As promised, here's a basic antibiotic sticky. For specific questions not addressed here, feel free to PM.
Here's some basic info on how they work. If you do not understand how to apply this info, and feel you may have an infection, it's best to consult your doctor for clarification.
Antibiotics are chemical compounds either from living or synthetic sources that, in low concentrations, are capable of inhibiting the life processes of microorganisms. ABs are either "-cidal" or "-static" meaning that they either directly kill or inhibit further reproductive cycles of the microbe.
Short breakdown of the common AB classes:
PENICILLINS:
Crystalline (powder) and salt forms (pills) are stable at room temperature for years. Although they do not require cold storage, they must be kept dry. The water-insoluble salts are often stable in solution for up to 6 years at standard refrigeration temp. 1.0mg of Pen G Procaine salt is equal to 1009 units. Some are allergic to pens and should determine sensitivity before use. Eating is usually not a problem with oral pen but buffers and anti-acids are to be avoided. This class is active against gram (-) and some gram (+) organisms.
Common products, doses and duration of therapy:
Pen G Procaine: 600,000u IM once daily or EOD for 1-10days
Pen G Benzathine: 1,200,000u IM 1-2x/wk for 1-2 weeks (long acting)
Pen V: 125-250mg Oral 4x/day for about 2 wks
Ampicillin: 250-500mg Oral 4x/day for 10 days
Amoxicillin: 500mg Oral 3x/day for 10 days
Augmentin: 875mg Oral 2x/day for 10 days (this is a strong form of Amoxil)
CEPHALOSPORINS:
These compounds are bacteriocidal in a similar way as to pens. They interfere with bacteria cell wall cross-linking. Although they are closely related to pens, people are less likely to demonstrate allergic reactions. This class has gram (-) and gram (+) activity. These are generally very good for soft tissue infection like an athlete my encounter. They start to work very quickly but require frequent dosing.
Common products, doses and duration of therapy:
Cephalexin: 125-250mg Oral 4-6x/day for 10 days)
Cefaclor: 250mg Oral 3xdaily for 10 days
Cefoxitin: 2g IV daily for 1 or 2 wks
MACROLIDES:
These compounds are very effective bacteriostatics that work by interfering with protein synthesis at the 50S subunit of ribosomes. They are generally more effective against gram (+) organisms. They are also fairly stable in solution at or below room temp. This is one of the ABs that can be catabolic to gains if used at high doses for long periods of time, but it is generally not a problem.
Common products, doses and duration of therapy:
Erythromycin: 500mg Oral 3-4x/day for about 2 wks (stomach upset can be a prob)
Clarithromycin: 500mg Oral 2x/day for not less than 5 days
Azithromycin: 500mg Oral 1x/day for 3-10 days
TETRACYCLINES:
These are broad spectrum agents. Old, expired tetracycline sometimes contains a very nasty, toxic degradent that is quite kidney toxic. If the pills or powder have been stored in cold, this is not usually a problem, but when in doubt don't use old tetracycline. Other drugs in this class are not prone to the problem. These compounds interfere with 30S subunit ribosomal protein synthesis. Tets work by chelating minerals, so iron, calcium and magnesium supps should generally be temporarily discontinued while on them. Also be aware that photosensitivity can be significant, so avoid long periods in direct sunlight or take measures to cover the skin if it can not be avoided. Sunblock may be helpful. This is another AB that can cause catabolism, but once again, short courses should generally not be problematic.
Common products, doses and duration of therapy:
Tetracycline: 500mg Oral 4x/day for 10 days (stomach upset can be a prob)
Doxycycline: 200mg Oral 1x/day for 5-30days (strong broad spectrum)
QUINOLONES:
These work on a variety of gram (-) and (+) organisms. It is cidal in that it inhibits DNA/m-RNA synthesis in an ATP-dependent manner. These are great broad spectrums, but can be toxic with extended use. Photosensitivity can occur but is generally less severe than is seen in the tetracycline class.
Common products, doses and duration of therapy:
Ciprofloxacin: 250-750mg Oral 2-3x/day for not less than 5 days
Norfloxacin: 400mg Oral 2x/day for 3-30 days
Trovafloxacin: 200mg Oral 1x/day for 2-10 days (very potent)
LINCOSAMIDES:
These are broad spectrums that interfere with 50s subunit ribosomal protein synthesis in a static way. They have a tendency toward pseudomembranous colitis (severe diarrhea) when used at high doses for too long. They are strong and work fast. If oral Clindamycin is combined with an equal dose of metronidazole, these sides are often avoidable. If colitis does develop, it may be wise to stop use.
