LYMPHEDEMA ANTIBIOTICS

Antibiotic Therapy, Types of Antibiotics

Home page: Lymphedema People

http://www.lymphedemapeople.com

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Antibiotics

Because of our constant battles with infections, I thought it might be interesting to know more about antibiotics. What they are, how they work, what they do and why we should be careful in taking them so as to not build up an immunity to them.

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Antibiotics - Definition

In common usage, an antibiotic is a drug that kills certain kinds of bacteria, but which is generally harmless to the host and is used to treat infection. The term was originally used to describe only antibacterial formulations derived from living organisms but is now used in reference to synthetic antimicrobials such as the Sulfonamides.
In general, the term can also apply to substances that affect prions, viruses, fungi, worms or any other intracellular or extracellular parasite, but the antibacterial kind are the most common. Generally, the antibiotics are not effective in viral infections.


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Antibiotics

. Antibiotics are meant to fight off bacterial infections such as pneumonia (e.g. legionnaires' disease), meningitis, cystitis, ear infections, abscess, Lyme disease (tick-transmitted), leprosy & tuberculosis. They cannot be used against viral infections.

. The first antibiotic discovered by Alexander Fleming, a Scottish scientist in 1928 is penicillin. It was only in 1941 that penicillin made it's public debut.

. Antibiotic drugs are grouped into families such as cephalosporins, fluoroquinolones, penicillins, erythromycins, polypeptides, tetracyclines, aminoglycosides, quinolones, streptogramins & sulfonamides. Each family comprises of many members.

. Antibiotics are classified as narrow-spectrum drugs when they are effective against a few types of bacteria & broad-spectrum drugs when they are effective against a wider range of bacteria.

. Combination of antibiotics are sometimes used to treat certain infections like leprosy & tuberculosis.

. They are sometimes prescribed to treat conditions such as acne, food poisoning, gout & nosebleed.

. Preventive antibiotic therapy is meant to prevent bacterial infection, e.g. to reduce the risk of endocarditis (inflammation of the lining inside the heart chambers & heart valves) or to reduce the risk of contracting traveler's diarrhea or to protect people who have a weak immune system because of AIDS or undergoing chemotherapy treatment for cancer.

. Different antibiotics kill different bacteria differently.

. Though antibiotics can kill off sensitive bacteria, the resistant ones survive & even prosper (i.e. grow & multiply).

. Animals like chickens, pigs, turkeys, cattle also receive their dose of antibiotics in order to either promote growth or to treat & prevent diseases. Fruits & vegetables are also not spared as antibiotics are sprayed to prevent bacterial infections.

Antibiotic resistance

. Antibiotic resistance (AR) is the result of an overuse or misuse of antibiotics. This resistance is certainly a big worry.

. Did you know there are certain strains of bacteria that have become impossible to eliminate with almost all types of antibiotics?

. Broad-spectrum antibiotics are the ones that can promote AR as well as interfere with the absorption of vitamins B6 & B12, folic acid, minerals like magnesium, calcium & potassium.

Side effects

. Allergies may develop with the use of antibiotics, frequently with penicillin.

. Side effects from antibiotics can include diarrhea, lightheadness, headaches, cramp, vomiting & stomach discomfort. Consult your physician if these side effects persist or become serious.

. Taking the antibiotic erythromycin (primarily used to treat bacteria infections e.g. bronchitis, Legionnaires' disease, pneumonia, rheumatic fever & venereal disease) with Liptor, a statin drug shown to lower cholesterol can cause muscle damage. Check with your physician before combining these 2 drugs or learn how to lower cholesterol without drugs here.

. Antibiotics can destroy the beneficial flora (needed for digestion & protection against infection) in the gut.

. Antibiotic therapy can weaken the immune system, simply because it suppresses the body's natural defense system against illness.

Prolong use

. A deficiency in vitamin K can occur.

. A reduction of the manufacture of biotin in the intestines.

. Cause people to be light-sensitive. Examples of such antibiotics : doxycycline, ciproflaxacin & ofloxacin.

Consuming antibiotics

If you must consume antibiotics :

. Complete the full course even if symptoms improve, otherwise, the antibiotics are not given enough time to work on the infection completely, which can cause a relapse. What's more, the bacteria can become so resistant that the antibiotics no longer work for you the next time.

. Follow all the instructions carefully. Take the correct dosages on time.

. Do not take a double dose to make up for a missed one. Either resume to take the forgotten dose at once or if it's time for the next dose, just continue with it & skip the earlier missed dose.

. Do not share antibiotics with anyone.

. Never consume previously prescribed leftovers. Discard them.

. If side effects occur from the course of antibiotics or if the condition shows no signs of improvement, see your physician again.

. Keep capsules or tablets in a cool dry place. Store liquid mixtures in the refrigerator

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Antibiotics: Antibacterial Agents

http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/A/Antibiotics.html

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Antibiotics Classifications

Definition

Antibiotics may be informally defined as the subgroup of anti-infectives that are derived from bacterial sources and are used to treat bacterial infections.

Antibiotics Classifications

Although there are several classification schemes for antibiotics, based on bacterial spectrum (broad versus narrow) or route of administration (injectable versus oral versus topical), or type of activity (bactericidal vs. bacteriostatic), the most useful is based on chemical structure.

PENICILLINS The penicillins are the oldest class of antibiotics, and have a common chemical structure which they share with the cephalosporins. The two groups are classed as the beta-lactam antibiotics, and are generally bacteriocidal -that is, they kill bacteria rather than inhibiting growth.

CEPHALOSPORINS Cephalopsorins are the usually preferred agents for surgical prophylaxis. Cefotaxime, ceftizoxime, ceftriaxone and others, cross the blood-brain barrier and may be used to treat meningitis and encephalitis.

FLUROQUINOLONES The fluroquinolones are synthetic antibacterial agents, and not derived from bacteria. They are included here because they can be readily interchanged with traditional antibiotics.

TETRACYCLINES Tetracyclines got their name because they share a chemical structure that has four rings. The tetracyclines may be effective against a wide variety of microorganisms, including rickettsia and amebic parasites.

MACROLIDES Erythromycin, the prototype of this class, has a spectrum and use similar to penicillin. Newer members of the group, azithromycin and clarithyromycin, are particularly useful for their high level of lung penetration. Clarithromycin has been widely used to treat Helicobacter pylori infections, the cause of stomach ulcers.

