BNF 80 (British National Formulary) September 2020
Key summaries of common antibiotics, mechanism of action, common indications, doses, side effects and counselling points for pharmacists and foundation trainee pharmacists
Antibiotics key summaries
- Common antibiotics mechanism of action (MOA)
Drug class MOA Spectrum - Use Main Pt Other
Bactericidal or ses counselli information
bacteriostatic ng
Beta-lactams Inhibit Broad ampicillin: Penicilli Take Broad spectrum:
+ Penicillin bacterial (ampicillin: utis, otitis n ampicilli Maculopapular
+ Cephalosporins cell wall high media, allergy n, co- rash commonly
+ Carbapenems synthesis resistance – copd; (beta- amoxicla occurs but does
+ monobactams amoxicillin & meningiti lactams v, not usually
co-amoxiclav s (pen g - cross- flucloxac indicate true
are less parentera sensitivi illin, pen pencillin allergy
resistant l only); ty), v on an (i.e. Immediate
derivatives; rtis in cholest empty confluent
cephalosporin children atic stomach rash/anaphylaxis)
s); narrow e.g. strep jaundic & - avoid in blind
(pen g, pen v); throat, e (co- amoxicill treatment of sore
penicillinase tonsilitis amoxicl in can be throat (risk of
resistant (pen v – av & taken rash in
(flucloxacillin); oral, for flucloxa before glandular/Epstein
antipseudomo minor cillin or after bar virus fever);
nal infections use food do not give
(piperacillin + ); should penicillin
tazobactam & penicillin- not intrathecally;
ticaricillin + resistant exceed Cephalosporins:m
clavulanic staph skin 14 days ay give 3rd gen or
acid) – infections use), cefuroxime (2nd
bactericidal except antibio gen) in penicillin
mrsa bic hypersensitivity;
(flucloxaci associat excreted renally
llin), ed (penicillin &
pseudom colitis cephalosporins)
onal
infection,
Cephalos
porins: uti
(pregnanc
y or
second
line),
meningiti
s, CAP,
sinusitis,
otits
media
Glycopeptides e.g. Inhibit Narrow - Mrsa & Nephro Report Only active
Vancomycin cell wall bactericidal antibiotic toxicity hearing against gram
Teicoplanin, synthesis associate - renally loss, positive bacteria
televancin & d colitis cleared, tinnitus including mrsa;
assembly (vancomy ototoxi (=discon Narrow
, cin), hap city, tinue), therapeutic
last-line thromb vertigo index; avoid
(sole use ophlebi vancomycin in
of tis pregnancy unless
televancin (most essential;
) commo Vancomycin &
n), red- teicoplanin: not
man used orally for
syndro systemic
me, infections
blood
dyscrasi
as
Quinolones e.g. Inhibit Broad - Lower Seizure Driving, Avoid in
Ciprofloxacin bacterial bactericidal rtis, utis, s, antacids/ pregnancy &<18s
(choice) DNA avoid in tendon zinc/iron (arthropathy);
replicatio mrsa damage , milk, quinolones are
n (resistanc , qt photose second or third
e) prolnga nsitivity line options due
tion, to risk of
arthrop resistance;
athy Moxifloxacin –
highest risk of qt
prolongation &
life threatening
hepatotoxicity –
reserved as last
line
Nalidixic acid –
sole use:
uncomplicated
UTI & avoid in
egfr < 20;
Interactions:
theophylline (pd
& pk effects),
nsaids, li +
ciprofloxacin =
seizure
Aminoglycosides Inhibit Broad - Severe Nephro Report Given
e.g. Gentamicin bacterial bactericidal sepsis, toxicity hearing parenterally - not
(choice), Amikacin, protein pyelonep – loss, absorbed by gut;
Tobramycin synthesis hritis, renally tinnitus, not for more than
by complicat cleared, vertigo 7 days;
binding ed uti, ototoxi Narrow
irreversib endocardi city, cns therapeutic index
ly to 30S tis, cystic disturb Avoid in
ribosoma fibrosis ance pregnancy
l subunit (tobramyc (cied in (gentamicin only
in via myasth if essential)
inhaler), enia Gentamicin:
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