Antibiotics Cautions, Contraindications, MHRA

Question 1

Antibiotics taken B4 food

Answer 1

Label 22 - 30/60min B4 food
Label 23 - Empty stomach 1hr b4 food or 2hrs after:

Demeclocycline
Rifampicin (22,23)
Oxytetracycline
Phenoxymethylpenicillin
Flucloxacillin
Ampicillin
Tetracycline

(DROP FAT)

NB: Amoxicillin can be taken with or without food.
- Check Table in pics

Question 2

Antibiotics WITH food

Answer 2

Label 21 - With or just after a food/meal:

Pivmecillinam
Metronidazole
Nitrofurantoin

(Pi-Met-Nitro)

Question 3

Label 5 - 7 KEY

Answer 3

Label 5 - Don’t take indigestion remedies 2 hrs b4/after taking this meds.
- Applies to EC and gabapentin.

NB: Label 5 forms part of label 6 and 7 but also states avoid meds with iron/zinc.

“Don’t take indigestion remedies or meds containing iron or zinc 2 hrs b4/after taking this med”

• Zinc/Iron decrease absorption of certain drugs (ie quinolones, tetracyclines

Label 6 vs 7:
7 NO milk
- everything else the same - no indigestion remedies/iron/zinc 2 hr b4 or after med.

Question 4

Antibiotics can be taken with MILK

Answer 4

Label 6 - Don’t take indigestion remedies or meds containing iron or zinc 2 hrs b4/after taking this med (Can take with milk):

Doxycycline
Lymecycline
Minocycline

Dox Like Milk
- All tetracycline

Question 5

Antibiotics AVOID with milk

Answer 5

Label 7 - DONT take with milk and indigestion remedies or meds containing iron or zinc 2 hrs b4/after taking this med:

Ciprofloxacin
Demeclocycline
Oxytetracycline
Tetracycline

C.DOT
- All tetracycline except cipro (quinolone)

Question 6

Antibiotics and Pregnancy

Answer 6

Use:
Penicillin’s
Erythromycin
Cephalosporin
Clindamycin

PEC C
- Eryhtro guideline change to - only use if benefit outweighs risk

NB: Some of the AVOID can be used in some trimesters of pregnancy

AVOID
Tetracycline
Aminoglycosides
Macrolides (except erythromycin)
Co-Trimoxazole
Rifampicin
Metronidazole
Quinolones
Nitrofurantoin (3rd trimester)

Key info
- Nitro unsafe after 3rd trimester (1 trimester = 13 weeks).
- Trimethoprim ok to use in 2nd/3rd trimester as 2nd line drug choice. AVOID in 1st - Teratogenic
- Macrolides - Eryhtro - if benefit outweighs risk
Clarithro - AVOID esp 1st unless benefit outweighs risk
Azithro - ONLY if ALT not available
- Rifampicin - Unless benefit outweighs risk
- Metronidazole - AVOID HIGH doses - use if benefit outweighs risk.

Question 7

Antibiotics requiring protection against Sunlight - Label 11

Answer 7

Photosensitivity:

• Doxycycline
• Demeclocycline (Most common with other tetracyclines)

Question 8

Important safety info/Advice

Answer 8

Drugs can cause:
Flucloxacillin - (Cholestatic jaundice & Hepatitis)

Co - Amoxiclav - (Cholestatic jaundice)

Linezolid {MAOi} [Lid - eyelid] - (Blood disorder & Optic neuropathy)

Co-Trimoxazole - (SJS [Severe allergic skin reaction] & Blood disorders)

Quinolones - (Tendon damage, Arthropathy [Joint issues] in children, Convulsion with NSAID [EXAM Q])

Question 9

Which Antibiotics discolour urine

Answer 9

3120