OTHERS Other classes of antibiotics include the aminoglycosides, which are particularly useful for their effectiveness in treating Pseudomonas aeruginosa infections; the lincosamindes, clindamycin and lincomycin, which are highly active against anaerobic pathogens.


http://health4.home.ro/b58_antib.html

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General List of Antibiotic Definitions and Terms

http://www.thefreedictionary.com/antibiotic

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How do antibiotics work?

Certain bacteria produce chemicals that damage or disable parts of our bodies. In an ear infection, for example, bacteria have gotten into the inner ear. The body is working to fight the bacteria, but the immune system's natural processes produce inflammation. Inflammation in your ear is painful. So you take an antibiotic to kill the bacteria and eliminate the inflammation.

An antibiotic is a selective poison. It has been chosen so that it will kill the desired bacteria, but not the cells in your body. Each different type of antibiotic affects different bacteria in different ways. For example, an antibiotic might inhibit a bacterium's ability to turn glucose into energy, or its ability to construct its cell wall. When this happens, the bacterium dies instead of reproducing. At the same time, the antibiotic acts only on the bacterium's cell-wall-building mechanism, not on a normal cell's.

Antibiotics do not work on viruses because viruses are not alive. A bacterium is a living, reproducing lifeform. A virus is just a piece of DNA (or RNA). A virus injects its DNA into a living cell and has that cell reproduce more of the viral DNA. With a virus there is nothing to "kill," so antibiotics don't work on it.

Here are some interesting links:

• What the Heck is an Antibiotic?
• Are we overusing antibiotics?
• How do bacteria become resistant to antibiotics?
• Is antibacterial soap any better than regular soap?
• How Cipro Works
• How Your Immune System Works
• How Cells Work
• How Viruses Work

http://www.howstuffworks.com/question88.htm

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Background on Antibiotic Resistance

Antibiotics, also known as antimicrobial drugs, are drugs that fight infections caused by bacteria. After their discovery in the 1940's they transformed medical care and dramatically reduced illness and death from infectious diseases. However, over the decades the bacteria that antibiotics control have developed resistance to these drugs. Today, virtually all important bacterial infections in the United States and throughout the world are becoming resistant. For this reason, antibiotic resistance is among CDC's top concerns.

Antibiotic resistance can cause significant danger and suffering for children and adults who have common infections, once easily treatable with antibiotics.

Antibiotic Resistance- what it is and how it happens:

Antibiotic use promotes development of antibiotic-resistant bacteria. Antibiotic resistance occurs when bacteria change in some way that reduces or eliminates the effectiveness of drugs, chemicals, or other agents designed to cure or prevent infections. The bacteria survive and continue to multiply causing more harm. Widespread use of antibiotics promotes the spread of antibiotic resistance. While antibiotics should be used to treat bacterial infections, they are not effective against viral infections like the common cold, most sore throats, and the flu.

Smart use of antibiotics is the key to controlling the spread of resistance.

What does CDC recommend?

By visiting this website you are taking the first step to reducing your risk of getting antibiotic-resistant infections. It is important to understand that, although they are very useful drugs, antibiotics designed for bacterial infections are not useful for viral infections such as a cold, cough, or flu.

How can you prevent antibiotic-resistant infections?

• Talk with your health care provider about antibiotic resistance.
  • Ask whether an antibiotic is likely to be beneficial for your illness.
  • Ask what else you can do to feel better sooner.
• Do not take an antibiotic for a viral infection like a cold or the flu.
  
• Do not save some of your antibiotic for the next time you get sick.
  
• Take an antibiotic exactly as the doctor tells you.
  
• Do not take an antibiotic that is prescribed for someone else.

Our Campaign

Tackling Antibiotic Resistance:
Overuse of antibiotics is jeopardizing the usefulness of essential drugs. Decreasing inappropriate antibiotic use is the best way to control resistance. In 1995, the Centers for Disease Control and Prevention (CDC) launched a national campaign to reduce antimicrobial resistance through promotion of more appropriate antibiotic use. 

CDC's National Campaign:

CDC's National Campaign for Appropriate Antibiotic Use has two OBJECTIVES:

• Reduce inappropriate antibiotic use
• Reduce the spread of resistance to antibiotics

To accomplish these objectives, the campaign uses the following approaches:

• Developing strategies and materials that will lead to changes in antibiotic use.
• Serving as a resource to groups undertaking their own campaigns.
• Forming partnerships to harness the resources of collaborating organizations.
• Assessing impact on antibiotic use, resistance, and patient/physician satisfaction.

Current campaign activities include:

1. Developing and distributing educational materials promoting appropriate antibiotic use
2. Funding states to develop, implement and evaluate local campaigns
3. Evaluating and promoting a medical school curriculum on appropriate use of antibiotics
4. Continuing to develop and test a Health Plan Employer Data and Information Set (HEDIS) measures for appropriate antibiotic use
5. Implementing a national advertising campaign promoting the appropriate use of antibiotics

http://www.cdc.gov/drugresistance/community/

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Antibiotics: When They Can and Can't Help

What are antibiotics?

Antibiotics are strong medicines that can stop some infections and save lives. But antibiotics can cause more harm than good if they are not used the right way. You can protect yourself and your family by knowing when you should use antibiotics and when you shouldn't.

Do antibiotics work against all infections?

No. Antibiotics only work against infections caused by bacteria. They don't work against any infections caused by viruses. Viruses cause colds, the flu, and most coughs and sore throats.

What is "antibiotic resistance"?

When bacteria are repeatedly exposed to the same antibiotics, the antibiotic can't fight the germs anymore. Being exposed to the same antibiotic for a long time can make some germs change. And sometimes germs just change by themselves. Some of the changes make the germs so strong they can fight back against antibiotics and win the fight. Then these germs are said to be "resistant" to this antibiotic.

Antibiotic resistance is becoming a common problem in many parts of the United States. Resistant bacteria develop faster when antibiotics are used too often or are not used correctly.

Resistant bacteria sometimes can be treated with antibiotics to which the bacteria have not yet become resistant. These medicines may have to be given intravenously (through a vein) in a hospital. A few kinds of resistant bacteria are untreatable.

Why should I worry about antibiotic resistance?

If you take antibiotics that can't fight the germs they are supposed to kill, your infection can last longer. Instead of getting better, your infection might get worse. You might have to make several visits to your doctor's office. You might have to take different medicines or go to a hospital for antibiotics given in your veins.

At the same time, your family members or other people you come in contact with may catch the resistant germs that you have. Then they might also get infections that are hard to cure.

Every time you take antibiotics when you don't really need them, you increase the chance that you will get an illness someday that is caused by germs that are resistant to antibiotics.

How do I know when I need antibiotics?