Common products, doses and duration of therapy:
Clindamycin (base): 150mg Oral 3-4x/day for 3-7 days
Clindamycin HCl: 150mg Oral 3-4x/day for up to 1 wk
Clindamycin Phosphate: 300mg IV or IM 2x/day for 5-10 days
Lincomycin HCl: 300-600mg IV or IM 1-2x/day for up to 1 month
MISC:
These are lesser used, or unclassified, but can still have a potential value. They all have special toxicity issues that should be investigated before attempting to use them...
Common products, doses and duration of therapy:
Vancomycin HCl: 500mg IV 4x/day for weeks if needed
Cycloserine: 250mg Oral 2-4x/day for weeks or longer (often used to treat TB)
Chloramphenicol: 250mg Oral 4x/day for 10 days
Streptomycin: 1g IM 1x/day for weeks as needed
Isoniazid: 300-500mg/d in one dose (often used to treat TB, acts as a MAOI so be advised)
Note:
To conclude, it is not as hard as one may thing to treat an abscess. The trick is to catch it fast at the first sign of infection. Drug interactions can be of concern on ABs and should be investigated prior to use. Another important consideration is to restore 'friendly flora' in the gut in between doses of ABs (with acidophilus for example) in the form of bulk powders, pills or yogurt. Taking an AB and acidophilus at the same time may nullify the AB to some degree. Remember, try not to need ABs in the first place! It is wise to use proper aseptic techniques if your doctor has you on an injectable preparation like HRT. It is important to remember that the more you use these compounds, the more resistant an organism may become. This reduces the effectiveness of the compound over time and can also compromise the usefulness of related ABs or ABs in other close classes that act by similar mechanism. And of course, always consult your doctor as to the proper use of the antibiotics prescribed to you! This is not a substitute for medical advice, just an overview of considerations.
All info taken from the Textbook of Organic Medicinal and Pharmaceutical Chemistry, 7'th Ed.
Here's some basic info on how they work. If you do not understand how to apply this info, and feel you may have an infection, it's best to consult your doctor for clarification.
Antibiotics are chemical compounds either from living or synthetic sources that, in low concentrations, are capable of inhibiting the life processes of microorganisms. ABs are either "-cidal" or "-static" meaning that they either directly kill or inhibit further reproductive cycles of the microbe.
Short breakdown of the common AB classes:
PENICILLINS:
Crystalline (powder) and salt forms (pills) are stable at room temperature for years. Although they do not require cold storage, they must be kept dry. The water-insoluble salts are often stable in solution for up to 6 years at standard refrigeration temp. 1.0mg of Pen G Procaine salt is equal to 1009 units. Some are allergic to pens and should determine sensitivity before use. Eating is usually not a problem with oral pen but buffers and anti-acids are to be avoided. This class is active against gram (-) and some gram (+) organisms.
Common products, doses and duration of therapy:
Pen G Procaine: 600,000u IM once daily or EOD for 1-10days
Pen G Benzathine: 1,200,000u IM 1-2x/wk for 1-2 weeks (long acting)
Pen V: 125-250mg Oral 4x/day for about 2 wks
Ampicillin: 250-500mg Oral 4x/day for 10 days
Amoxicillin: 500mg Oral 3x/day for 10 days
Augmentin: 875mg Oral 2x/day for 10 days (this is a strong form of Amoxil)
CEPHALOSPORINS:
These compounds are bacteriocidal in a similar way as to pens. They interfere with bacteria cell wall cross-linking. Although they are closely related to pens, people are less likely to demonstrate allergic reactions. This class has gram (-) and gram (+) activity. These are generally very good for soft tissue infection like an athlete my encounter. They start to work very quickly but require frequent dosing.
Common products, doses and duration of therapy:
Cephalexin: 125-250mg Oral 4-6x/day for 10 days)
Cefaclor: 250mg Oral 3xdaily for 10 days
Cefoxitin: 2g IV daily for 1 or 2 wks
MACROLIDES:
These compounds are very effective bacteriostatics that work by interfering with protein synthesis at the 50S subunit of ribosomes. They are generally more effective against gram (+) organisms. They are also fairly stable in solution at or below room temp. This is one of the ABs that can be catabolic to gains if used at high doses for long periods of time, but it is generally not a problem.
