Miscellaneous antibiotics

What are Miscellaneous antibiotics?

Miscellaneous antibiotics are antibiotics which are the only agent available in their class. This means that they are unique in their action and not comparable to other antibiotics, although their spectrum of activity or certain side effects may be similar to other antibiotics.

Antibiotics are medicines that are used to treat infections by killing bacteria or other susceptible organisms or inhibiting their growth.

What are miscellaneous antibiotics used for?

Miscellaneous antibiotics are used to treat infections caused by susceptible bacteria or other susceptible organisms, usually when other more common agents are not effective or not tolerated. There is not a single antibiotic that will treat all infectious disease scenarios.

Laboratory culture determines which antibiotic will be the most effective at killing or inhibiting the growth of the bacteria causing the infection. Examples of infections for which miscellaneous antibiotics may be used for include:

Atovaquone: For the treatment or prevention of pneumonia caused by Pneumocystis carinii (also called P. jiroveci)
Bacitracin: Use is restricted to infants with pneumonia and empyema (a collection of pus within the layers of the lungs)
Chloramphenicol: Serious infections when less hazardous antibiotics are ineffective or contraindicated
Colistimethate: Infections caused by gram negative bacilli, particularly Pseudomonas aeruginosa, Enterobacter aerogenes, Escherichia coli, Klebsiella pneumoniae
Daptomycin:
- Infections caused by resistant gram-positive bacteria such as multi-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE)
- Typically, bacteremia’s, endocarditis, skin and soft tissue infections.
Metronidazole:
- Anaerobic infections such as bacteroides infections, Clostridium difficile-associated diarrhea, Helicobacter pylori-associated peptic ulcer disease
- Parasitic infections such as trichomonas, giardia.
Pentamidine: This is actually an antifungal agent that has been included in the list of miscellaneous antibiotics. It may be used for the treatment or prevention of pneumonia caused by P. carinii (also called P. jiroveci)
Rifaximin:
- travelers diarrhea caused by E. coli in adults and children over the age of 12
- Irritable bowel syndrome in adults whose main symptom is diarrhea
- Hepatic encephalopathy.

What are the differences between miscellaneous antibiotics?

Each miscellaneous antibiotic has a different way of killing or inhibiting the growth of bacteria, so they are all unique, although their spectrum of activity or certain side effects may be similar to other antibiotics.

In addition, they can differ by their preferred route of administration (eg, oral, rectal, vaginally, or by injection).

Please refer to individual drug monographs for their mechanism of action, route of administration, and antibiotic spectrum.

Generic name	Brand name examples
atovaquone	Mepron
aztreonam	Azactam
bacitracin	Baci-IM
chloramphenicol	Chloromycetin
colistimethate	Coly Mycin M
daptomycin	Cubicin
metronidazole	Flagyl
pentamidine	Nebupent, Pentam 300
rifaximin	Xifaxan

Are miscellaneous antibiotics safe?

Each miscellaneous antibiotic works in a different way, which means their risk of severe side effects differs. Examples of severe side effects associated with miscellaneous antibiotics include:

Allergic reactions. These have been reported with most antibiotics; symptoms may include a rash, hives (urticaria), swelling, or rarely, anaphylaxis
Rarely, some people may develop a super-infection due to overgrowth of a naturally occurring bacterium called Clostridium difficile, following use of any antibiotic. Symptoms include severe diarrhea
Atovaquone: Increased liver enzymes and liver damage have been reported in people taking atovaquone
Bacitracin: May cause kidney failure. Infants should be monitored during use, the daily dose should not be exceeded, and it should not be given with other drugs that have the potential to cause kidney damage
Chloramphenicol: Serious, potentially fatal, blood disorders have occurred after chloramphenicol administration. “Gray Baby Syndrome” – a potentially fatal condition associated with chloramphenicol administration to newborns or pregnant women may occur because newborns lack the liver enzymes necessary to metabolize the drug
Colistimethate: short-lasting neurological disturbances, kidney damage (usually reversible), and breathing difficulties have been reported
Daptomycin: Muscle aching or muscle weakness in conjunction with increases in laboratory values of creatine phosphokinase over 10 times the upper limit of normal. Rhabdomyolysis (the destruction of muscle fibers), with or without kidney damage has also been reported. Daptomycin has also been associated with eosinophilic pneumonia (the accumulation of white blood cells in the lung), peripheral neuropathy and other nervous system effects
Metronidazole: Has been shown to be carcinogenic in mice and rats; association with cancer in humans is unknown but unnecessary use of the drug should be avoided
Pentamidine: Fatalities due to severely low blood pressure, low blood sugar, acute pancreatitis or cardiac arrhythmias have been reported. Severe skin reactions, resulting in surgery and skin grafting have also been associated with injection extravasation.

