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208 PART 5 Antiviral Drugs Adverse Effects These drugs are generally well tolerated with few adverse effects. The most concerning adverse effect is nephrotoxicity through either crystallization or acute interstitial nephritis (AIN), most commonly associated with IV acyclovir in higher doses. Crystallization is preventable through hydration and correct dosing in renally impaired patients. Seizures, tremors, or other CNS effects can also occur. Nausea, diarrhea, and rash are more common. Thrombotic thrombocytopenic purpura has been reported with valacyclovir in HIV patients. ■■ Important Facts • Valacyclovir is a pro-drug of acyclovir with substantially improved bioavailability and lessfrequent dosing. Its disadvantage is higher cost. Famciclovir is a pro-drug of penciclovir, an agent that is available only as a topical preparation. • Acyclovir dosing varies widely by indication and host status. Be sure to double-check that it is appropriate for your patients. • Acyclovir is most nephrotoxic in combination with diuretics or other nephrotoxins. Keep your patients hydrated during acyclovir therapy, particularly if it is given in higher IV doses. What They’re Good For Acyclovir is the drug of choice for severe or difficultto-treat HSV infections, such as encephalitis or severe HSV outbreaks among HIV patients. Any of
chapter 32 Anti-HSV and VZV Agents 209 these agents can be used to treat HSV-2 infections (genital herpes) to prevent outbreaks or decrease symptom duration. They are all also effective in treating VZV infection. Don’t Forget! Make sure your patient can afford valacyclovir or famciclovir before prescribing either one. Oral acyclovir is less convenient, but much less expensive.
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Antibiotics Simplified third EDITIO
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Contents Acknowledgments Introducti
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Contents v Chapter 28: Antifungal A
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Acknowledgments Our thanks go to th
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x Introduction ■■ How to Use Th
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New to the Third Edition The Third
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The Wonderful World of Microbiology
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chapter 1 Microbiology 5 More like
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chapter 1 Microbiology 7 Influenza
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chapter 1 Microbiology 9 Bacilli An
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chapter 1 Microbiology 11 Gram-nega
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chapter 1 Microbiology 13 Cocci Aer
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General Approach to Infectious Dise
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chapter 2 Infectious Diseases 17 Th
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chapter 2 Infectious Diseases 19 Su
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chapter 2 Infectious Diseases 21 al
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Antibiotic Pharmacokinetics 3 The t
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chapter 3 Pharmacokinetics 25 Table
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chapter 3 Pharmacokinetics 27 can b
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chapter 3 Pharmacokinetics 29 becau
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chapter 3 Pharmacokinetics 31 Table
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34 PART 1 Antibiotic Therapy No vis
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36 PART 1 Antibiotic Therapy Table
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38 PART 1 Antibiotic Therapy done i
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Adverse Consequences of Antibiotic
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chapter 5 Adverse Consequences 43 f
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chapter 5 Adverse Consequences 45 U
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Antibacterial Drugs Part 2
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50 PART 2 Antibacterial Drugs to be
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52 PART 2 Antibacterial Drugs is ne
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54 PART 2 Antibacterial Drugs Spect
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Antistaphylococcal Penicillins Agen
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Aminopenicillins Agents: amoxicilli
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chapter 6 Beta-Lactams 61 Don’t F
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64 PART 2 Antibacterial Drugs Adver
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66 PART 2 Antibacterial Drugs enhan
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68 PART 2 Antibacterial Drugs good
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70 PART 2 Antibacterial Drugs Cefaz
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72 PART 2 Antibacterial Drugs ■
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Third-Generation Cephalosporins Age
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chapter 6 Beta-Lactams 79 biliary e
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82 PART 2 Antibacterial Drugs but o
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84 PART 2 Antibacterial Drugs bind
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Carbapenems Agents: imipenem/cilast
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chapter 6 Beta-Lactams 89 and thus
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94 PART 2 Antibacterial Drugs Mecha
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96 PART 2 Antibacterial Drugs as be
