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Cillins and Cephs CANNOT be mixed. Other antibiotics can be mixed.
Cillin – always take with food and shake very well.
Ceph causes diarrhea.
Cillin – monitor platelet count.
Peak and trough – always check at least 15-30 minutes before next dose. If peak is too high than
the kidney will die, if its too low, then the infection will grow.
o Report ear damage such as vertigo, tinnitus
Vancomycin burns the veins because it is strong. It has to be strong enough to kill MRSA and C
Diff.
o PICC line is the preferred route.
o Assess site every 30 mins if given by peripheral IV.
o Red man syndrome: Rapid infusion
 Hypotension (biggest priority)
 Flushing
 Pruritis
 Red skin
o No nausea/vomiting
Macrolides (Azithromycin)
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Liver toxic, so monitor liver labs
No acetaminophen
Nausea and vomiting is common
Tetracyclines
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Not pregnancy safe
Tooth discoloration
Use sun screen
Use additional contraception
Take on empty stomach
Sit up 30 mins after taking…don’t lay down
No calcium! No iron! No antacids
Metronidazole (Flagyl)
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#1 drug used to treat C. Diff
Also treats trichomoniasis (sTI)
Avoid alcohol during and 3 days after tx
o Metallic taste is normal
o Brown urine is normal
Report any new rash or skin peeling