Abx by drug

Question 1

Natural PCNs

Answer 1

Good: Syphilis, Some strep
Moderate: Enterococci
Poor: Atypicals, Almost everything else (narrow spectrum of activity)

Question 2

Anti-staph PCNs

Answer 2

Good: MSSA, Streptococci
Poor: GNRs, Enterococci, Anaerobes, Atypicals

Question 3

Aminopenicillins

Answer 3

Good: Streptococci, Enterococci
Moderate: Some GNRs
Poor: Staph, anaerobes, Atypicals

Question 4

Antipseudomonal

Answer 4

Good: Pseudomonas (and other GNRs), Streptococci, Enterococci
Moderate: More resistant GNRs
Poor: Staph, Anaerobes, Atypicals

Question 5

Beta-Lactam/Beta-Lactamase Inhibitor Combinations

Answer 5

Good: MSSA, strep, enterococci, anaerobes, enteric GNRs (including pseudomonas w/only Zosyn and Timentin)
Poor: MRSA, atypicals, GNRs w/ESBL (extended-spectrum beta-lactamase)

Question 6

1st Generation Cephalosporins

Answer 6

Good: MSSA (if can’t tolerate PCN), Streptococci
Moderate: Some enteric GNRs
Poor: enterococci, MRSA, Anaerobes, pseudomonas

Question 7

2nd Generation Cephalosporins

Answer 7

Good: Some GNRs, Haemophilus influenzae, Neisseria
Moderate: Strep, staph, anaerboes (cefotetan, cefoxitin)
Poor: Enterococci, MRSA, Pseudomonas

Question 8

3rd Generation Cephalosporins

Answer 8

Good: Streptococci (except ceftazidime), enteric GNRs, Pseudomonas (ceftazidime only)
Moderate: MSSA (except ceftaz.)
Poor: Enterococci, anaerobes, MRSA, Pseudomonas (except ceftaz)

Question 9

4th Generation Cephalosporins

Answer 9

Good: Pseudomonas, strep, MSSA, enteric GNRs
Poor: Enterococci, anaerobes, MRSA

Question 10

Anti-MRSA Ceph

Answer 10

Good: MRSA, MSSA, strep, enteric GNRs
Poor: Pseudomonas, anaerobic

Question 11

Cephalosporin/Beta-lactamase inhibitors

Answer 11

Good: Pseudomonas, other enteric GNRs (Ceftaz/avibactam > ceftolozane/tazo)
Poor: Most anaerobes, MSSA/MRSA

Question 12

Carbapenems

Answer 12

Good: MSSA, streptococci, anaerobes, Enteric GNRs, Pseudomonas (except ertapenem), acinetobacter (except ertapenem), ESBL-producing GNR
Poor: MRSA, PCN-resistant strep

Question 13

Beta-Lactams: Monobactams

Answer 13

Good: Pseudomonas, most GNRs
Poor: Gram +

Question 14

Ciprofloxacin

Answer 14

Good: Enteric GNRs (E. coli, Proteus, klebsiella), H. influenzae
Moderate: Pseudomonas, atypical
Poor: Gram +, S. pneumoniae, enterococci, anaerobes

Question 15

Fluoroquinolones except Cipro

Answer 15

Good: S. pneumoniae, enteric GNRs, atypicals, H. influenziae
Moderate: Pseudomonas (only levo.), MSSA
Poor: Anaerobes (except moxi which has moderate activity), enterococci

Question 16

Macrolides and Ketolides

Answer 16

Good: Atypicals, H. influenzae, M. catarrhalis, H. pylori, mycobacterium avium
Moderate: S. pneumoniae (ketolides > macrolides)
Poor: Staph (do not use for skin infxn), Enteric GNRs (do nt use for UTIs), anaerobes, enterococci

Question 17

Aminoglycosides

Answer 17

Good: GNRs
Moderate: Gram +, only in combo w/beta-lactam or glycopeptide (vanco): staph (including MRSA, veridians, strep, enterococci)
Poor: Atypicals, anaerobes, gram + as monotherapy

Question 18

Glycopeptides

Answer 18

Good: MRSA, MSSA, streptococci, Vanco po: c. difficile
Moderate: Some enterococci (that are not VRE yet)
Poor: Gram-, atypicals, anaerobes

Question 19

Cyclic Lipopeptides

Answer 19

Good: MRSA, MSSA, Streptococci, Enterococci (including VRE)
Poor: All gram -, anaerobes, atypicals

Question 20

Oxazolidinones

Answer 20

Good: MRSA, MSSA, streptococci, enterococci (including VRE)
Poor: Any gram -, anaerobes, atyipicals

Question 21

Streptogramins

Answer 21

Good: MRSA, MSSA, streptococci, enterococci (only E. faecium including VRE - faecium - the more resistant enterococci)
Poor: E. faecalis (the more common; don’t use until confirmed with culture), gram - , anaerobes, atypicals

Question 22

Tetracyclines

Answer 22

Good: Atypicals, Rickettsia, Spriochetes, plasmodium spp (malaria)
Moderate: some staph (including MRSA-community acquired), some strep pneumoniae
Poor: Most GNRs, anaerobes, enterococci

Question 23

Glycyclines

Answer 23

Good: Enterococci (including VRE), staph (includes both hospital and community MRSA), atypical, S. pneumoniae
Acceptable: GNRs, anaerobes
Poor: Pseudomonas, proteus, providencia spp.

Question 24

Nitroimidazoles

Answer 24

Good: Anaerobes (gram +/- including bacteroides, fusobacterium and clostridium), protozoa
Moderate: H. pylori
Poor: Aerobic gram +/-, anaerobes that reside in the mouth (peptostreptococcus, acinomyces, prionibacterium)

Question 25

Lincosamides

Answer 25

Good: G+ anaerobes, plasmodium (malaria), s. pyogenes
Moderate: S. aureus (includes some MRSA), some G- anaerobes, some gut anaerobes, toxoplasma, pneumocystitis jirovecii, Some chlamydia (esp trachomatis), acinomyces (G+ anaerobe in the mouth)
Poor: G- aerobes, C. difficile, enterococci

Question 26

Nitrofurans and Fosfomycin

Answer 26

Good: E. coli, staphylococcus saprophyticus
Poor: Most other GNRs

Question 27

Folate Agnoists

Answer 27

Mainly Bactrim
Good: Staph aureus (including many MRSA strains), H. influenzae, Stentrophomonas maltophilia, listeria, Pneumocystitis jirovecii (formerly known as P. carinii), Toxoplasma gondii (pyrimetheumine and sulfadiazine only)
Moderate: Enteric GNRs, s. pneumoniae, salmonella, shigella, s. pyogenes, nocardia
Poor: Pseudomonas, enterococci, anaerobes, atypicals

Question 28

Polymixins

Answer 28

GNRs, including MDR acinetovacter, pseudomonas, klebsiella

Poor: Everything else

Question 29

Fidaxomicin

Answer 29

Good: C. difficile
Poor: Everything else