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98 PART 2 Antibacterial Drugs Spect
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chapter 9 Aminoglycosides 103 equal
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Aminoglycosides 9 Agents: gentamici
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chapter 9 Aminoglycosides 103 equal
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Tetracyclines and Glycylcyclines 10
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chapter 10 Tetracyclines 107 admini
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Macrolides and Ketolides 11 Agents:
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chapter 11 Macrolides and Ketolides
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Oxazolidinones 12 Agent: linezolid
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chapter 12 Oxazolidinones 115 What
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118 PART 2 Antibacterial Drugs Spec
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Nitrofurans and Fosfomycin 14 Agent
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chapter 14 Nitrofurans and Fosfomyc
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Cyclic Lipopeptides 16 Agent: dapto
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chapter 16 Cyclic Lipopeptides 131
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136 PART 2 Antibacterial Drugs What
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140 PART 2 Antibacterial Drugs Don
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144 PART 2 Antibacterial Drugs Beca
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146 PART 2 Antibacterial Drugs asso
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Antimycobacterial Drugs 21 ■■ I
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chapter 21 Antimycobacterial Drugs
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154 PART 3 Antimycobacterial Drugs
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156 PART 3 Antimycobacterial Drugs
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Page 175 and 176: Pyrazinamide 24 Agent: pyrazinamide
Page 177 and 178: Ethambutol 25 Agent: ethambutol (EM
Page 179: Antifungal Drugs Part 4
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Page 185 and 186: Polyenes 27 Agents: amphotericin B,
Page 187 and 188: chapter 27 Polyenes 173 1.5 mg/kg/d
Page 189 and 190: Antifungal Antimetabolites 28 Agent
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Page 195 and 196: Fluconazole The introduction of flu
Page 197: chapter 29 Azoles 183 • The high
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Page 203 and 204: Voriconazole The introduction of vo
Page 205 and 206: chapter 29 Azoles 191 ■■ Import
Page 207 and 208: Posaconazole Posaconazole is the ne
Page 209: chapter 29 Azoles 195 inhibitors lo
Page 212 and 213: 198 PART 4 Antifungal Drugs Spectru
Page 215: Antiviral Drugs Part 5
Page 218 and 219: 204 PART 5 Antiviral Drugs The unde
Page 221: Anti-Herpes Simplex Virus and Varic
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Page 229 and 230: Neuraminidase Inhibitors 34 Agents:
Page 231: chapter 34 Neuraminidase Inhibitors
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Page 244 and 245: 230 PART 5 Antiviral Drugs The drug
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Page 249 and 250: Integrase Inhibitors Agents: ralteg
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Page 262 and 263: 248 PART 5 Antiviral Drugs ribaviri
Page 264 and 265: 250 PART 5 Antiviral Drugs administ
Page 267 and 268: Hepatitis B Nucleoside Analogs 39 A
Page 269: Antiparasitic Drugs Part 6
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258 PART 6 Antiparasitic Drugs Tabl
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Quinolines 41 Agents: chloroquine,
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chapter 41 Quinolines 263 majority
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Atovaquone 42 Agents: atovaquone, a
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chapter 42 Atovaquone 267 Don’t F
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270 PART 6 Antiparasitic Drugs Adve
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Pentamidine 44 Agent: pentamidine P
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chapter 44 Pentamidine 275 as appro
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278 PART 6 Antiparasitic Drugs Spec
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Appendix 1 Selected Normal Human Fl
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Appendix 2 Spectrum of Activity A N
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284 appendix 2 and thus less likely
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286 appendix 2 Table A-2 Clinically
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Appendix 3 Empiric Regimens for Com
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290 appendix 3 Infection Common Pat
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292 appendix 3 Infection Common Pat
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294 Index Amoxicillin/clavulanate,
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296 Index Broad-spectrum antibacter
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298 Index Combivir, 221 Community-a
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300 Index Eukaryotes, 5, 203 Extend
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302 Index HIV (continued) anti-herp
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304 Index Minimum bactericidal conc
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306 Index PEG. See Polyethylene gly
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308 Index Pseudomonas (continued) P
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310 Index Sustained virologic respo
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