IV Antibiotics: Types, Administration, and Side Effects

Reviewed by: Gregory Weingart, MD, a practicing ER physician, and Assistant Professor at the Eastern Virginia Medical School

IV antibiotic therapy has become a popular topic of interest, and in this updated post, we will cover the following range of topics:

• What are Intravenous Antibiotics?

• Types of IV Antibiotics

• Antibiotic Delivery through IVs

• Receiving Antibiotic Treatment through IVs

• Guidelines for Administering through a PICC line

• Common Concerns and Complaints

• Warning Signs and Side Effects

What are Intravenous Antibiotics?

Intravenous antibiotics are antibiotics that are administered directly into a vein so that they can enter the bloodstream immediately and bypass the absorption in the gut. It is estimated that more than 250,000 patients in the US receive outpatient IV antibiotics to treat bacterial infections. Typically, they are arranged by a physician that specializes in infectious disease.

Types of IV Antibiotics

The main classes of antibiotics are as follows:

• Cephalosporins such as cefepime (maxipime), cefazolin (Ancef), ceftriaxone (Rocephin)
• Fluoroquinolones such as moxifloxacin (Avelox), ciprofloxacin (Cipro) and levofloxacin (Levaquin)
• Penicillin such as piperacillin/tazobactam (Zosyn)
• Glycopeptides such as Vancomycin, Daptomycin, Dalbavancin (Dalvance), Oritavancin (Orbactiv), Telavancin (Vibativ)
• Nitroimidazoles such as metronidazole (Flagyl)
• Oxazolidinone such as Linezolid (Zyvox)
• Carbapenems such as Meropenum (Merrem)

Antibiotic Delivery through IVs

According to the National Library of Medicine, intravenous antibiotics are often used for bacterial infections in the lungs, hearts, bones, soft tissue, and brain. They can be used to treat bacterial infections that are resistant to traditional oral medications. Likewise, a combination of different antibiotics can be used to treat multidrug-resistant bacterial infections. Antibiotics fight infection caused by bacteria, and intravenous antibiotics are used for infections that are resistant to oral antibiotics or for infections that may require high doses of antibiotics that cannot be taken orally.

Receiving Antibiotic Treatment through IVs

Most of the time, intravenous (IV) antibiotic treatment is provided in a hospital. However, when it is safe and appropriate, antibiotic therapy can effectively treat patients at home or another healthcare facility. Each year, over 250,000 patients are successfully treated with IV antibiotics at home.

The antibiotic is administered through a small narrow flexible tube called a catheter or IV line, which is inserted into a vein using a needle. The needle is removed, and the IV line is left in place and secured by a dressing. There are different types of IV lines available, and the one chosen for your treatment will depend on your veins and how long you will need the antibiotics.

For example, patients with small peripheral veins often utilize something called PICC lines (Peripherally Inserted Central Catheters), where medication is administered directly to the heart. Considering PICC lines must be flushed daily, and their dressings have to be inspected and changed, patients with PICC lines must avoid getting them wet or dirty.

Guidelines for Administering through a PICC Line

• Wash your hands. Use warm water and soap to scrub for 1 minute. Wash between fingers and rinse thoroughly.
• Dry your hands. Use a fresh paper towel and use it to turn off the water so that you do not touch a dirty surface after washing. Set the paper towel aside, and throw it away after the IV care is done.
• Put gloves on. Always wear medical gloves when touching and administering IV antibiotics. Be sure to keep gloves clean at all times and discard after use.
• Prep injection site. Wipe down all IV antibiotics injection sites with alcohol prep before injection. Wipe the PICC line opening with alcohol before attaching it to the IV.
• Hang the IV bag. The drip chamber should be at least 18 inches above your head.
• Make sure everything is clean and sterile. Always clean the catheter port with an alcohol wipe before use. Flush the catheter with saline or heparin as directed by your medical team.
• Attach IV and begin. Attach the IV tubing to your catheter and secure it with tape. Start the medication as directed by your doctor.

Common Concerns and Complaints

The most common risks associated with intravenous catheters include blockages, blood clots, and infection. Patients need to contact a healthcare professional if they notice any fever, swelling, pain, or redness in the arm with the catheter.

Warning Signs and Side Effects

The most common side effects associated with using IV antibiotics include rash, itch, diarrhea. Rarely the medications can cause abnormal kidney or liver laboratory test results. Your doctor may need to monitor for these side effects and adjusts the antibiotic when necessary. However, it is crucial to be aware of warning signs related to receiving IV therapy, including:

• Allergic reactions: itching, swelling of the throat, tongue, rash, etc
• Swelling of your vein or discoloration around the skin
• Numbness or tingling in the arm of the PICC line
• Air embolism (a bubble of air gets into the vein and travels to your heart or lungs)
• If an IV comes out of your vein, first put pressure over the opening where the IV was until the bleeding stops and call your home health care agency or doctor right away.

Call your doctor, nurse, or healthcare professional if you have these signs of infection:

• Redness, swelling or bruising at the site where the needle enters the vein
• Pain
• Bleeding
• Fever over 100.5 °F (38.0 °C)

Call 9-1-1 immediately if you experience:

• Any breathing problems
• A fast heart rate
• Dizziness
• Chest pain

If you are looking for more resources and support for those going using IV Antibitoics, check out our other blogs: 

What is a PICC Line?

Susan's PICC Line Journey

What It's Like Living With A Rare Disease: Cystic Fibrosis

Lindsay's Fearless Fight Against Lyme