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9780521704632c22 CUFX213A/Peck 9780521618168 December 29, 2007 14:51
Section IVOther important drugsTable 22.2.(cont.)Drug Main uses Notes
Tetracycline Used to coverChlamydia,
brucellosis, Rickettsia,
Mycoplasma and Borrelia
burgdorferi(Lyme disease).Intestinal chelation with Ca^2 +
and Mg^2 +reduces
absorption. May discolour
teeth in children.
Erythromycin Gram-positive infection in
patients allergic to penicillin.
First-line treatment of
Legionella and Mycoplasma
infection.Irritant to peripheral veins.
Potentially serious drug
interactions (prolongs QT
interval).Gentamicin Severe gram-negative sepsis
(especially urinary).
Endocarditis and surgical
prophylaxis.Blood assays required. Oto-
and nephrotoxicity.
Streptococcusand anaerobes
are resistant.
Ciprofloxacin Gram-negative sepsis, enteric
fevers, biliary, urinary and joint
sepsis. Increasing use in
Legionella.Excellent tissue penetration.
First-line treatment for
Anthrax and Pneumonic
Plaque. Problematic
resistance due to overuse.
Vancomycin MRSA, other Staphylococcal and
Streptococcal infection,
endocarditis,
pseudomembranous colitis.Potentially toxic – blood
assays required. Red man
syndrome and
neutropaenia associated.
Poor penetration.
Clindamycin Staphylococci, Streptococci,E.
faecalisand anaerobic infection
(joint, peritonitis, soft tissue).Good penetration into bone.
Useful when penicillin
allergic. Role in necrotising
fasciitis.
Rifampicin Mycobacteria, Staphylococci
Streptococci, and Neisseria
infection.Major role in treatment of TB.
Monitor liver function.
Restricted use.
Fusidic Acid Staphylococcal infection
(osteomyelitis, endocarditis and
soft tissue).Reserved for severe sepsis
(adjunct).E.faecalis,
Giardia andP.falciparum
covered. Hepatotoxic.
Metronidazole Exclusive anaerobic and parasitic
cover (Entamoeba, Giardia,
Trichomonas).Avoid concomitant ethanol
administration.