (intrathecal administration) among its list of drug classes which have a heightened risk of causing significant patient harm when used in error.

Sulfamethoxazole and Trimethoprim

Brand Names: Bactrim; Bactrim DS, septrin
Therapeutic Category: Antibiotic, Sulfonamide Derivative
Dosage Forms: Solution IV/ Oral tablet or suspension
Use: Antibiotics
Labeled Indications: Treatment of urinary tract infections due to Escherichia coli, Klebsiella and Enterobacter/ treatment and prophylaxis of Pneumocystis pneumonia (PCP); traveller’s diarrhoea due to enterotoxigenic E. coli.
Off-Label Indications: Bite wound infections (animal and human bites)/ Brain abscess, empyema, and epidural abscess (methicillin-resistant Staphylococcus aureus)/ Diabetic foot infection/ Head lice/ Osteomyelitis
Dosing:
Dosing Adult: Weight-based dosing recommendations are based on the trimethoprim (TMP) component. Usual 1 to 2 double-strength tablets every 12 to 24 hours
Geriatric: Refer to adult
Pediatric: Infants ≥ two months of age, Children, and Adolescents: Oral, IV: 6 to 12 mg TMP/kg/day in divided doses every 12 hours
Renal Impairment: CrCl >30 mL/minute: No dosage adjustment necessary.
- CrCl 15 to 30 mL/minute: Administer 50%
- CrCl <15 mL/minute: Use is not recommended
Hepatic Impairment: Adult: no dosage adjustments
Adverse Drug Interaction:
– Allergic myocarditis, depression, fatigue, hallucination, headache, insomnia, nervousness, peripheral neuritis, Anaphylaxis, angioedema, hypersensitivity reaction, serum sickness
Pharmacodynamics/Kinetics:
- Half-life elimination:TMP: Prolonged in renal failure
- Time to peak, serum: Oral: 1 to 4 hours
- Excretion: Both are excreted in urine as metabolites and unchanged drug
Important Notes:
- – Tell your doctor if you have an allergy to sulfamethoxazole, trimethoprim, or any other part of this drug.
- -shouldn’t be given to infants younger than two months.
Pregnancy & Lactation: risk factor D/ present in breast milk
Drug safety issue:
- Bactrim may be confused with bacitracin, Bactine, Bactroban
- Co-trimoxazole may be confused with clotrimazole
- Septra may be confused with Ceptaz, Sectral
- Septra DS may be confused with Semprex-D

Ceftriaxone

Brand Names: Ceftriaxone Sandoz

Therapeutic Category: Antibiotic, Cephalosporin (Third Generation)>

Dosage Forms: Solution Reconstituted, Injection

Use: Antibiotic

Labelled Indications:

Bloodstream infection.
Bone and joint infections (osteomyelitis and/or discitis, prosthetic joint infection, septic arthritis).
Gonococcal infection, uncomplicated (cervical/urethral, rectal, and pharyngeal).
Lower respiratory tract infections (pneumonia, community-acquired).
Meningitis, bacterial.
Otitis media, acute.
Pelvic inflammatory disease (mild to moderate).
Skin and soft tissue infections.
Surgical prophylaxis, colorectal.

Off-Label Indications:

Actinomycosis, severe or extensive.
Bite wound infection, treatment, animal or human bite.
Chronic obstructive pulmonary disease, acute exacerbation (hospitalised patients without risk factors for Pseudomonas aeruginosa).
Diabetic foot infection.
Empiric treatment (of sexually transmitted infections) following sexual assault.

Dosing:

Dosing Adult: IV: 1 g once daily for 5 to 7 days.

Geriatric: Refer to adult dosing.

Pediatric: General dosing: Infants, Children, and Adolescents: IM, IV: 50 to 75 mg/kg/dose every 24 hours; maximum dose: 1,000 mg/dose; higher doses are recommended in certain infections (e.g., endocarditis, meningitis)