The answer depends on what is causing your infection. The following are some basic guidelines:

• Colds and flu. Viruses cause these illnesses. They can't be cured with antibiotics.
• Cough or bronchitis. Viruses almost always cause these. However, if you have
  a problem with your lungs or an illness that lasts a long time, bacteria may be the cause. Your doctor may decide to try using an antibiotic.
• Sore throat. Most sore throats are caused by viruses and don't need antibiotics. However, strep throat is caused by bacteria. A throat swab and a lab test are usually needed before your doctor will prescribe an antibiotic for strep throat.
• Ear infections. There are several types of ear infections. Antibiotics are used for some, but not all of them.
• Sinus infections. Antibiotics are often used to treat sinus infections. A runny nose and yellow or green mucus do not necessarily mean you need an antibiotic.

How should I take the antibiotics that my doctor prescribes?

Follow your doctor's directions carefully. Your doctor will tell you to take all of the antibiotic. Don't save some of the medicine for the next time you are sick.

What else can I do to reduce the risk of antibiotic resistance?

Wash your hands with soap and water before you eat and after you use the bathroom. Regular handwashing during the daytime will help keep you healthy and prevent the spread of germs.

Ask your doctor if you have all the vaccinations (shots) you need to protect yourself from illness.

Where can I get more information about antibiotic resistance?

Your doctor.
Centers for Disease Control and Prevention
1-888-246-2675
http://www.cdc.gov/getsmart

Alliance for the Prudent Use of Antibiotics
http://www.apua.org

http://www.aafp.org/afp/20040115/375ph.html

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*** Recommended site: ***

Antibiotics

Layperson's guide to antibiotics, uses for, when not to use, news info and research articles

http://antibioticinformation.blogspot.com/

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Get Smart: Know When Antibiotics Work!

http://www2.state.tn.us/health/CEDS/Antibiotics/program.htm br /

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When and How to Take Antibiotics

Alliance for the Prudent Use of Antibiotics

http://www.tufts.edu/med/apua/Patients/How2Take.html

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Types of Antibiotics

http://www.encyclopedia.com/html/section/antibiot_TypesofAntibiotics.asp

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Antibiotics

Last Updated: May 8, 2001 Rate this Article
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Synonyms and related keywords: medicine, antibiotic, penicillin, cephalosporin, macrolides, fluoroquinolone, sulfonamide, tetracycline, aminoglycoside

Author: Everett Stephens, MD, Assistant Clinical Professor, Department of Emergency Medicine, University of Lou

http://www.emedicine.com/aaem/topic25.htm

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Antibiotic Functions

http://www.esb.utexas.edu/palmer/bio303/group13/af.html

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Antibiotics - A Compendium

Medline Plus

http://www.nlm.nih.gov/medlineplus/antibiotics.html

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The Alliance for the Prudent Use of Antibiotics

http://www.tufts.edu/med/apua/

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Keep Antibiotics Working.com

http://www.keepantibioticsworking.com/pages/home.cfm

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Types of antibiotics and related resistance genes

http://www.antibioresistance.be/

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Penicillin and other antibiotics

http://helios.bto.ed.ac.uk/bto/microbes/penicill.htm

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Nurse Directories on: The Nurse Friendly
Antibiotics, Antiinfectives Drugs Links

http://www.nursefriendly.com/nursing/drugs/antibiotics.antiinfectives.htm

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Antibiotics - History and Classes

http://www.wordiq.com/cgi-bin/knowledge/lookup.cgi?title=Antibiotics

PX Antibacterial Project

Class A Penicillin Binding Protein Research:
Development gateway for a new family of antibiotics

http://www.proteinexpert.com/custom/inhouse/jdc_antibio2.php

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Amoxicillin Clavulanate (Augmentin)

AUGMENTIN is an oral antibacterial combination consisting of the semisynthetic antibiotic amoxicillin and the ß-lactamase inhibitor, clavulanate potassium (the potassium salt of clavulanic acid). Amoxicillin is an analog of ampicillin, derived from the basic penicillin nucleus, 6-aminopenicillanic acid. The amoxicillin molecular formula is C₁₆H₁₉N₃O₅S•3H₂O, and the molecular weight is 419.46. Chemically, amoxicillin is (2S,5R,6R)-6-[(R)-(-)-2-Amino-2- (p -hydroxyphenyl)acetamido]-3,3-dimethyl-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2- carboxylic acid trihydrate

Clavulanic acid is produced by the fermentation of Streptomyces clavuligerus. It is a ß-lactam structurally related to the penicillins and possesses the ability to inactivate a wide variety of ß-lactamases by blocking the active sites of these enzymes. Clavulanic acid is particularly active against the clinically important plasmid-mediated ß-lactamases frequently responsible for transferred drug resistance to penicillins and cephalosporins. The clavulanate potassium molecular formula is C₈H₈KNO₅, and the molecular weight is 237.25. Chemically, clavulanate potassium is potassium (Z)-(2R,5R)-3-(2-hydroxyethylidene)-7-oxo-4-oxa-1-azabicyclo[3.2.0]- heptane-2-carboxylate,

Colloidal silicon dioxide, hypromellose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, sodium starch glycolate, and titanium dioxide. Each tablet of AUGMENTIN contains 0.63 mEq potassium.

http://www.rxlist.com/cgi/generic/amoxclav.htm

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Augmentin - Amoxicillin and Clavulanate

http://www.drugs.com/augmentin.html

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AMOXICILLIN; CLAVULANATE POTASSIUM

http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Overview&DrugName=AUGMENTIN%20XR

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Keflex

Keflex is a semisynthetic cephalosporin antibiotic intended for oral administration. It is 7-(D-a-Amino-a-phenylacetamido)- 3-methyl-3-cephem-4-carboxylic acid monohydrate. Cephalexin has the molecular formula C₁₆H₁₇N₃O₄S·H₂O and the molecular weight is 365.41.

The nucleus of cephalexin is related to that of other cephalosporin antibiotics. The compound is a zwitterion; i.e., the molecule contains both a basic and an acidic group. The isoelectric point of cephalexin in water is approximately 4.5 to 5.

The crystalline form of cephalexin which is available is a monohydrate. It is a white crystalline solid having a bitter taste. Solubility in water is low at room temperature; 1 or 2 mg/ml may be dissolved readily, but higher concentrations are obtained with increasing difficulty.

The cephalosporins differ from penicillins in the structure of the bicyclic ring system. Cephalexin has a D-phenylglycyl group as substituent at the 7-amino position and an unsubstituted methyl group at the 3-position.