For a complete list of severe side effects, please refer to the individual drug monographs.

What are the side effects of miscellaneous antibiotics?

Each miscellaneous antibiotic works in a different way, which means their risk of side effects differ. An example of side effects associated with some miscellaneous antibiotics include:

Atovaquone: diarrhea, fever, headache, nausea, rash, rhinitis
Aztreonam: diarrhea, injection-site reactions, nausea, vomiting
Bacitracin: kidney damage, nausea, vomiting, skin rashes
Chloramphenicol: headache, nausea, vomiting
Colistimethate: gastrointestinal effects, tingling of the extremities, urinary problems
Daptomycin: diarrhea, dizziness, headache, muscle pain or weakness, urinary problems
Metronidazole: loss of appetite, metallic taste, nausea, vomiting, interacts with alcohol (causing nausea, vomiting, skin flushing fast heartbeat), interacts with some medicines (such as warfarin)
Pentamidine: low blood pressure, nausea, blood disorders, low blood sugar, changes in laboratory tests
Rifaximin: abnormal liver function tests, dizziness, fatigue, headache, nausea, swelling.

For a complete list of side effects, please refer to the individual drug monographs.

List drug with Miscellaneous antibiotics

Drug Name
Atovaquone Generic name: Atovaquone
Azactam Generic name: Aztreonam
Azactam injection Generic name: Aztreonam (injection)
Aztreonam (Intravenous, Injection) Generic name: Aztreonam
Aztreonam inhalation Generic name: Aztreonam (inhalation)
Aztreonam injection Generic name: Aztreonam (injection)
Cubicin Generic name: Daptomycin
Baci-IM injection Generic name: Bacitracin (injection)
Bacitracin injection Generic name: Bacitracin (injection)
Benznidazole Generic name: Benznidazole
Cayston Generic name: Aztreonam (inhalation)
Chloramphenicol (Oral, Intravenous, Injection) Generic name: Chloramphenicol
Chloromycetin Sodium Succinate Generic name: Chloramphenicol
Daptomycin Generic name: Daptomycin
Erythromycin and sulfisoxazole Generic name: Erythromycin And Sulfisoxazole
Eryzole Generic name: Erythromycin And Sulfisoxazole
E.S.P. Generic name: Erythromycin And Sulfisoxazole
Furazolidone Generic name: Furazolidone
Lampit Generic name: Nifurtimox
Lefamulin (Intravenous) Generic name: Lefamulin
Lefamulin (Oral) Generic name: Lefamulin
Lefamulin oral/injection Generic name: Lefamulin (oral/injection)
Mepron Generic name: Atovaquone
Nifurtimox Generic name: Nifurtimox
Pediazole Generic name: Erythromycin And Sulfisoxazole
Polymyxin b Generic name: Polymyxin B
Rifaximin Generic name: Rifaximin
Xenleta (Lefamulin Intravenous) Generic name: Lefamulin
Xenleta (Lefamulin Oral) Generic name: Lefamulin
Xenleta oral/injection Generic name: Lefamulin (oral/injection)
Xifaxan Generic name: Rifaximin

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