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A little history

Durng mena the manknd has been sub|ect to nfectous dseases


whch carred away mons ves and were a prncpa cause of death. In
1929 the Engsh mcroboogst A.Femng has opened the frst antbotc -
pencn. It began one of the most oustandng openng XX century. The
new era n boogy and drug - an era of antbotcs began. Snce 40th
years the medca products kng or nterferng
growth of mcroorgansms, have wdey come n
medca practce. Abty of antbotcs
successfuy to strugge wth nfectous dseases,
before consdered fatay dangerous, has been
percevedas panacea. However, soon after the
begnnng of use of antbotcs physcans have
faced wth a probem - the bactera toerant to
ther acton began to appear. Unfortunatey,
every year the number mcroorgansms steady grows. In many respects
t s connected by that, overookng about the care, many peope appy
antbotcs under own dscreton.
Antibiotics
Definition
Antbotcs are among the most frequenty prescrbed medcatons n
modern medcne. Antbotcs cure dsease by kng or n|urng bactera.
The frst antbotc was pencn, dscovered accdentay from a mod
cuture. Today, over 100 dfferent antbotcs are avaabe to cure mnor,
as we as fe-threatenng nfectons.
Athough antbotcs are usefu n a wde varety of nfectons, t s
mportant to reaze that antbotcs ony treat bactera nfectons.
Antbotcs are useess aganst vra nfectons (for exampe, the common
cod) and funga nfectons (such as rngworm). Your doctor can best
determne f an antbotc s rght for your condton.
Antbotcs are drugs that are used to treat nfectons caused by bactera
and other organsms, ncudng protozoa, parastes, and fung.
Purpose
Many treatments for cancer destroy dsease-fghtng whte bood ces,
thereby reducng the body's abty to fght nfecton. For exampe,
badder, pumonary, and urnary tract nfectons may occur wth
chemotherapy. Snge-ceed organsms caed protozoa are rarey a
probem for heathy ndvduas. However, they can cause serous
nfectons n ndvduas wth ow whte bood ce counts. Because of the
dangers that nfectons present for cancer patents, antbotc treatment
often s ntated before the exact nature of the nfecton has been
determned; nstead, the choce of antbotc may depend on the ste of
the nfecton and the organsm that s key to be the cause. Often, an
antbotc that ks a broad spectrum of bactera s chosen and severa
antbotcs may be used together.
Description
The common antibiotics that are used during cancer treatment
include:
Atovaquone (Mapren): antprotozoa drug used to prevent and treat
a very serous type of pneumona caed Pneumocysts carn
pneumona (PCP), n ndvduas who experence serous sde effects
wth SMZ-TMP (Sufamethoxazoe/Trmethoprm, brand name
Bactrm).
Aztreonam (Azactam): monobactam antbotc used to treat gram-
negatve bactera nfectons of the urnary and ower respratory
tracts and the femae organs, and nfectons that are present
throughout the body (systemc nfectons or septcema).
Cefepme (Maxpme), ceftazdme (Ceptaz, Fortaz, Tazcef,
Tazdme), and ceftraxone sodum (Rocephn): members of a group
of antbotcs caed cephaosporns used to treat bactera
nfectons of the urnary and ower respratory tracts, and nfectons
of the skn, bones, |onts, pevs, and abdomen.
Cprofoxacn (Cpro): fuoroqunoone antbotc used to treat
certan gram-negatve and gram-postve bactera and some
mycobactera.
Cndamycn phosphate (Ceocn): used to treat gram-postve and
gram-negatve bactera nfectons and, n ndvduas who are
aergc to sufadazne, toxopasmoss caused by a parastc
protozoa.
Gentamcn (gentamycn) sufate (generc name product,
Garamycn, G-Mycn, |enamcn): amnogycosde antbotc used to
treat serous nfectons by many gram-negatve bactera that
cannot be treated wth other medcnes.
Metrondazoe hydrochorde (Fagy, Metrc 21, Metro I.V.,
Protostat): used for anaerobc bactera and protozoa.
Pentamdne (generc name product, Pentam 300): used to treat
PCP f serous sde effects deveop wth SMZTMP.
Pyrmethamne (Daraprm): antprotozoa medcne used together
wth sufadazne to treat toxopasmoss; or n combnaton wth
other medcnes for treatng md to moderate PCP, n ndvduas
who cannot toerate the standard treatment.
Sufadazne (generc name product): sufonamde antbotc used
wth pyrmethamne to treat toxopasmoss.
