Antibiotics for Community Acquired Pneumonia
Antibiotic
Uses
Special Precautions
Nursing Interventions
Vancocin (vancomycin)
Glycopeptides
Active against many gram
positive organisms;
MRSA
Ototoxic
Nephrotoxic; report tinnitus or
diminished hearing; monitor
renal function
Nursing Interventions for all
antibiotics
1. Take history of allergies;
even if negative observe
for allergic response
especially during the first
30 minutes of infusion
2. C&S done before the first
dose started
3. Monitor for nausea,
diarrhea (all have some
risk of
pseudomembraneous
colitis, possibly secondary
to the anaerobic bacteria
clostridium difficile
4. Suprainfections: oral
thrush, vaginal or perineal
yeast; usually after long
term administration
5. IV antibiotics need to be
given on time to maintain
a constant blood level.
Follow mixing instructions
and rate of administration
carefully.
Getting the right blood level is
important; trough should be
measured 30 minutes prior to
the third dose (accuracy would
be dependent on the 2nd dose
being given on time)
Rocephin (ceftriaxone)
Effective against serious gramThird generation cephalosporin negative and penetrates the
CSF in concentrations useful in
treatment of meningitis;
Pseudomembraneous colitis
Zosyn (piperacillin/tazobatam)
Beta-lactam antibiotic;
penicillin
azithromycin (Zithromax)
macrolide
Aminoglycoside + piperacillin
Cipro, Levoquin (levofloxacin)
(Flouroquinolones)
linezolid (Zyvox)
Combination has antibiotic
activity against an extremely
broad spectrum of gram =positive, gram-negative, and
anaerobic bacteria; aspiration
pneumonia has anaerobic
organisms
Tazobatam is the bata-lactam
component; it has little
antibacterial activity however
extends the spectrum of
bacteria susceptible to
piperacillin
Effective for treatment of mild
to moderate infections by
pyogenic organisms
Pseudomonas aeruginosa
Aerobic gram negative and
some aerobic gram positive
Aminoglycosides are reserved
for serious infections
Gram positive and gram
negative
Aerobic gram positive and
gram negative
Core measures
Offer pneumonia and influenza vaccine
For po adm take aluminum or
magnesium antacids 2 h before
or after; diararrea may be
pseudomembranous colitis
Aminoglycosides are ototoxic
and nephrotoxic
1st dose antibiotics to be given within 4 hours of arrival and after blood culture (door to dose; reduces mortality). Symptoms should
improve in 48-72 hours.
Smoking cessation counseling
Discharge criteria: during rthe 24 hours prior to discharge to home, no more than one: temperature > 100.4, pulse > 100, resp > 24,
systolicBP <90, oxygen sat <90, and inability to maintain oral intake