Each Pulvule contains cephalexin monohydrate equivalent to 250 mg (720 mcmol) or 500 mg (1,439 mcmol) of cephalexin. The Pulvules also contain cellulose, Dy & C Yellow No. 10, F Dy & C Blue No. 1, F Dy & C Yellow No. 6, gelatin, magnesium stearate, silicone, titanium dioxide, and other inactive ingredients.

Each capsule manufactured by Mylan contains cephalexin monohydrate equivalent to 250 mg (720 mcmol) or 500 mg (1,439 mcmol) of cephalexin. The capsules also contain cellulose, F Dy & C Blue No. 1, gelatin, magnesium stearate, silicone, titanium dioxide, and other inactive ingredients.

After mixing, each 5 ml of Keflex, for oral suspension, will contain cephalexin monohydrate equivalent to 125 mg (360 mcmol) or 250 mg (720 mcmol) of cephalexin. The suspensions also contain flavors, methylcellulose, silicone, sodium lauryl sulfate, and sucrose. The 125-mg suspension contains F Dy & C Red No. 40, and the 250-mg suspension contains F Dy & C Yellow No. 6.

http://www.rxlist.com/cgi/generic/cephalex.htm

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Keflex - cephalexin

http://www.drugs.com/keflex.html

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Keflex - cephalexin

Why is this medication prescribed?

Cephalexin is a cephalosporin antibiotic used to treat certain infections caused by bacteria such as pneumonia and bone, ear, skin, and urinary tract infections. Antibiotics will not work for colds, flu, or other viral infections.

This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

How should this medicine be used?

Cephalexin comes as a capsule, tablet, and liquid to take by mouth. It is usually taken every 6 hours (four times a day) or every 12 hours (twice a day) for 7-10 days. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take cephalexin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Shake the liquid well before each use to mix the medication evenly.

The capsules and tablets should be swallowed whole and taken with a full glass of water.

Continue to take cephalexin even if you feel well. Do not stop taking cephalexin without talking to your doctor.

What special precautions should I follow?

Before taking cephalexin,

• tell your doctor and pharmacist if you are allergic to cephalexin or any other cephalosporin antibiotic such as cefadroxil (Duricef) or cephradine (Velosef), penicillin, or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially other antibiotics, anticoagulants ('blood thinners') such as warfarin (Coumadin), probenecid (Benemid), and vitamins.
• tell your doctor if you have or have ever had kidney or liver disease, colitis, or stomach problems.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking cephalexin, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking cephalexin.

What special dietary instructions should I follow?

Cephalexin may cause an upset stomach. Take cephalexin with food or milk.

What should I do if I forget a dose?

Take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What side effects can this medication cause?

Although side effects from cephalexin are not common, they can occur. Tell your doctor if any of these symptoms are severe or do not go away:

• upset stomach
• diarrhea
• vomiting
• mild skin rash

If you experience any of the following symptoms, call your doctor immediately:

• severe skin rash
• itching
• hives
• difficulty breathing or swallowing
• wheezing
• unusual bleeding or bruising
• sore throat
• painful mouth or throat sores
• vaginal infection

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store the capsules and tablets at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Keep liquid medicine in the refrigerator, tightly closed, and throw away any unused medication after 14 days. Do not freeze. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to cephalexin.

If you are diabetic, use Clinistix or TesTape (not Clinitest) to test your urine for sugar while taking this drug.

Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish the cephalexin, call your doctor.

Last Revised - 01/01/2003

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682733.html

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Gentamicin Sulfate Injection

IMPORTANT WARNING:

About your treatment

Your doctor has ordered gentamicin, an antibiotic, to help treat your infection. The drug will be either injected into a large muscle (such as your buttock or hip) or added to an intravenous fluid that will drip through a needle or catheter placed in your vein for at least 30 minutes, one to three times a day.

Gentamicin eliminates bacteria that cause many kinds of infections, including lung, skin, bone, joint, stomach, blood, and urinary tract infections. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Your health care provider (doctor, nurse, or pharmacist) may measure the effectiveness and side effects of your treatment using laboratory tests and physical examinations. It is important to keep all appointments with your doctor and the laboratory. The length of treatment depends on how your infection and symptoms respond to the medication.

Precautions

Before administering gentamicin,

• tell your doctor and pharmacist if you are allergic to amikacin (Amikin), gentamicin, kanamycin (Kantrex), neomycin, netilmicin (Netromycin), streptomycin, tobramycin (Nebcin), or any other drugs.
• tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially diuretics ('water pills'), cisplatin (Platinol), amphotericin (Amphotec, Fungizone), other antibiotics, and vitamins.
• tell your doctor if you have or have ever had kidney disease, vertigo, hearing loss, ringing in the ears, myasthenia gravis, or Parkinson's disease.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking gentamicin, call your doctor immediately. Gentamicin can harm the fetus.

Administering your medication

Before you administer gentamicin, look at the solution closely. It should be clear and free of floating material. Gently squeeze the bag or observe the solution container to make sure there are no leaks. Do not use the solution if it is discolored, if it contains particles, or if the bag or container leaks. Use a new solution, but show the damaged one to your health care provider.

It is important that you use your medication exactly as directed. Do not stop your therapy on your own for any reason because your infection could worsen and result in hospitalization. Do not change your dosing schedule without talking to your health care provider. Your health care provider may tell you to stop your infusion if you have a mechanical problem (such as a blockage in the tubing, needle, or catheter); if you have to stop an infusion, call your health care provider immediately so your therapy can continue.

Side effects

Gentamicin occasionally causes side effects. To reduce this risk, your health care provider may adjust your dose based on your blood test results. Follow the directions in the IMPORTANT WARNING section for the symptoms listed there and tell your health care provider if any of the following symptoms are severe or do not go away:

• upset stomach
• vomiting
• fatigue
• pale skin

Storing your medication

• Your health care provider probably will give you a several-day supply of gentamicin at a time. If you are receiving gentamicin intravenously (in your vein), you probably will be told to store it in the refrigerator or freezer.
• Take your next dose from the refrigerator 1 hour before using it; place it in a clean, dry area to allow it to warm to room temperature.
• If you are told to store additional gentamicin in the freezer, always move a 24-hour supply to the refrigerator for the next day's use.
• Do not refreeze medications.

If you are receiving gentamicin intramuscularly (in your muscle), your health care provider will tell you how to store it properly.

Store your medication only as directed. Make sure you understand what you need to store your medication properly.

