Side Effects of Antimicrobial

Side Effects of Antimicrobial

Antibiotic Class	Antibiotic Class Members	Most Common Side Effects
Penicillins	penicillin,amoxicillin, ampicillin,piperacillin-tazobactam, nafcillin, oxacillin	rash, , abdominal pain, diarrhea, vomiting ,nausea, drug fever, hypersensitivity (allergic) reactions
Cephalosporins	cephalexin, , cefuroxime, cefdinir, cefixime, ceftibuten, ceftriaxone, cefaclor	rash, diarrhea, nausea/vomiting (rare), hypersensitivity (allergic) reactions
Aminoglycosides	Gentamicin, tobramycin, amikacin	renal (kidney) toxicity, ototoxicity (hearing loss), dizziness, nausea/vomiting, nystagmus, diarrhea,
Carbapenems	Meropenem, ertapenem, doripenem, imipenem-cilastatin	nausea/vomiting, headache, rash, liver toxicity, eosinophilia , diarrhea
Antituberculosis Agents	rifampin, rifabutin, isoniazid, pyrazinamide, ethambutol, dapsone	nausea/vomiting, anorexia, hemolytic anemia, liver toxicity, peripheral neuropathy, dizziness, headache, reddish-orange body fluids (rifampin, rifabutin only)
Macrolides	erythromycin, azithromycin, clarithromycin	abdominal pain, diarrhea, anorexia, nausea/vomiting, taste alterations (clarithromycin)
Sulfonamides	trimethoprin-sulfamethoxazole, erythromycin-sulfisoxazole, sulfadiazine	Nausea or vomiting, , anorexia, abdominal pain, rash, headache, dizziness, diarrhea, photosensitivity
Tetracyclines	tetracycline, doxycycline, minocycline	nausea/vomiting, diarrhea, anorexia, abdominal pain, tooth discoloration in children  more than 8 years, liver toxicity
Quinolones	ciprofloxacin , levofloxacin, moxifloxacin , ofloxacin	Nausea or vomiting, , insomnia, headache, photosensitivity, diarrhea, lethargy, abdominal pain,
Lincosamide	clindamycin, lincomycin	pseudomembranous colitis, diarrhea, nausea or vomiting, hypersensitivity, jaundice, rash
Miscellaneous	metronidazole	nausea/vomiting, headache, dizziness, vaginal candidiasis

There are also other side effects that are common to most antibiotics. These side effects may include antibiotic-associated diarrhea, serious allergic skin reactions, yeast infections and complications from intravenous use of antibiotic.

• Antibiotic-associated diarrhea - Antibiotic-associated diarrhea occurs in patients receiving antibiotics and occurs for no explainable reasons. This diarrhea occurs due to eradication of the normal gut flora by the antibiotic and results in an overgrowth of infectious bacteria, such as Clostridium dificile. 5-25% of patients may develop antibiotic-associated diarrhea. Most common antibiotics implicated in antibiotic-associated diarrhea are amoxicillin, ampicillin, cefixime and clavulanate.
• Stevens Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN): Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but serious allergic reactions to drugs that result in serious skin and mucous membrane disorder. Antibiotic such as sulfonamides, cephalosporins, penicillins, and fluoroquinolones may result in SJS and TEN. They can cause skin peeling, rash and sores on the mucous membranes and may be also life-threatening.
• Vaginal yeast infections or oral thrush (candida species): Antibiotics may also change the normal flora balance in the vagina, leading to an overgrowth of funus.  Candida albicans is a common fungus normally present in small amounts in mouth, gastrointestinal tract, vagina, and also on the skin. It does not normally cause disease or symptoms. This fungus may take over when there is limited competition from bacteria due to antibiotic treatment.
• Injection site reactions and phlebitis: A reaction to an antibiotic can occur if the antibiotic is given intravenously in a vein. Sometimes injection site reactions and phlebitis (vein inflammation) can occur with intravenously (IV) administered antibiotic.