levaquin with azithromycin

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jarjar5606

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Can Levaquin be given with azithromycin? If yes what is the treatment?
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jarjar5606 said:
Can Levaquin be given with azithromycin? If yes what is the treatment?
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What does azithromycin cover that levaquin doesn't?

Having said that, I have seen erthromycin being used in a non-antibiotic purpose. You should know this as a resident.

There are some relatively recent studies of azithromycin being used for something other than its antibiotic effect for COPD, look that up, see if it's the case.
 
xiphoid2010 said:
What does azithromycin cover that levaquin doesn't?

Having said that, I have seen erthromycin being used in a non-antibiotic purpose. You should know this as a resident.

There are some relatively recent studies of azithromycin being used for something other than its antibiotic effect for COPD, look that up, see if it's the case.
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Wow. Cant believe totally forgot about the anti-inflammatory effect of zpak.. Just had my critical care rotation 4 months ago too.
 
double cover legionella?
 
Holy heck people. We use azithromycin in almost all the CF kids. And it doesn't cover pseudomonas. Go look it up.

Erythromycin has a nasty GI side effect profile....hint hint...
 
I'm just a pharmacy student but one thing that comes to mind is for the coverage of pneumonia, both drugs can be used at the same time for double coverage of atypical bacteria (azithromycin) as well as the normal causitive organisms (levofloxacin)
 
Hendlefe said:
I'm just a pharmacy student but one thing that comes to mind is for the coverage of pneumonia, both drugs can be used at the same time for double coverage of atypical bacteria (azithromycin) as well as the normal causitive organisms (levofloxacin)
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Ok, yes for pneumonia. But we use it in CF for another reason not related (directly) to the antibacterial effect.
 
cycloketocaine said:
Ok, yes for pneumonia. But we use it in CF for another reason not related (directly) to the antibacterial effect.
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Isn't it for the anti-inflammatory effect? Some also recommend it for COPD patients as well with certain criteria
 
Do you typically double cover atypicals? Go read the guidelines.
 
RickRossPharmD said:
Are guidelines there to substitute for clinical judgement?
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Guidelines help ensure that clinical practice follows current evidence based medicine, but inter-patient variability still requires clinical judgement. I've been told its like there are a lot of right solutions for tx with some being more accurate than others, but there are also a LOT of wrong answers. Guidelines help to eliminate the latter imo.
 
RickRossPharmD said:
Are guidelines there to substitute for clinical judgement?
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No one ever said they did...in what cases would you empirically double cover atypical organisms for CAP? You didn't answer my question. Guidelines are for guidance and they are there to help. They do not recommend double coverage for atypicals, so I am asking in which situations you would do this.

Please enlighten me oh wise 2012 grad...
 
Also, look at the dosing. One of my genius coworkers was ready to go postal on a doc for the pt being on azithro and LQ.

Until I pointed out the Azithro was 1200mg po weekly.

*slow clap*
 
There are a couple of doctors in my area who insist on this combo. I'm not as leery of it when its being started in the hospital and the pt is being monitored, but it does make me a bit nervous though when outpatients are started on the combo (and yes, this is at the standard dosing 500mg QD Levaquin & Z-Pak) In fairness, I've never seen an actual problem from this combo--if doctors are careful on patient selection & the pt isn't on other drugs that could contritube to QT elongation, I suspect problems from the combo are rare.

edited to add, my personal feeling is this combo is overused, and that most people aren't going to have a benefit by taking both drugs as opposed to one.
 
KARM12 said:
No one ever said they did...in what cases would you empirically double cover atypical organisms for CAP? You didn't answer my question. Guidelines are for guidance and they are there to help. They do not recommend double coverage for atypicals, so I am asking in which situations you would do this.

Please enlighten me oh wise 2012 grad...
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I wouldn't double cover atypicals in CAP and I never said I would unless there's some tremendous nursing home with whooping cough outbreak and legionella in the vents.
 
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