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Discussion

Question about antibiotics

We recently started a patient on Keflex and Bractrim and one of our nurses stated that they had to be given at different times and couldn't be given within 2 hours of each other. I have never heard of this. I researched this and couldn't find any information on it. All the drug guides say they can be given together. I have been giving these together for 7 years. I like to learn new things so I didn't discount what she said. We scheduled them apart. I was wondering if anyone else has heard this or if you have, can you please give me a link to research it?

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    This is a question for your pharmacist. Ask how they would like it given, and if they want to have the order change, contact the MD.

    But I will say that I am curious as to the stomach upset that COULD result from these 2 together......

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    I looked it up and could not find any reason they can not be given at the same time. The only thing I can think of and this may just apply to the first few doses. If the patient has never taken the medication it may be good to space it out just in case the patient may be allergic to one or the other. This way you can ID the culprit.

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    I looked it up and could not find any reason they can not be given at the same time. The only thing I can think of and this may just apply to the first few doses. If the patient has never taken the medication it may be good to space it out just in case the patient may be allergic to one or the other. This way you can ID the culprit.

    That's the only reason I could think to give them apart.

    ETA: Did anyone ask the nurse WHY she thought this? Or consult pharmacy?

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    Many antibiotics have interactions with a variety of meds but these two are pretty benign with each other.

    However, antibiotics usually cause GI issues so administering them separately is probably for patient comfort rather than an absolute contraindication.

    In addition a lot of people have allergies to sulfa(Bactrim) and penicillins which have a cross allergy with cephasporins like Keflex (especially older generations).

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    • Author

    Thank you so much! Those are some great ideas. I will ask a pharmacist. We don't have one but I will ask our local pharmacy. The other nurse and I work opposite schedules this was passed on by another nurse. Thanks again!

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    Just wondering what infection was being treated? Wound of some type? that would require two antibiotics? for MRSA I have at times prescribed both Bactrim & Clindamycin. Also, next time another nurse says something, don't be afraid to ask what the reasoning is being what ever topic is being discussed. That's another way to learn & find another person that you can use as a resource.

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