Antibiotic Actions (Specific) Flashcards
ceftriaxone, cefotaxime ceftibuten, cefdinir, cefpodoxime, cefixime
(cephalosporin 3)
- great strep, moderate MSSA
- broad G- (NO pseudo)
- oral anero
- H/S, ceftri=biliary sludging
- ceftri has biliary elimination and long half life/ CA-meningitis, gonorrhea, neuro lyme
ceftazidime
(cephalosporin 3)
-
- broad G- (incl pseudo)
- oral anero
- H/S
-
extended spectrum penicillins + B-lactamase inhibitor
- strep, entero, MSSA (penic + MSSA)
- broad G- (incl. pseudo)
- broad anero (incl. B fragilis)
- H/S, diarrhea
- p+t more potent so more common
fidaxomicin
-variable strep, entero, and staph
-
-C diff (similar to vanco)
-
-C diff infection
Penicillins
-strep, entero
-
- syphilis, oral anero
- H/S
- only cidal against entro when with aminoglycoside
cefoxitin
(cephalosporin 2)
- strep
- ceph 2a (E coli, klebs, H influ)
- oral anero, moderate B fragilis (only ceph with more than oral) !!
- H/S
- intra-abdominal and pelvic infection
tigecycline
(glycylcycline)
- broad G+ (incl MRSA + VRE)
- broad G- (NO pseudo)
- broad anero (incl fragilis)
- GI and esophageal ulcers -> take with water and upright, gray teeth in kids, photosensitivity
- low serum levels so not good for bacteremia
metranidazole
(DNA damaging)
-
-
- great anero (incl fragilis), trich, giardia, H pylori, C diff
- GI, metallic taste, peripheral neuropathy
- DoC for moderate C diff, extensively used for anero
cefuroxime, cefaclor, cefprozil
(cephalosporin 2)
- moderate MSSA and strep
- ceph 1 + H influenzae
- oral anero
- H/S
- otitis media, sinusitis
nitrofurantoin
(DNA damaging)
- broad G+ (incl VRE)
- good E coli, variable klebs and entero
-
- GI and pulmonary risks
- for UTI but not pyelonephritis, very low serum levels
gentamicin, tobramycin, amikacin
(aminoglycosides)
- used in combo for G+
- broad G- (incl pseudo)
-
- nephrotoxic, ototoxic
- almost always in combo with cell wall drug, pharmacokinetic montitoring
polymyxin B, colistin
(polymyxin)
-
-broad G- (incl pseudo)
-
- dose related reversible nephrotoxicity, neurotoxicity and paresthesias
- usually as combo, last resort for resistant G-
cefazolin, cephalexin, cefadroxil
(cephalosporin 1)
- great MSSA and strep
- some E coli and klebs
- oral anero
- H/S
- skin and soft tissue infections, surgical, cefadroxil half life > cephalexin
rifampin
- staph and strep but ONLY AS COMBO THERAPY
- N meningitidis prophylaxis
- M tuberculosis
- orange fluids, hepatotoxicity (elevated bilirubin)
- many drug interactions/ never as mono therapy/ treat TB, staph endocarditis, prosthetic infection
vancomycin
(glycopeptide)
-strep, MRSA, MRSE, entero (NO VRE)
-
- C diff (PO therapy)
- Red Man’s with rapid infusion, nephrotoxic, neutropenia, rare H
- G+ infection (IV therapy), C diff diarrhea (PO)
cefepime
(cephalosporin 4)
- good MSSA and strep
- broad G- (incl pseudo)
- oral anero
- H/S
-
daptomycin
(lipopeptide)
-broad G+ (incl MSSA, MRSA, MRSE, resistant strep, VRE)
-
-
- muscle pain+weakness (elevated creatinine), rash
- NOT effective for pneumonia/ for tough G+ bacteremia
Aminopenicillins + B-lactamase inhibitor
- aminos + MSSA
- aminos + klebsiella, better H influenzae
- aminos + broad anero (incl. B fragilis)
- H/S, diarrhea (from B-lactam inhib)
-
imipenem/cilastatin, meropenem, doripenem
(carbapenem)
- good MSSA, strep, entero faecalis
- broad G- (incl pseudo)
- broad anero (incl B fragilis)
- H/S, imipenem=increased S in renal impaired
-
ertapenem
(carbapenem)
-
- broad G- (NO pseudo)
- broad anero (incl B fragilis)
- H/S
- 1/day dosing
penicillinase resistant
-strep, great MSSA (DoC)
-
-
- H/S, naf=inter. nephritis, oxa=hepatotoxicity
- hepatic elimination
aztreonam
(monobactam)
-
-good G- (incl pseudo)
-
- H/S
- safe with penicillin allergies
trimethoprim+sulfamethoxazole
- good MRSA and MRSE
- broad G- incl stenotrophomonas maltophilia (NO pseudo)
- nocardia, pneumocystis j, toxoplasma gondii
- TMP inhibits creatinine clearance, hyperkalemia, acute tubular necrosis and interstitial nephritis
- TMP interaction with warfarin (monitor INR), dose by TMP
ceftaroline
(cephalosporin 3)
- MRSA, great strep
- broad G- (NO pseudo)
- oral anero
- H/S
- =ceftriaxone+MRSA
ciprofloxacin, levofloxacin, moxifloxacin
(quinolones)
- strep=levo/MOXI
- broad G- (incl pseudo)=cipro/levo
- chlamydia, mycoplasma, legionella, moxi=B fragilis
- CNS, tendinitis (especially elderly w/ roids), long QT, C diff risk
- broad use
Aminopenicillins
- penic + listeria
- E coli, proteus, and some H influenza
- penic + lyme
- H/S
-
clindamycin
(lincosamide)
-strep, MRSA -> but not 1st line
-
- good anero (some B fragilis)
- nausea, vomiting, diarrhea, C diff risk
- rarely use because of C diff risk, oral/skin infections for penic allergy, combo for necrotizing fasciitis
linezolid
(oxazolidinone)
-broad G+ (incl MRSA + VRE)
-
-
- myelosuppression (thrombocytopenia) with time, serotonin syndrome with MAO-I
- reserved for resistant G+ infections
doxycycline, tetracycline, minocycline
(tetracyclines)
- strep pneumo, staph (incl MRSA), entero
- H influ, N gonorrhea, M catarrhalis, camplyobacter
- broad anero, atypicals, rickettsials/ lyme
- GI and esophageal ulcers -> take with water and upright, gray teeth, photosensitivity
- mostly with COPD and upper respiratory but technically broad applicability
azithromycin, clarithromycin
(macrolides)
- strep (incl pneumo), MSSA; NOT 1st LINE
- H influ, N gonorrhea, M catarrhalis, campylobacter, H pylori
- legionella, mycoplasma, chlamydia, broad anero (NO fragilis), MAC
- erythromycin for GI kinesis, torsades de points with clarithromycin
- for atypicals, CA-pneumonia, otitis, sinusitis/ drug interactions with clarithro (CYP3A4)
fosfomycin
- staph, strep, entero
- great E coli and others (NO pseudo)
-
- well tolerated
- single dose for acute cystitis in females
