Some patients stop taking medication as soon as the symptoms of infection
dissipate, however the bacterium is still alive and actively growing. As a result,
the patient has a relapse and is again prescribed the antibiotic.
Other times, the prescriber may underprescribe an antibiotic by giving the
patient a lower-than-effective dose or order the antibiotic for a short period of
time. At first this seems like a logical way to prevent the bacterium from becom-
ing resistant to the antibiotic. However, a low dose may not completely kill the
bacterium resulting in a recurrence of symptoms that requires additional doses
of antibiotics. It is very important to choose the right antibiotic, in the right dose,
for the right amount of time.
Preparing to Administer
Antimicrobial Medication
Antimicrobial medication requires the nurse to follow the same general admin-
istration procedures that are required for any type of medication. The most
critical step is to determine if the patient has allergies to drugs, food, environ-
mental stimuli, and a family history of allergies to antibiotics. There is also a
high incidence of cross sensitivity between some antibiotics such as penicillin
and cephalasporins. Always display allergies in red and clearly write them
on the patient’s record. Even if the patient’s record indicates that the patient
doesn’t have allergies, always ask the patient each time you administer the
antimicrobial medication.
Always have emergency medications such as epinephrine, Benadryl, and
steroids handy so they can be given to counteract any adverse side effect of the
antimicrobial medication. Be sure to carefully monitor the patient for a half
hour after the medication is given to determine if the patient experiences an
adverse reaction.
During treatment, you’ll need to monitor the therapeutic effect of the med-
ication by monitoring the signs and symptoms of the disease and by obtaining
the patient’s white blood cell count. Although you can monitor the antimicro-
bial serum level to determine if the medication has achieved a therapeutic level,
this is only done in cases where the therapeutic range is narrow resulting in pos-
sible toxicities (i.e., vancomycin ototoxicity).
It is important to administer antimicrobials at the times described in the pre-
scriber’s order in order to maintain a therapeutic blood level of the medication.
CHAPTER 13 Antimicrobials—Fighting Infection^207