Keep your supplies in a clean, dry place when you are not using them, and keep all medications and supplies out of reach of children. Your health care provider will tell you how to throw away used needles, syringes, tubing, and containers to avoid accidental injury.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Signs of infection

You should be aware of the symptoms of infection in case your infection worsens or a new infection develops. If you notice any of the following symptoms, tell your health care provider as soon as possible:

• fever
• unusual tiredness or weakness
• chills
• shaking
• nighttime sweating
• loss of appetite

If you are receiving gentamicin in your vein or under your skin, you need to know the symptoms of a catheter-related infection (an infection where the needle enters your vein or skin). If you experience any of these effects near your intravenous catheter, tell your health care provider as soon as possible:

• tenderness
• warmth
• irritation
• drainage
• redness
• swelling
• pain

Last Revised - 01/01/2003

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a682275.html

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Gentamicin sulfate

http://www.healthdigest.org/drugs/gentamicinsulfate.html

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Gentamicin

http://www.vitacost.com/science/hn/Drug/Gentamicin.htm

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Unasyn

Penicillins and beta-lactamase inhibitors are used to treat infections caused by bacteria. They work by killing the bacteria or preventing their growth. The beta-lactamase inhibitor is added to the penicillin to protect the penicillin from certain substances (enzymes) that will destroy the penicillin before it can kill the bacteria.

http://health.yahoo.com/health/drug/202705/unasyn

http://health.yahoo.com/health/drug/202705/overview

Precautions & Side Effects

http://health.yahoo.com/health/drug/202705/precaution

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Aminopenicillins

• See Also
  1. Penicillin
• Preparations: Amoxicillin and Ampicillin
  1. Ampicillin
     1. Child: 50-200 mg/kg/day IV divided qid
  2. Amoxicillin
     1. Adult: 875 mg PO bid
     2. Child: 45 mg/kg/day divided PO bid
• Preparations: Added Beta-lactamase resistance
  1. Ampicillin Sulbactam (Unasyn)
     1. Adult: 1.5-3 grams IV every 6 hours
  2. Amoxicillin Clavulanate (Augmentin)
     1. Adult: 875 mg PO bid
     2. Child: 45 mg/kg/day divided PO bid
• Mechanisms of action
  1. Same as for Natural Penicillins
  2. Penetrates outer membrane of some Gram Negatives
  3. Clavulanic acid and sulbactam bind Beta-lactamases
• Pharmacokinetics
  1. Keep Augmentin suspension refrigerated
  2. Clavulanate suspension breaks down at room temperature
     1. Turns brown with breakdown
     2. Loses 90% of potency after 2 days at room temperature
• Bacterial Resistance Mechanisms Overcome
  1. Beta-lactamase Production
  2. Alteration of Penicillin binding protein
• Activity Spectrum
  1. General
     1. Gram Positive Cocci
     2. Gram Negative Rods
     3. Spirochetes (e.g. Treponema pallidum)
  2. Conditions
     1. Otitis Media
     2. Sinusitis
     3. CNS Infection
     4. Urinary Tract Infection
     5. Infectious Enteritis
     6. Borrelia Burgdorferi (Lyme Disease)
     7. Helicobacter Pylori
• Adverse effects
  1. Similar to Natural Penicillins
  2. Maculopapular rash
  3. Diarrhea (modifications can decrease stools to 12%)
     1. Dose exactly by kilogram for children
     2. Avoid food before dose
     3. Consider eating yogurt with each dose

http://www.fpnotebook.com/ID153.htm

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Azithromycin - Zithromax

Zithromax (azithromycin tablets, azithromycin capsules and azithromycin for oral suspension) contain the active ingredient azithromycin, an azalide, a subclass of macrolide antibiotics, for oral administration. Azithromycin has the chemical name (2R,3S,4R,5R,8R,10R,11R,12S,13S,14R)-13-[ (2,6-dideoxy-3-C-methyl-3-O -methyl-a-L-ribo-hexopyranosyl)oxy]-2-ethyl-3,4,10- trihydroxy-3,5,6,8,10,12,14-heptamethyl-11- [[3,4,6-trideoxy-3-(dimethylamino)-b-D- xylo-hexopyranosyl]oxy]-1-oxa-6- azacyclopentadecan-15-one. Azithromycin is derived from erythromycin; however, it differs chemically from erythromycin in that a methyl-substituted nitrogen atom is incorporated into the lactone ring. Its molecular formula is C₃₈H₇₂N₂O₁₂, and its molecular weight is 749.00.

Azithromycin, as the dihydrate, is a white crystalline powder with a molecular formula of C₃₈H₇₂N₂O₁₂•2H₂O and a molecular weight of 785.0.

Zithromax is supplied for oral administration as film-coated, modified capsular shaped tablets containing azithromycin dihydrate equivalent to 250 mg azithromycin and the following inactive ingredients: dibasic calcium phosphate anhydrous, pregelatinized starch, sodium croscarmellose, magnesium stearate, sodium lauryl sulfate, hydroxypropyl methylcellulose, lactose, titanium dioxide, triacetin and D&C red #30 aluminum lake

Zithromax capsules contain azithromycin dihydrate equivalent to 250 mg of azithromycin. The capsules are supplied in red opaque hard-gelatin capsules (containing FD&C red #40). They also contain the following inactive ingredients: anhydrous lactose, corn starch, magnesium stearate, and sodium lauryl sulfate.

It is also supplied as a powder for oral suspension.

Zithromax for oral suspension is supplied in bottles containing azithromycin dihydrate powder equivalent to 300 mg, 600 mg, 900 mg, or 1200 mg azithromycin per bottle and the following inactive ingredients: sucrose; sodium phosphate; tribasic; anhydrous; hydroxypropyl cellulose; xanthan gum; FD&C red #40; and spray dried artificial cherry, creme de vanilla and banana flavors. After constitution, each 5 ml of suspension contains 100 mg or 200 mg of azithromycin.

http://www.rxlist.com/cgi/generic/azith.htm

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Azithromycin - Zithromax

GENERIC NAME: azithromycin

BRAND NAME: Zithromax

DRUG CLASS AND MECHANISM: Azithromycin is a semi-synthetic macrolide antibiotic chemically related to erythromycin and clarithromycin (Biaxin). It is effective against a wide variety of bacteria organisms, such as Hemophilus influenzae, Streptococcus pneumoniae, Mycoplasma pneumoniae, Staphylococcus aureus, and mycobacterium avium, and many others. It is unusual in that it stays in the body for quite a while, allowing for once a day dosing and for shorter treatment courses for most infections.

Azithromycin, like all macrolide antibiotics, prevents bacteria from growing by interfering with their ability to make proteins. Due to the differences in the way proteins are made in bacteria and humans, the macrolide antibiotics do not interfere with humans' ability to make proteins.

