Abx utilities Flashcards
Natural PCNs
Syphilis
Susceptible strep infxn (pharyngitis, endocarditis)
Antistaphylococcal PCNs
MSSA infxn (endocarditis, skin/soft tissue)
Aminopenicllins
Ampicillin DOC for for susceptible enterococci
Susceptible GNRs
URTIs (pharyngitis, otitis media)
Beta-lactam/Beta-lactamase Inhibitor Combinations
Zosyn/Timentin: Empiric therapy for nosocomial infxns
Augmentin: URTIs, LRTIs, UTIs
Mixed infxns d/t anaerobic activity (intra-abdominal, diabetic ulcers, aspiration pneumonia)
1st Generation Cephalosporins
Skin and soft tissue infxns
Surgical prophylaxis (cefazolin)
Staph bloodstream infxns
Endocarditis (MSSA)
2nd Generation Cephalosporins
URTIs
CAP
Gonorrhea
Surgical Prophylaxis (cefotetan, cefoxitin)
3rd Generation Cephalosporins
Lower respiratory tract infxns Pyelonephritis Nosocomial infxns (ceftazidime) Lyme disease (ceftriaxone) Meningitis Skin/soft tissue infxns Febrile neutropenia (ceftazidime) Gonorrhea (ceftriaxone DOC)
4th Generation Cephalosporins
Febrile neutropenia
Nosocomial infxns
Anti-MRSA Cephalosporin
FDA approved for only skin and soft tissue infxn and CAP
Cephalosporin/Beta-lactamase inhibitors
MDR pseudomonas infxns, mixed aerobic/anaerobic infxns, infxns caused by ESBL-producing organisms, intra-abdominal infxns
Ceftazidime/avibactam: carbapenem-resistant Enterobacteriacaea infxns
Carbapenems
Mixred aerobic/anaerobic infxns, infxns caused by ESBL-producing organisms, intra-abdominal infxns
Imipenem, doripenem, meropenem: nosocomial infxn, febrile neutropenia
Monobactams
G- infxns including pseudomonas, particularly in pts w/hx of beta-lactam allergy
Ciprofloxacin indications
UTI Intra-abdominal infxns Systemic G- infxns Pseudomonas infxns (+/- beta-lactam) Bioterrorism treatment/prophylaxis
Levofloxacin
CAP, sinusitis, bronchitis UTI intra-abdominal infxns Systemic G- infxns Skin/soft tissue infxns Pseudomonas infxns (+/- beta-lactam) Bioterrorism treatment/prophylaxis
Moxifloxacin
CAP, sinusitis, bronchitis
intra-abdominal infxns
Systemic G- infxns
Skin/soft tissue infxns
Gemifloxacin
CAP, sinusitis, bronchitis
Skin/soft tissue infxns
Macrolides and Ketolides
Respiratory tract infxns Chlamydia Atypical mycobacterial infxns Traveler's diarrhea (azithro) Clarithromycin is a key component in the treatment of H. pylori-induced GI ulcer disease, in combination with other drugs
Aminoglycosides
In combination with a beta-lactam agent, treatment of serious infections with documented or suspected G- pathogens, including febrile neutropenia, sepsis, exacerbations of CF, and nosocomial pneumonia.
In combination with a beta-lactam or glycopeptides, for treatment of serious G+ infxns, including endocarditis, osteomyelitis, and sepsis
In combination with other antimycobacterials, for treatment of drug-resistant infxns with M. tuberculosis
Glycopeptides
Vancomycin is the drug of choice for MRSA infections and for empiric use where MRSA is a concern, such as nosocomial pneumonia.
Vancomycin is useful in other G+ infxns when the patient has a severe beta-lactam allergy.
Telavancin: place in therapy is still being determined, but FDA-approved for complicated skin/skin structure infections and hospital acquired pneumonia.
Dalbavancin, oritavancin: acute bacterial skin/skin structure infxns
Cyclic lipopeptides
Skin and soft tissue infxns caused by resistant G+ organisms and staphylococcal bactermia, including right-sided endocarditis.
Has utility in enterococcal bacteremia, but is not indicated or well-studied for this use.
Used in osteomyelitis, prosthetic joint infxns, and septic arthritis, but these are unlabeled in uses
Oxazolidinones
Linezolid: infxns caused by resistant G+ organisms such as VRE and MRSA, and nosocomial pneumonia or skin/soft tissue infxns
Tedizolid: skin/skin structure infections
Streptogramins
Infections caused by E. faecium or MRSA in patients not responding to or intolerant of other medications
Tetracyclines and glycylcyclines
Uncomplicated respiratory tract infxns
Acute exacerbations of chronic bronchitis
Sinusitis
CAP
DOC for many tick-borne diseases
Malaria prophylaxis and treatment
Tigecycline may have a role in the treatment of polymicrobial complicated infections (b/c of its spectrum)
Nitroimidazoles
Infxns with documented or suspected abdominal anaerobic bacteria, with adjunctive coverage of aerobes by a second drug when necessary.
Treatment of vaginal trichomoniasis.
GI infections caused by susceptible protozoa (amebiasis, giardiases, etc.)
Mild-moderate C. difficile
Lincosamides
Treatment of skin and soft-tissue infxns, infxns of oral cavity, anaerobic intra-abdominal infxns
Topically used for treatment of acne
Nitrofurans and Fosfomycin
Nitrofurantoin and fosfomycin: uncomplicated cystitis in patients with good renal fxn
Nitrofurantoin: prophylaxis against recurrent uncomplicated lower UTIs
Folate antagonists
Treatment of uncomplicated UTIs (in areas with low local resistance); prophylaxis against recurrent UTIs
Treatment of Listeria meningitis
Treatment of and prophylaxis for pneumocystis jirovecci pneumonia
Community acquired MRSA skin infxns
Sulfadiazine is used to treat toxoplasmosis
Polymixins
Treatment of G- infxns resistant to all other drugs
Fidamoxin
Clostrifium difficile-associated diarrhea