Timely Oral Antibiotic Administration

Caleb was standing in line with his fellow student nurses as their Clinical Instructor briefs them on what they are expected to do for the day’s duty. It was again a series of vital signs taking, performing tepid sponge baths for febrile patients, performing assessments and many more. It was always the same, well most of the days.

As the CI went on and on about the topics to be discussed during ward class, his eyes wanders on the wards. One staff nurse was busy reading the patients’ charts, while the other was busy organizing medication cards when a folk of a patient approached them.

“Nurse, my patient has finished eating his meal,” said the folk.

“Okay, ma’am. I’ll be right there with his due antibiotic,” responded the staff nurse as she checks the chart and medicine card, fished something from the patient’s medication tray and approached the patient.

Caleb thought to himself, “Why does the folk need to inform the nurse when his patient has finished eating his meal? Can’t the nurse just give the antibiotic without considering the patient’s meal time just like in other cases?”


When to administer what antibiotics

Just like the care that we render to patients which should be individualized not generalized, not all medication administrations are the same. Some meds may be small, others big; some may be in the tablet form while others are administered intravenously; some may be taken with meal, while others should be taken on an empty stomach. Take for example the case of oral antibiotics.

As we all know, antibiotics are given as treatment for infections caused by bacteria, fungi and other parasites. Yes, they mean well, however if not administered correctly, or are overused, antibiotics might just not work anymore. It may become less effective as there is a risk that the bacteria will develop some sense of resistance. This happens when some bacteria that survive when you did not complete the treatment course or may have incorrectly administered the medication have gained some exposure and may have eventually developed a resistance to it.


Empty stomach

There are antibiotics that need to be taken on an empty stomach. This may either be before meals or at least 2 hours or more after meals. Food may decrease the amount of antibiotic in the body when a person takes them too close to their meals, thus making the antibiotic less effective. Also, the patient may be placed at risk of antibiotic resistance. For example, Ciprofloxacin and Ampicillin should be taken 2 hours before or 4 hours after meals. Other antibiotics that must be taken on an empty stomach are Doxycycline, Metronidazole ER, and tetracycline.

With food

While there are antibiotics that must be taken without food in the stomach, there are also those that require food or meals as food makes it easier for the body to absorb the drug. Some examples are Amoxicillin Clavulanate, Metronidazole and Nitrofurantoin.

With or without food

There are also antibiotics that do not regard the time of meal for the patient to take in the drug. This is because the acid in one’s stomach does not change how well the medicine is absorbed into the body. Examples of these antibiotics are Azithromycin, Cefuroxime, Erythromycin and Levofloxacin.


As nurses, we serve to help save lives and assist our patients to recovery. Instead of just basically administering medications, let us take time to pause and understand some considerations that we need to take. By doing so, we are assured of the effectiveness of the medication and that what we are doing is right. Let us not let our negligence get in the way in providing quality nursing care to our patients.



Liane Clores, RN MAN

Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.

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