PRESCRIPTION: yes

GENERIC AVAILABLE: no

PREPARATIONS: Capsules (red): 250mg; Suspension: 100 mg/teaspoon; 200 mg/teaspoon.

STORAGE: Capsules should be kept below 30°C (86°F). Suspension should be kept between 5° and 30°C (41° and 86°F).

PRESCRIBED FOR: Azithromycin is effective against susceptible bacteria causing infections of the middle ear, tonsillitis, throat infections, laryngitis, bronchitis, pneumonia, sinuses and. It is also effective against certain sexually transmitted infectious diseases, such as nongonococcal urethritis and cervicitis.

DOSING: Azithromycin should be taken at least one hour before or two hours after meals since it may bind to food and not be absorbed from the intestine. For most infections, azithromycin is taken once daily for a relatively short course of treatment (usually five days). The first dose is often a "double dose," twice as much as the remainder of the doses given. For acute bacterial sinusitis, azithromycin way be taken once daily for three days.

DRUG INTERACTIONS: Unlike erythromycin and clarithromycin, azithromycin is generally considered free of interactions with most other medicines. It is recommended that azithromycin not be taken at the same time as aluminum- or magnesium- based antacids, such as Mylanta or Maalox because antacids will bind the azithromycin and prevent it from being absorbed from the intestine.

PREGNANCY: There are no adequate studies of azithromycin in pregnant women. However, studies in animals suggest no important effects on the fetus. Azithromycin therefore can be used in pregnancy if the physician feels that it is clearly necessary.

NURSING MOTHERS: It is not known if azithromycin is secreted in breast milk.

SIDE EFFECTS: Azithromycin is generally well tolerated. The most common side effects are diarrhea or loose stools, nausea, abdominal pain, and vomiting, each of which may occur in fewer than one in twenty persons who receive azithromycin. Rarer side effects include abnormal liver tests, allergic reactions, and nervousness.

8 additional azithromycin related articles -- click here

http://www.medicinenet.com/azithromycin/article.htm

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Ciprofloxacin

CIPRO^® (ciprofloxacin hydrochloride) Tablets and CIPRO (ciprofloxacin*) Oral Suspension are synthetic broad spectrum antimicrobial agents for oral administration. Ciprofloxacin hydrochloride, USP, a fluoroquinolone, is the monohydrochloride monohydrate salt of 1-cyclopropyl-6-fluoro-1, 4-dihydro-4-oxo-7-(1-piperazinyl)-3-quinolinecarboxylic acid. It is a faintly yellowish to light yellow crystalline substance with a molecular weight of 385.8. Its empirical formula is C₁₇H₁₈FN₃O₃•HCl•H₂O

Ciprofloxacin is 1-cyclopropyl-6-fluoro-1,4-dihydro-4-oxo-7-(1-piperazinyl)-3- quinolinecarboxylic acid. Its empirical formula is C₁₇H₁₈FN₃O₃ and its molecular weight is 331.4. It is a faintly yellowish to light yellow crystalline substance

CIPRO film-coated tablets are available in 100 mg, 250 mg, 500 mg and 750 mg (ciprofloxacin equivalent) strengths. Ciprofloxacin tablets are white to slightly yellowish. The inactive ingredients are cornstarch, microcrystalline cellulose, silicon dioxide, crospovidone, magnesium stearate, hypromellose, titanium dioxide, polyethylene glycol and water.

Ciprofloxacin Oral Suspension is available in 5% (5 g ciprofloxacin in 100 mL) and 10% (10 g ciprofloxacin in 100 mL) strengths. Ciprofloxacin Oral Suspension is a white to slightly yellowish suspension with strawberry flavor which may contain yellow-orange droplets. It is composed of ciprofloxacin microcapsules and diluent which are mixed prior to dispensing (See instructions for use/handling). The components of the suspension have the following compositions:

Microcapsules - ciprofloxacin, povidone, methacrylic acid copolymer, hypromellose, magnesium stearate, and Polysorbate 20.

Diluent - medium-chain triglycerides, sucrose, lecithin, water, and strawberry flavor.

* Does not comply with USP with regards to "loss on drying" and "residue on ignition".

http://www.rxlist.com/cgi/generic/cipro.htm

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Ciprofloxacin

Why is this medication prescribed?

Ciprofloxacin is an antibiotic used to treat certain infections caused by bacteria. Ciprofloxacin tablets and suspension (liquid) are used to treat pneumonia (lung infection); bronchitis (infection of the tubes that lead to the lungs); some types of gonorrhea (a sexually transmitted disease); diarrhea caused by bacteria; typhoid fever (a contagious illness common in developing countries); and bone, joint, skin, prostate (a male reproductive gland), sinus, and urinary tract (bladder) infections. Ciprofloxacin is also used to prevent and/or treat anthrax in people exposed to anthrax germs in the air. Ciprofloxacin is also used with another medication to treat certain infections of the internal organs. Ciprofloxacin extended release (long-acting) tablets are used to treat urinary tract and kidney infections. Ciprofloxacin is in a class of antibiotics called fluoroquinolones. It works by killing bacteria. Antibiotics will not work for colds, flu, or other viral infections.

How should this medicine be used?

Ciprofloxacin comes as a tablet, a suspension (liquid) and an extended release (long-acting) tablet to take by mouth with or without food. The tablet and suspension are usually taken every 12 hours (twice a day). The extended release tablets are usually taken once a day. To help you remember to take ciprofloxacin, take it around the same time(s) every day. The length of your treatment depends on the type of infection you have. Your doctor will tell you how long you need to take ciprofloxacin. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take ciprofloxacin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Swallow the extended release tablets whole; do not split, crush, or chew them.

If you are taking the liquid, shake the bottle for 15 seconds before each use to mix the medication evenly. Swallow the correct dose without chewing the granules in the liquid. Do not give the liquid to a patient through a feeding tube.

If you are taking the tablets or extended release tablets, swallow them with a full glass of water.

You should begin feeling better during the first few days of treatment with ciprofloxacin. If you do not, call your doctor.

Take ciprofloxacin until you finish the prescription, even if you feel better. If you stop taking ciprofloxacin too soon or skip doses, your infection may not be completely cured and bacteria may become resistant to antibiotics.

