Anti microbial Treatments Flashcards by Alyssa Smith

mostly used for gram pos- S. pneumo, S. pyogenes, Actinomyces
also for GNC- N. meningitidis
also for spirochetes- T. pallidum
bactericidal- GPC, GPR, GNC, spirochetes
penicllinase sensitive

PCN G

PCN V

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extended spec PCN- H. influenze, H. pylor, E. coli, Listeria, Proteus mirabilis, Salmonella, shigella, enterococci
‘HHELPSS kill entercocci’
penicillinase sensitive

Amoxicillin

Ampicillin

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tx S. aureus EXCEPT MRSA

penicillinase resistant

Dicloxacillin, Nafcillin, Oxacillin

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tx Pseudomonas & GNR

susceptible to penicillinase

Piperacillin

Ticarcillin

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bugs NOT covered by cephalosporins are LAME

Listeria
Atypicals- Chlamydia, Mycoplasma
MRSA (EXCEPT ceftaroline does cover MRSA)
Enterococci

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Cephalosporins

cover GPC, Proteus mirabilis, E. coli, K. pneumo

1st generation: Cefazolin, Cephalexin

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used prior to surgery to prevent S. aureus wound infection

Cefazolin

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Cephalosporins

cover GPC, H. influenzae, Enterobacter aerogenes, Neisseria, Proteus mirabilis, E. coli, K. pneumo, Serratia

2nd generation: Cefoxitin, Cefaclor, Cefuroxime

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Cephalosporins

cover serious gram neg’s resistant to other B lactams

3rd generation: Ceftriaxone, Cefotaxime, Ceftazidime

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3rd generation cephalosporin used to tx meningitis, gonorrhea, disseminated Lyme

Ceftriaxone

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3rd generation cephalosporin used to tx Pseudomonas

Ceftazidime

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Cephalosprins

cover gram neg’s with higher activity against Pseudomonas & gram pos

4th generation: Cefepime

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Cephalosporins
broad gram pos & gram neg coverage including MRSA
does NOT cover Pseudomonas

5th generation: Ceftaroline

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cover GPC, GNR, anaerobes
wide spec
major SE limit its use for life threatening infections or if other drugs fail

Carbapenems: Imipenem, Meropenem, Ertapenem, Doripenem

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cover GNR only
NOT for gram pos or anaerobes
for PCN allergic or with renal insufficiency who cannot tolerate aminoglycosides

Monobactam: Aztreonam

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covers gram pos only- serious, MDR bugs including MRSA, S. epidermidis, sensitive enterococcus, C. diff
oral dose for pseudomembranous colitis

Vancomycin

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cover severe GNR (aerobes only)

synergistic with B lactam abx

Aminoglycosides: Gentamicin, Neomycin, Amikacin, Tobramycin, Streptomycin

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cover Borrelia burgdorferi, M. pneumoniae
builds up intracell - works for Chlamydia & Rickettsia
also tx acne

Tetracycline, Doxycycline, Minocycline

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tx meningitis by H. influenze, Neisseria meningitidis, Strep pneumo
tx Rocky Mountain Spotted Fever (Rickettsia rickettsii)
limited use d/t toxic SE

Chloramphenicol

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anaerobic infections ABOVE diaphragm- Bacteroides, C. perfringens in aspiration pneumo, lung abscess, oral infections
works for invasive group A strep also
SE: C. diff colitis

Clindamycin

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covers gram pos- MRSA, VRE

Linezolid

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tx atypical pneumonia- Mycoplasma, Chlamydia, Legionella
STI’s- Chlamydia
GPC- strep in PCN allergic
B. pertussis

Macrolides: Azithromycin, Clarithromycin, Erythromycin

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used in combo with sulfonamides to tx UTIs, Shigella, Salmonella, P. jirovecii pneumonia tx/prophylx toxoplasmosis prophyl

Trimethoprim

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covers gram pos, gram neg, Nocardia, Chlamydia, UTI

Sulfonamides- sulfamethoxazole, sulfisoxazole, sulfadiazine

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GNR of urinary and GIT including Pseudomonas, Neisseria, some gram pos

Fluoroquinolones- Ciprofloxacin, Norfloxacin, Levofloxacin, Ofloxacin, Moxifloxacin, Gemifloxacin, Enoxacin

tx S. aureus skin infection esp MRSA, bacteremia, endocarditis, VRE NOT used for pneumonia (binds to & inactivated by surfactant)

Daptomycin

tx Giardia, Entamoeba, Trichomonas, Gardnerella vaginalis, Anaerobes (Bacteroides, C. diff) use with PPI + Clarithromycin to tx H. pylori

