Additional abx

Question 1

Tygacil

Answer 1

Tigecycline
IV
Broad coverage of gram positive, gram negative, and atypical pathogens (gram negative exceptions: Pseudomonas, Proteus, Providencia)
BW:
- inc risk of death, use only when alt treatments are not suitable
Warnings:
- Hepatotoxicity
- lower cure rates in VAP
Notes:
- do not use for bloodstream infections
- reconstituted solution should be yellow-orange (discard if not this color)

Question 2

Cleocin

Answer 2

Clindamycin
Injection, capsule, suspension, topical
active against most gram positive bacteria (inc CA-MRSA & anaerobes)
does not cover Enterococcus or gram negatives
BW:
- colitis (C. diff)
ADE:
- N/V/D
Notes:
- induction test (D-test) should be performed on S. aureus
- no renal dose adjustments required

Question 3

Flagyl

Answer 3

Metronidazole
tablet, capsule, injection, topical, vaginal
Active against anaerobes & protozoal organisms (vaginal infections, intra-abdominal infections)
CI:
- in 1st trimester of pregnancy, use of alcohol or propylene glycol-containing products during treatment or within 3 days of dc -> disulfiram reaction
ADE:
- metallic taste

Question 4

Flagyl DDI

Answer 4

• NO ALCOHOL during and 3 days after treatment -> disulfiram-like rxn (abd cramping, headaches, N/V, flushing)
• Metronidazole can cause an increase in INR in pts taking warfarin

Question 5

Dificid

Answer 5

Fidaxomicin
tablet, suspension
Warnings:
- not effective for systemic infections

Question 6

Macrobid, Macrodantin

Answer 6

Nitrofurantoin
CI:
- renal impairment (CrCl < 60)
Warnings:
- G6PD deficiency -> hemolytic anemia
ADE:
- GI upset (take with food)
- brown urine discoloration (harmless)