Other uses for this medicine

Ciprofloxacin is also sometimes used to treat patients with cystic fibrosis who have lung infections. Ciprofloxacin is sometimes used to treat various sexually transmitted diseases and various infections such as Legionnaire disease (a type of lung infection), cat scratch disease (an infection that may develop after a patient is bitten or scratched by a cat), and brucellosis (a type of infection that causes a rising and falling fever and other symptoms). In the event of biological warfare, ciprofloxacin may be used to treat and prevent dangerous illness that are deliberately spread such as plague, tularemia, and anthrax of the skin or mouth. Ciprofloxacin may also be used to reduce the amount of certain types of bacteria in the nose to prevent serious illness. Ciprofloxacin may be used with another medication to treat disseminated Mycobacterium avium complex (MAC) (a type of lung disease that often affects people with human immunodeficiency virus [HIV] ), and tuberculosis (TB) (a type of lung infection). Talk to your doctor about the possible risks of using this drug for your condition.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking ciprofloxacin,

• tell your doctor and pharmacist if you are allergic to ciprofloxacin; other quinolone and fluoroquinolone antibiotics such as cinoxacin (Cinobac), enoxacin (Penetrex), gatifloxacin (Tequin), gemifloxacin (Factive), levofloxacin (Levaquin), lomefloxacin (Maxaquin), moxifloxacin (Avelox), nalidixic acid (NegGram), norfloxacin (Noroxin), ofloxacin (Floxin), sparfloxacin (Zagam), trovafloxacin and alatrofloxacin combination (Trovan); or any other medications.
• tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: acetazolamide (Diamox); anticoagulants ('blood thinners') such as warfarin (Coumadin); brinzolamide (Azopt); cancer chemotherapy medications; chloroquine (Aralen); cyclosporine (Neoral, Sandimmune), dichlorphenamide (Daranide); dorzolamide (Cosopt, Trusopt); glyburide (DiaBeta, Glycron, Glynase, Micronase); isoniazid (INH, Nydrazid); medications for depression , pain, or mental illness; medications for diarrhea, such as dicyclomine (Bentyl), diphenoxylate (Lomotil), and loperamide (Imodium); medications that contain caffeine (NoDoz, Vivarin, others); methazolamide (GlaucTabs, Nepatazane); methocarbamol (Robaxin); metoclopramide (Reglan); methotrexate (Rheumatrex, Trexall); mycophenolate mofetil (CellCept); neostigmine (Prostigmin); nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn); oral steroids such as dexamethasone (Decadron, Dexone), methylprednisolone (Medrol), and prednisone (Deltasone); other antibiotics; phenytoin (Dilantin, Phenytek); physostigmine (Antilirium); potassium citrate and citric acid (Cytra-K, Polycitra-K); probenecid (Benemid); pyridostigmine (Mestinon, Regonol); pyrimethamine (Daraprim); sedatives and sleeping pills; sodium bicarbonate (Soda Mint, baking soda); sodium citrate and citric acid (Bicitra, Oracit); theophylline (Theobid, Theo-Dur, Slo-bid, others); or tacrolimus (Prograf). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• if you are taking antacids (Maalox, Mylanta); didanosine (Videx) chewable tablets or solution (liquid); calcium, iron, zinc or vitamin supplements; or sucralfate (Carafate), take them 6 hours before or 2 hours after ciprofloxacin.
• tell your doctor if you have or have ever had arthritis; dementia (memory loss and personality changes); depression; mental illness; diarrhea during or after antibiotic therapy; recent head injury; seizures; stroke or mini-stroke; or kidney or liver disease.
• you should know that ciprofloxacin and other similar antibiotics have caused serious and occasionally fatal allergic reactions in some patients. If you develop hives; difficulty breathing or swallowing; rapid, irregular or pounding heartbeat; fainting; dizziness; blurred vision, or other symptoms of a severe allergic reaction, seek emergency medical care right away. If you develop a skin rash, stop taking gemifloxacin and call your doctor. Call your doctor if you experience other signs of an allergic reaction such as itching; tingling; swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs; fever; hoarseness; joint or muscle pain; unusual bruising or bleeding; extreme tiredness; lack of energy; loss of appetite; pain in the upper right part of the stomach; yellowing of the skin or eyes; flu- like symptoms; or upset stomach.
• tell your doctor if you have ever had tendonitis (swelling or tearing of the fiber that connects a bone to a muscle) and if you participate in regular athletic activity. If you experience symptoms of tendonitis, such as pain, swelling, tenderness, stiffness, or difficulty in moving a muscle, stop taking ciprofloxacin, rest, and call your doctor immediately.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking ciprofloxacin, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking ciprofloxacin.
• you should know that ciprofloxacin may cause dizziness, lightheadedness, and tiredness. Do not drive a car or operate machinery until you know how this medication affects you.
• plan to avoid unnecessary or prolonged exposure to sunlight or ultraviolet light (tanning beds) and to wear protective clothing, sunglasses, and sunscreen. Ciprofloxacin may make your skin sensitive to sunlight.
• you should know that ciprofloxacin may cause diarrhea during or after your treatment. You should not treat this diarrhea with over the counter medications. Instead, call your doctor to find out what to do.

What special dietary instructions should I follow?

Do not take ciprofloxacin with dairy products (like milk or yogurt) or calcium-added juices alone. You may take ciprofloxacin with a meal that includes these foods. Drink at least eight full glasses of water or liquid every day. Do not drink or eat a lot of caffeine-containing products such as coffee, tea, cola, or chocolate. Ciprofloxacin increases nervousness, sleeplessness, heart pounding, and anxiety caused by caffeine.

What should I do if I forget a dose?

If you are taking ciprofloxacin tablets or suspension, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

If you are taking ciprofloxacin extended release tablets and forget to take your dose at the usual time, you may take the dose later in the day. However, do not take more than one ciprofloxacin extended release tablet in one day, even if you missed a dose.

What side effects can this medication cause?

Ciprofloxacin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• upset stomach
• vomiting
• stomach pain
• indigestion
• headache
• nervousness
• agitation
• anxiety
• difficulty falling asleep or staying asleep
• nightmares or abnormal dreams

Some side effects can be serious. The following symptoms are uncommon, but if you experience any of them or those mentioned in the SPECIAL PRECAUTIONS section, call your doctor immediately:

• seizures
• vaginal yeast infection
• confusion
• shaking hands that you cannot control
• believing that others want to harm you
• hallucination (seeing things or hearing voices that do not exist)
• depression
• thoughts about dying or killing yourself

You should know that ciprofloxacin has slowed the growth and damaged the joints of young laboratory animals. It is not known if ciprofloxacin has these effects on children. Therefore, ciprofloxacin should not normally be given to children younger than 18 years old. However, if a child has been exposed to anthrax in the air, the benefits of taking ciprofloxacin to prevent this serious illness may be greater than the risk of joint damage. Talk to your child's doctor about the risks of giving ciprofloxacin to your child.