Sufamethoxazoe-Trmethoprm (SMZ-TMP) (generc name product,
Bactrm, Cofatrm Forte, Cotrm, Septra, Sufatrm): the sufonamde
antbotc, sufamethoxazoe, used n combnaton wth
trmethoprm, to prevent and treat PCP and bactera nfectons,
such as bronchts and mdde ear and urnary tract nfectons.
Trmethoprm (generc name product, Prooprm, Trmpex):
prmary used to prevent or treat urnary tract nfectons.
Vancomycn hydrochorde (generc name product, Vancocn):
gycopeptde antbotc used to treat a varety of serous gram-
postve bactera nfectons for whch other medcnes are
neffectve, ncudng strans of Staphyococcus that are resstant to
most ora antbotcs.
Most of these antbotcs k bactera by preventng them from makng
proten for ther ce was. Cprofoxacn and metrondazoe prevent
bactera from reproducng by nterferng wth ther abty to make new
DNA. A of these drugs are approved for prescrpton by the U.S. Food
and Drug Admnstraton.
Recommended dosage
Dosages of antbotcs depend on the ndvdua, the nfecton that s
beng treated, and the presence of other medca condtons. For chdren,
the dosage usuay s based on body weght and s ower than the adut
dosage. To be effectve, an entre treatment wth antbotcs must be
competed, even f the symptoms of nfecton have dsappeared.
Furthermore, t s mportant to keep the eve of antbotc n the body at a
constant eve durng treatment. Therefore, the drug shoud be taken on a
reguar schedue. If a dose s mssed, t shoud be taken as soon as
possbe. If t s amost tme for the next dose, the mssed dose shoud be
skpped. Doubng up doses s generay not recommended.
Average adult dosages of common antibiotics for cancer patients
are as follows:
Atovaquone: for PCP treatment, 750 mg ora suspenson twce a
day, or tabets three tmes per day, for 21 days; for PCP preventon,
1, 500 mg ora suspenson, once a day; must be taken wth
baanced meas.
Aztreonam: 1-2 gm every 6-12 hours, n|ected nto a ven, over a
20-60 mnute-perod.
Cefepme: 500 mg to 2 gm, n|ected nto a ven or musce, every 8-
12 hours for 7-10 days.
Ceftazdme: 250 mg to 2 gm, n|ected nto a ven or musce, every
8-12 hours.
Ceftraxone: 1-2 gm, n|ected nto a ven or musce, every 24 hours.
Cprofoxacn: 500-750 mg of the tabet or suspenson, every 12
hours, for 3-28 days, taken two hours after meas wth 8 oz of
water; bone and |ont nfectons usuay are treated for at east 4-6
weeks; 200-400 mg n|ected every 8-12 hours.
Cndamycn: 150-300 mg of capsue or souton, every sx hours;
300-600 mg every sx to eght hours or 900 mg every eght hours,
n|ected nto a ven or musce.
Gentamcn: dosage determned by body weght, every 8-24 hours
for at east 7-10 days, n|ected nto a ven or musce.
Metrondazoe: for bactera nfectons, 7.5 mg per kg (3.4 mg per
b) of body weght up to a maxmum of 1 gm, every sx hours for at
east seven days (capsues or tabets); 15 mg per kg (6.8 mg per b)
for the frst dose, foowed by haf that dosage every sx hours for at
east seven days (n|ected nto a ven); for protozoa nfectons
caused by amebas, 500-750 mg of ora medcne, three tmes per
day for 5-10 days; for trchomonass, 2 gm for one day or 250 mg
three tmes per day for seven days (ora medcne); extended-
reease tabets for vagna bactera nfectons, 750 mg once a day
for seven days.
Pentamdne: for treatng PCP, 4 mg per kg (1.8 mg per b) of body
weght, once per day for 14-21 days, n|ected nto a ven over one
to two hours, whe yng down.
Pyrmethamne: for toxopasmoss, 25-200 mg tabets, taken wth
other medcne, for severa weeks.
Sufadazne: for bactera and protozoa nfectons, 2-4 gm for the
frst dose, foowed by 1 gm every four to sx hours (tabets).
SMZ-TMP: 800 mg of sufamethoxazoe and 160 mg of
trmethoprm, (tabet or ora suspenson), every 12 hours for
bactera nfectons and every 24 hours for preventon of PCP;
dosage based on body weght for PCP treatment; n|ectons based
on body weght, every sx, eght or 12 hours for bactera nfectons
and every sx hours for PCP treatment.