Metronidazole

prophylaxis for M. tuberculosis

Isoniazid

tx for M. tuberculosis

RIPE | Rifampin, Isoniazid, Pyrazinamide, Ethambutol

prophylaxis for M. avium intracellulare

Azithromycin, rifabutin

tx for M. avium intracellulare

Azithromycin or clarithromycin + ehtambutol | can add rifabutin or ciprofloxacin

tx for M. leprae

tuberculoid: long term with dapsone + rifampin lepromatous: dapsone + rifampin + clofazimine

tx Mycobacterium tuberculosis delays resistance to dapsone when used for leprosy meningococcal prophyl in contacts of kids with Hib

Rifampin | Rifabutin

tx MTB | only agent used solo as prophyl against TB

Isoniazid

tx for MTB, prodrug

Pyrazinamide

tx for MTB | SE: optic neuropathy

Ethambutol

used for high risk endocarditis undergoing surg or dental procedure

Amoxicillin

used when exposed to gonorrhea

Ceftriaxone

used for hx of recurrent UTIs

TMP-SMX

used if exposed to meningococcal infection

Ceftriaxone, Ciprofloxacin, Rifampin

use for pregnant carrying group B strep

PCN G

use to prevent gonococcal conjunctivitis in newborn

Erythromycin ointment

use to prevent post surg infection d/t S. aureus

Cefazolin

use for prophyl of strep pharyngitis in kid with prior rheumatic fever

Benzathine PCN G or oral PCN V

use if exposed to syphilis

Benzathine PCN G

prophyl for Pneumocystis pneumonia in HIV pt with CD4 <200

TMP-SMX

prophyl for Pneumocystis pneumonia/toxoplasmosis in HIV pt with CD4<100

TMP-SMX

prophyl for M. avium complex in HIV pt with CD4<50

Azithromycin or Clarithromycin

tx for MRSA

vancomycin, daptomycin, linezolid, tigecycline, ceftaroline

tx for VRE

linezolid, streptogramins (quinupristin, dalfopristin)

tx for MDR P. aeruginosa, MDR Acinetobacter baumannii

polymyxin B and E

for serious systemic mycoses: crypto, blasto, coccidoides, histo, candida, mucor intrathecal for fungal meningitis

Amphotericin B

swish & swallow for oran candidiasis | topical for diaper rash or vaginal candidiasis

Nystatin

for systemic fungal infection esp meningitis by Cryptococcus in combo with amphotericin B

Flucytosine

for local & less severe systemic mycoses | for chronic suppression of cryptococcal meningitis in AIDS pt & candida of all types

Fluconazole

for local & less severe systemic mycoses | esp for Blasto, coccidioides, histo

Itraconazole

for local & less severe systemic mycoses | esp for topical fungal infections

Clotrimazole, miconazole

for dermatophytoses esp onychomycosis

Terbinafine

for invasive aspergillosis & candida

Echinocandins: Anidulafungin, caspofungin, micafungin

oral tx of superficial infections, inhib growth of dermatophytes (tinea, ringworm)

Griseofulvin

anti protozoan for toxoplasmosis

Pyrimethamine

anti protozoan for T. brucei (African Sleeping Sickness)

suramin & melarsoprol

anti protozoan for T. cruzi (Chagas)

nifurtimox

anti protozoan for leishmaniasis

sodium stibogluconate

used to treat scabies and lice

permethrin, malathion, lindane

tx plasmodial spp. other than P. falciparum

chloroquine

tx for P. falciparum malaria

artemether/lumefantrine or atovaquone/proguanil

tx for life threatening malaria in U.S.

quinidine

anti helminthic therapy

mebendazole, pyrantel pamoate, ivermectin, diethylcarbamazine, praziquantel

tx/prevent influenza A & B

oseltamivir, zanamivir

for HSV and VZV, weak against EBV, NOT for CMV for mucocutan/genital lesions & encephalitis by HSV prophyl compromised pt. no effect on latent virus

Acyclovir, Famciclovir, Valacyclovir

tx of herpes zoster

Famciclovir

tx CMV in compromised

Ganciclovir

tx CMV retinitis in compromised when ganciclovir fails | for acyclovir-resistant HSV

Foscarnet

tx CMV retinitis in compromised for acyclovir-resistant HSV long half life

Cidofovir

abx to avoid in pregnancy

Sulfonamides, aminoglycosides, fluoroquinolones, clarithromycin, tetracyclines, ribavirin, griseofulvin, chloramphenicol