Ciprofloxacin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

What storage conditions are needed for this medicine?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Store the suspension in the refrigerator or at room temperature, closed tightly, for up to 14 days. Throw away any liquid that is left over after 14 days and any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

In case of emergency/overdose

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

What other information should I know?

Keep all appointments with your doctor and the laboratory. Your doctor may order certain lab tests to check your body's response to ciprofloxacin.

Do not let anyone else take your medication. Your prescription is probably not refillable. If you still have symptoms of infection after you finish the ciprofloxacin, call your doctor.

Last Revised - 07/01/2004

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a688016.html

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Daptomycin

Introduction

http://www.medscape.com/px/viewindex/more?Bucket=columns&SectionId=1584

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Daptomycin

http://www.drugs.com/MTM/daptomycin.html

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Daptomycin  (Systemic)

Brand Names

Category

Description

Before Using This Medicine

Proper Use of This Medicine

Precautions While Using This Medicine

Side Effects of This Medicine

http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/500489.html

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INVANZ

INVANZ is indicated for the treatment of adult patients with the following moderate to severe infections caused by susceptible strains of the designated microorganisms:
http://www.invanz.com/ertapenem_sodium/invanz/hcp/index.jsp
Complicated intra-abdominal infections due to Escherichia coli, Clostridium clostridioforme, Eubacterium lentum, Peptostreptococcus species, Bacteroides fragilis, Bacteroides distasonis, Bacteroides ovatus, Bacteroides thetaiotaomicron, or Bacteroides uniformis.

Complicated skin/skin structure infections due to Staphylococcus aureus (methicillin-susceptible strains only), Streptococcus pyogenes, Escherichia coli, or Peptostreptococcus species.

Community-acquired pneumonia due to Streptococcus pneumoniae (penicillin-susceptible strains only), including cases with concurrent bacteremia, Haemophilus influenzae (beta-lactamase–negative strains only), or Moraxella catarrhalis.

Complicated urinary tract infections, including pyelonephritis, due to Escherichia coli, including cases with concurrent bacteremia, or Klebsiella pneumoniae.

Acute pelvic infections, including postpartum endomyometritis, septic abortion, and postsurgical gynecologic infections, due to Streptococcus agalactiae, Escherichia coli, Bacteroides fragilis, Porphyromonas asaccharolytica, Peptostreptococcus species, or Prevotella bivia.

Appropriate specimens for bacteriological examination should be obtained in order to isolate and identify the causative organisms and to determine their susceptibility to ertapenem. Therapy with INVANZ may be initiated empirically before results of these tests are known; once results become available, antimicrobial therapy should be adjusted accordingly.

To reduce the development of drug-resistant bacteria and maintain the effectiveness of INVANZ and other antibacterial drugs, INVANZ should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria.

INVANZ is contraindicated in patients with known hypersensitivity to any component of this product or to other drugs in the same class or in patients who have demonstrated anaphylactic reactions to beta-lactams.

Due to the use of lidocaine HCl as a diluent, INVANZ administered intramuscularly is contraindicated in patients with a known hypersensitivity to local anesthetics of the amide type. (Refer to the prescribing information for lidocaine HCl.)

Pseudomembranous colitis has been reported with nearly all antibacterial agents, including ertapenem, and may range in severity from mild to life threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhea subsequent to the administration of antibacterial agents.

http://www.invanz.com/ertapenem_sodium/invanz/hcp/index.jsp

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Invanz

The Following Information Provided by Thomson MICROMEDEX

Also known as:
GENERIC NAME(S):
Ertapenem (Systemic)

BRAND NAMES:
In the U.S.

• Invanz

Description
Ertapenem (er-ta-PEN-em) is used in the treatment of infections caused by bacteria. It works by killing bacteria or preventing their growth. This medicine will not work for colds, flu, or other virus infections. Ertapenem is used to treat infections in many different parts of the body. It is sometimes given with other antibiotics.

This medicine is available only with your doctor's prescription, in the following dosage forms:

Parenteral
• Injection (U.S.)

Proper Use of This Medicine
To help clear up your infection completely, ertapenem must be given for the full time of treatment, even if you begin to feel better after a few days. Skipping doses or not completing the full course of therapy may decrease the usefulness of this medicine. It may also increase the likelihood that the bacteria causing your infection will develop resistance. If this happens, ertapenem and other medicines used to treat infections will not work in the future. Also, this medicine works best when there is a constant amount in the blood or urine. To help keep the amount constant, it must be given on a regular schedule.

Dosing - The dose of ertapenem will be different for different patients. If you are receiving this medicine at home, follow your doctor's orders. The following information includes only the average doses of ertapenem. If your dose is different, do not change it unless your doctor tells you to do so.

. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are taking ertapenem

• For injection dosage form:
  • For bacterial infections:
    • Adults 1 gram injected into a vein or injected into a muscle once a day. Your doctor will determine whether the medication is injected into a vein or injected into a muscle and the length of time that you will take it

Missed dose - If you miss a dose of this medicine, take it as soon as possible. Do not double doses.

Storage - To store this medicine:

• Keep out of the reach of children.
• Do not keep outdated medicine or medicine no longer needed. Ask your health care professional how you should dispose of any medicine you do not use. Be sure that any discarded medicine is out of the reach of children

http://health.yahoo.com/drug/500395/overview

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Short-Course Levofloxacin as Effective as Standard Treatment for Uncomplicated Cellulitis 

News Author: Laurie Barclay, MD
CME Author: Désirée Lie, MD, MSEd
Release Date: August 11, 2004

Aug. 11, 2004 — Short-course (five days) and standard (10 days) of levofloxacin treatment are equally effective for uncomplicated cellulitis, according to the results of a double-blind randomized trial published in the Aug. 9 issue of the Archives of Internal Medicine.

"No previous study has compared a short (five days) vs. standard (10 days) course of therapy with the same antibiotic in patients with uncomplicated cellulitis," write MAJ Matthew J. Hepburn, MC, USA, from Brooke Army Medical Center in Fort Sam Houston, Texas, and colleagues. "We hypothesized that there would be no difference in outcomes."

Of 121 subjects evaluated after five days of therapy for cellulitis, 43 were randomized to receive five more days of levofloxacin therapy (500 mg/day; 10 days total), and 44 to receive five days of placebo therapy. Subjects with complicated cellulitis were excluded.

At both 14 and 28 days of therapy, ther