Common products, doses and duration of therapy:
Erythromycin: 500mg Oral 3-4x/day for about 2 wks (stomach upset can be a prob)
Clarithromycin: 500mg Oral 2x/day for not less than 5 days
Azithromycin: 500mg Oral 1x/day for 3-10 days
TETRACYCLINES:
These are broad spectrum agents. Old, expired tetracycline sometimes contains a very nasty, toxic degradent that is quite kidney toxic. If the pills or powder have been stored in cold, this is not usually a problem, but when in doubt don't use old tetracycline. Other drugs in this class are not prone to the problem. These compounds interfere with 30S subunit ribosomal protein synthesis. Tets work by chelating minerals, so iron, calcium and magnesium supps should generally be temporarily discontinued while on them. Also be aware that photosensitivity can be significant, so avoid long periods in direct sunlight or take measures to cover the skin if it can not be avoided. Sunblock may be helpful. This is another AB that can cause catabolism, but once again, short courses should generally not be problematic.
Common products, doses and duration of therapy:
Tetracycline: 500mg Oral 4x/day for 10 days (stomach upset can be a prob)
Doxycycline: 200mg Oral 1x/day for 5-30days (strong broad spectrum)
QUINOLONES:
These work on a variety of gram (-) and (+) organisms. It is cidal in that it inhibits DNA/m-RNA synthesis in an ATP-dependent manner. These are great broad spectrums, but can be toxic with extended use. Photosensitivity can occur but is generally less severe than is seen in the tetracycline class.
Common products, doses and duration of therapy:
Ciprofloxacin: 250-750mg Oral 2-3x/day for not less than 5 days
Norfloxacin: 400mg Oral 2x/day for 3-30 days
Trovafloxacin: 200mg Oral 1x/day for 2-10 days (very potent)
LINCOSAMIDES:
These are broad spectrums that interfere with 50s subunit ribosomal protein synthesis in a static way. They have a tendency toward pseudomembranous colitis (severe diarrhea) when used at high doses for too long. They are strong and work fast. If oral Clindamycin is combined with an equal dose of metronidazole, these sides are often avoidable. If colitis does develop, it may be wise to stop use.
Common products, doses and duration of therapy:
Clindamycin (base): 150mg Oral 3-4x/day for 3-7 days
Clindamycin HCl: 150mg Oral 3-4x/day for up to 1 wk
Clindamycin Phosphate: 300mg IV or IM 2x/day for 5-10 days
Lincomycin HCl: 300-600mg IV or IM 1-2x/day for up to 1 month
MISC:
These are lesser used, or unclassified, but can still have a potential value. They all have special toxicity issues that should be investigated before attempting to use them...
Common products, doses and duration of therapy:
Vancomycin HCl: 500mg IV 4x/day for weeks if needed
Cycloserine: 250mg Oral 2-4x/day for weeks or longer (often used to treat TB)
Chloramphenicol: 250mg Oral 4x/day for 10 days
Streptomycin: 1g IM 1x/day for weeks as needed
Isoniazid: 300-500mg/d in one dose (often used to treat TB, acts as a MAOI so be advised)
Note:
To conclude, it is not as hard as one may thing to treat an abscess. The trick is to catch it fast at the first sign of infection. Drug interactions can be of concern on ABs and should be investigated prior to use. Another important consideration is to restore 'friendly flora' in the gut in between doses of ABs (with acidophilus for example) in the form of bulk powders, pills or yogurt. Taking an AB and acidophilus at the same time may nullify the AB to some degree. Remember, try not to need ABs in the first place! It is wise to use proper aseptic techniques if your doctor has you on an injectable preparation like HRT. It is important to remember that the more you use these compounds, the more resistant an organism may become. This reduces the effectiveness of the compound over time and can also compromise the usefulness of related ABs or ABs in other close classes that act by similar mechanism. And of course, always consult your doctor as to the proper use of the antibiotics prescribed to you! This is not a substitute for medical advice, just an overview of considerations.
All info taken from the Textbook of Organic Medicinal and Pharmaceutical Chemistry, 7'th Ed.
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