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Anti-infective drugs

Dlal, Kavitha S. PharmD; Bridgeman, Mary Barna PharmD, BCPS

doi: 10.1097/01.NURSE.0000527606.47710.8d

Kavitha S. Dalal is a critical care pharmacist at Virtua in Marlton, N.J. Mary Barna Bridgeman is a clinical associate professor at Rutgers University Ernest Mario School of Pharmacy in Piscataway, N.J.

Unless otherwise specified, the information in the preceding summaries applies to adults, not children. Consult the package insert for information about each drug's safety during pregnancy and breastfeeding. Also consult a pharmacist, the package insert, or a comprehensive drug reference for more details on precautions, drug interactions, and adverse reactions.

Can you identify these drugs and their indications? To find out, match each brand name in Section I with its generic name in Section II.

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Section I

_____ 1. Avycaz (Allergan USA)

_____ 2. Zinplava (Merck & Co.)

_____ 3. Cresemba (Astellas Pharma US)

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Section II

a. ceftazidime and avibactam. This antibiotic, which combines a third-generation cephalosporin and a beta-lactamase inhibitor, is indicated to treat complicated intra-abdominal infections (in conjunction with metronidazole) and complicated urinary tract infections in adults age 18 and older. Dosing is adjusted based on renal function and administered as an intermittent infusion over 2 hours. Adverse reactions can include seizures and other neurologic events, especially in patients with renal impairment.

b. isavuconazonium sulfate. This azole antifungal agent, which is available in both I.V. and oral formulations, is a prodrug that is rapidly hydrolyzed in the blood to isavuconazole. Indicated to treat invasive aspergillosis and invasive mucormycosis, it's administered once daily. When administered I.V., an in-line filter must be used. This drug is contraindicated in patients with familial short QT syndrome. Teach patients using the oral formulation that the capsules can be taken without regard to food.

c. bezlotoxumab. This human monoclonal antibody binds to Clostridium difficile toxin B and is indicated as adjunctive therapy for patients age 18 and older with C. difficile infection (CDI) who are receiving antibacterial therapy and are at high risk for CDI recurrence. It's not indicated as a treatment for CDI because it's not an antibacterial agent. This drug is administered as a one-time I.V. dose infused over 1 hour using a low-protein binding 0.2-to-5 micron in-line filter or add-on filter. Patients with a history of heart failure may experience exacerbations of heart failure, as seen in clinical studies comparing bezlotoxumab with placebo.

Resources available upon request.

ANSWERS: 1a, 2c, 3b

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