Anti Infectives
- Fluoroquinolones
Nursing management
Favorable Outcomes
•
Before administering any antibiotic be sure to evaluate
the results of the culture and sensitivity test.
•
Monitor labs and evaluate the effectiveness of the
treatment
•
Monitor vitals and temperature
•
Complete the entire course of treatment. Do not stop
the drug, except on the advice of a primary health care
provider, before the course of treatment is completed,
even if symptoms improve or disappear. Failure to
complete the prescribed course of treatment may
result in a return of the infection.
•
There is a risk with all fluoroquinolone drugs of causing
pain, inflammation, or rupture of a tendon. The Achilles
tendon is particularly vulnerable. Those 60 years of age
and older who take corticosteroids are at greatest risk
for tendon rupture.
How do they work? “Action”
The fluoroquinolones exert their bactericidal effect by
interfering with the synthesis of bacterial DNA. This
interference prevents cell reproduction, causing death
of the bacterial cell (Ford 96)
Indications
•
Lower respiratory infections
•
Bone and joint infections
•
Urinary tract infections
•
Infections of the skin
•
Sexually transmitted infections
Adverse Reactions
•
Nausea
•
Diarrhea
•
Headache
•
Abdominal pain or discomfort
•
Dizziness
•
Photosensitivity
Contraindications & Caution
•
Hypersensitivity
•
Children younger than 12 or adults older than 60
who are on corticosteroids because of the risk of
achilles tendonitis
Interactions:
•
Theophylline: Increased serum theophylline level
•
Cimetidine: Interferes with elimination of the
antibiotic
•
Oral anticoagulants: Increased risk of bleeding
•
Antacids, iron salts, or zinc: Decreased absorption
of the antibiotic
•
Nonsteroidal anti-inflammatory drugs (NSAIDs):
Risk of seizure.
•
A superinfection can develop rapidly and is potentially
serious and even life-threatening. Antibiotics can
disrupt the normal flora (nonpathogenic bacteria in the
bowel), causing a secondary infection or superinfection.
This new infection is “superimposed” on the original
infection. The destruction of large numbers of
nonpathogenic bacteria (normal flora) by the antibiotic
alters the chemical environment. This allows
uncontrolled growth of bacteria or fungal
microorganisms that are not affected by the antibiotic
being administered. A superinfection may occur with
the use of any antibiotic, especially when these drugs
are given for a long time or when repeated courses of
therapy are necessary. (Ford 96)
Generic Trade Use Dose
Cipro Treatment of infections due to
susceptible microorganisms
250–750 mg orally q 12 hr;
200–400 mg IV q 12 hr
Gemifloxacin Factive
Treatment of infections due to
susceptible microorganisms
320 mg/day orally
Levofloxacin Levaquin
Bronchitis and
community-acquired pneumonia
250-750 mg/day orally
Ciprofloxacin
