In this article an infectious diseases pharmacist discusses something cool and something lame with 5 antibiotics.
Authored By: Timothy P. Gauthier, Pharm.D., BCPS, BCIDP
Article Posted October 2024, First Released in the August 2024 IDstewardship Newsletter
1. Ciprofloxacin
Something cool: It can be given orally to treat a variety of different Pseudomonas aeruginosa infections – yay for avoiding intravenous catheters!
Something lame: It is associated with a laundry list of toxicities – big yikes!
2. Doxycycline
Something cool: Not only can it kill a wide variety of pathogenic microbes, it can also be used for non-infectious purposes as a sclerosis agent.
Something lame: It can cause esophagitis if a tablet gets stuck in your throat. It’s a bad time.
3. Methenamine
Something cool: The mechanism of action is that at a low urine pH (goal typically less than 5.5) it turns to formaldehyde which exerts a bacterial effect and most bacteria cannot become resistant to formaldehyde.
Something lame: It’s only indication is for prevention of UTI, it cannot be used for treatment.
4. Linezolid
Something cool: It can be given orally for very complicated infections caused by drug-resistant organisms such as VRE and MRSA. Awesome oral bioavailability FTW!
Something lame: Long-term use is associated with numerous toxicities, including optic neuritis leading to complete blindness. FWIW at least it’s typically reversible.
5. Rifampin
Something cool: It can penetrate into biofilms to help treat hardware-related infections. This is special, many antibiotics do not get into biofilms well.
Something lame: Is an inducer of CYP-450 and may cause the concentrations of other drugs to become considerably lowered. It also has almost no use as monotherapy, which is also pretty sad.
Disclaimer: The views and opinions presented in this article represent those of the author and do not necessarily reflect the policy or position of any previous, current, or potential future employer.
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