Trmethoprm: 100 mg tabet every 12 hours for 10 days; for
preventon of urnary tract nfectons, once a day for a ong perod.
Vancomycn: 7.5 mg per kg (3.4 mg per b) of body weght, or 500
mg-1 gram, n|ected or taken oray, every 6-12 hours.
Precautions
Stomach or intestinal problems or colitis (inflammation of the
colon) may affect the use of:
Atovaquone
Cephaosporns
Cndamycn
Kidney or liver disease may affect the use of:
Aztreonam
Cefepme
Ceftazdme
Cprofoxacn
Cndamycn
Gentamcn
Metrondazoe
Pentamdne
Pyrmethamne
Sufadazne
SMZ-TMP
Trmethoprm
Vancomycn
Central nervous system or seizure disorders may affect the use
of:
Cprofoxacn
Metrondazoe
Pyrmethamne
Anemia (low red blood cell count) or other blood disorders may
affect the use of:
Metrondazoe
Pentamdne
Pyrmethamne
Sufadazne
SMZ-TMP
Trmethoprm
Cprofoxacn may not be sutabe for ndvduas wth tendnts or wth
skn senstvtes to sunght. Gentamcn may not be sutabe for peope
wth hearng probems, myasthena gravs, or Parknson's dsease.
Metrondazoe may not be sutabe for ndvduas wth heart dsease, ora
or vagna yeast nfectons, or a hstory of acohosm. Pentamdne may
not be sutabe for ndvduas wth heart dsease, beedng dsorders, or
ow bood pressure. Pentamdne may affect bood sugar eves, makng
contro of dabetes metus or hypogycema (ow bood sugar) dffcut.
Vancomycn may not be approprate for ndvduas wth hearng
probems.
Many antbotcs shoud not be taken durng pregnancy or whe breast-
feedng. Oder ndvduas may be more susceptbe to the sde effects of
sufadazne, SMZ-TMP, or trmethoprm.
Sde effects
Some ndvduas may have aergc reactons to antbotcs. If symptoms
of an aergc reacton (such as rash, shortness of breath, sweng of the
face and neck), severe darrhea, or abdomna crampng occur, the
antbotc shoud be stopped and the ndvdua shoud seek medca
advce.
Because antbotcs can affect bactera that are benefca, as we as
those that are harmfu, women may become susceptbe to nfectons by
fung when takng antbotcs. Vagna tchng or dscharge may be
symptoms of such nfectons. A patents may deveop ora funga
nfectons of the mouth, ndcated by whte paques n the mouth.
In|ected antbotcs may resut n rrtaton, pan, tenderness, or sweng
n the ven used for n|ecton. Antbotcs used n cancer patents may
have numerous sde effects, both mnor and severe; however, most sde
effects are uncommon or rare.
The more common side effects of atovauone! aztreonam!
cephalosporins! ciproflo"acin! clindamycin! gentamicin!
metronidazole! and S#$%T#& include:
nausea and vomtng
darrhea
oss of appette
Eatng actve cutured yogurt may hep counteract darrhea, but f a
patent has ow whte bood ces, ths remedy s not recommended. For
md darrhea wth cephaosporns, ony darrhea medcnes contanng
kaon or attapugte shoud be taken. Wth cndamycn, darrhea
medcnes contanng attapugte shoud be taken severa hours before or
after the ora antbotc. Darrhea foowng antbotcs ke cndamycn
may ndcate a bactera nfecton that needs addtona therapy, and a
physcan shoud be consuted.
'ther side effects of atovauone may include:
fever
skn rash
cough
headache
nsomna
'ther side effects of ciproflo"acin may include:
abdomna pan
ncrease n bood tests for kdney functon
dzzness or ght-headedness
nfammaton or tearng of a tendon
drowsness
nsomna
Other common sde effects of cndamycn ncude abdomna pan and
fever. Sde effects may occur up to severa weeks after treatment wth
ths medcne.
Gentamcn and vancomycn may cause serous sde effects, partcuary
n edery ndvduas and newborn nfants. These ncude kdney damage
and damage to the audtory nerve that contros hearng. Other, more
common sde effects of gentamcn may ncude:
changes n urnaton
ncreased thrst
musce twtchng or sezures
headache
ethargy
(hen gentamicin is in)ected into a muscle! vein! or the spinal
fluid! the following side effects may occur:
eg cramps
skn rash
fever
sezures
Sde effects from gentamcn may deveop up to severa weeks after the
medcne s stopped.
#ore common side effects of metronidazole include:
mouth dryness
unpeasant or metac taste
dzzness or ght-headedness
headache
stomach pan
Sugaress candy or gum, bts of ce, or a sava substtute may reeve
symptoms of dry mouth.
Pentamdne, pyrmethamne, sufonamdes, SMZTMP, and trmethoprm
can ower the number of whte bood ces, resutng n an ncreased rsk
of nfecton. These drugs aso can ower the number of bood pateets
that are mportant for bood cottng. Thus, there s an ncreased rsk of
beedng or brusng whe takng these drugs.
Serious side effects of pentamidine may include:
heart probems
ow bood pressure
hgh or ow bood sugar
other bood probems
decrease n urnaton
sore throat and fever
sharp pan n upper abdomen
Some of these symptoms may not occur unt severa months after
treatment wth pentamdne.
Pyrmethamne and trmethoprm may ower the red bood ce count,
causng anema. Leucovorn or the vtamn foc acd may be prescrbed
for anema.
Some ndvduas become more senstve to sunght when takng
sufonamdes, SMZ-TMP, or trmethoprm. Other common sde effects of
sufonamdes and SMZTMP ncude:
dzzness
tchng
skn rash
headache
mouth sores or sweng of the tongue
fatgue
If vancomycn s n|ected nto a ven too qucky, t can cause fushng and
a rash over the neck, face, and chest, wheezng or dffcuty breathng,
and a dangerous decrease n bood pressure.
Interactons
Many prescrpton and non-prescrpton medcnes can nteract wth these
antbotcs. Therefore, t s mportant to consut a compete st of known
drug nteractons. Among the more common or dangerous nteractons:
Antbotcs that ower the number of bood pateets, wth bood
thnners (antcoaguants), such as warfarn
Aztreonam and metrondazoe wth acoho; t s mportant not to
consume acoho unt at east three days after treatment wth
these antbotcs
Cprofoxacn wth antacds, ron suppements, or caffene
Pentamdne or pyrmethamne wth prevous treatments wth x
rays or cancer medcnes (ncreased rsk of bood ce damage)
Trmethoprm wth duretcs to remove excess fud n the edery
Many medcnes can ncrease the rsk of hearng or kdney damage from
gentamcn. These ncude:
cspatn
combnaton pan medcne wth acetamnophen and asprn or
other sacyates (taken reguary n arge amounts)
cycosporne
nfammaton or pan medcne, except narcotcs
thum
methotrexate
other medcnes for nfecton
The following drugs may increase the ris* of liver effects with
sulfadiazine or S#$%T#&:
acetamnophen, ong-term, hgh-dose (eg Tyeno)
brth contro ps contanng estrogens
dsufram (Antabuse)
other medcnes for nfecton
Antibiotics are useless to apply at:
1. A fu - these condtons are caused by vruses, on whch antbotcs do
not render any acton;
2. To the rased temperature - antbotcs are not febrfuga and
anesthetzng prescrptons;
3. Infammatory processes - antbotcs have no ant-nfammatory acton;
4. Cough - there s a set of the reasons of cough: vrus nfectons, an
aergy, the broncha asthma, the rased senstvty of broncha tubes an
envronment both many others, and ony sma share of cough s
connected to mcroorgansms;
5. Frustraton of ntestnes - t s absoutey not necessary, that the gven
condton s an attrbute of an ntestna nfecton. Infrngement of a char
many reasons, startng from smpe ntoerance of any product and
fnshng food when n an organsm the actvator gets not, and deveoped
t can cause toxn. Besdes t s necessary to note, that the ma|orty of
ntestna nfectons are caused by vruses, but even f the actvator -
bactera appcaton of antbotcs qute often ncreases duraton of
dsease;
6. To appy antbotcs t s necessary under strct ndcatons and ony
then when the doctor w estabsh the dagnoss of an nfectous dsease.
A prescrptons of ths cass, unfortunatey, are not unversa and
competey not harmess. Each antbotc has the spectrum of acton, .e.
operates ony on the certan mcroorgansms senstve to t. Ony the
doctor can defne, what antbotc s necessary at ths or that dsease.
REFERENCE:
http://www.heathne.com/gaecontent/antbotcs-1#4
http://abxst.com/
ANTIBIOTIC
S
NCM 106A
Submtted by: Kerwin Ian S. Mempin
BSN IV-|
Submtted to: Filomena Demoni
NCM 106A
Advser