Antibiotic Indications Flashcards
Narrow Spectrum PCNs
Strep Pharyngitis DOC
Strep Pneumoniae infections (if sensitive)
Endocarditis due to Strep viridans and Endocarditis Px
Meningitis due to Neisseria meningitidis
Syphilis DOC
Lyme disease
Penicillinase-Resistant PCNs
Skin infections due to Staph aureus (MSSA or MSSE)
Osteomyelitis due to MSSA or MSSE
Infection of prosthetic joint due to MSSA or MSSE
Line infections due to Staph
Amino PCNs
Upper resp infections Otitis Media DOC Strep Pharyngitis Enterococcus infection (combo with Aminoglycoside) UTI Meningitis due to Listeria monocytogenes H. pylori (with PPI + other antibiotic) Lyme disease
Amino PCN + Beta-Lactamase Inhibitors
Otitis Media Sinusitis Aspiration Pneumonia Bites UTI Anaerobic infections (abscess)
Anti-Pseudomonal PCN + Beta-Lactamase Inhibitors
Empiric broad spectrum coverage +/- other antimicrobials. GI organisms - ruptured appy, GI surgery, diverticulitis, nosocomial pneumonia (hosp acquired).
Pseudomonas infection (w/aminoglycoside)
Febrile neutropenia
1st Gen Cephalosporins
Skin infections
Bone infections (osteomyelitis)
Surgical prophylaxis
Uncomplicated UTI
2nd Gen Cephalosporins
Community Acquired Pneumonia Sinusitis AECB Otitis Media UTI Cystitis Pyelonephritis Cefoxitin/Cefotetan - surgical px (GI, GU, GYN procedures) and Tx for PID with Doxy
3rd/4th Gen Cephalosporins
PO Agents - Resp Tract Infections; UTI - cystitis, pyelonephritis
IV Agents - empiric tx of serious infections; Meningitis (DOC + Vanco); w/Aminoglycoside for Pseudomonas (Ceftazidime, Cefipime), Febrile neutropenia.
Carbapenems
Serious nosocomial infections such as pneumonia, bacteremia and urosepsis
Serious polymicrobial infections (diabetic infections)
Nosocomial intra-abdominal infections
Pseudomonas infections (w/aminoglycoside)
Febrile neutropenia
Ertapenem
Intra-abdominal infections
Skin infections
UTI - pyelonephritis
Monobactams
Gram (-) sepsis - pneumonia, osteomyelititis
UTI
Intra-abdominal infections (w/anti-anaerobe)
CF (inhaled)
Vancomycin
Serious infections caused by HCA-MRSA (DOC), MRSE, and Enterococci (option for PCN allergic)
Serious infections caused by S. aureus, Enterococcus, or Strep in pts intolerant of Beta-Lactams
Infections caused by resistant Gram (+) organisms
C. difficile colitis (PO) only if Metronidazole fails
Endocarditis Px - for selected GU/GI procedures
Oxazolidinone
Strictly reserved for serious infections due to resistant organisms
Streptogramin
Strictly reserved for serious infections due to resistant organisms
Cyclic Lipopeptide
MRSA skin infections, bacteremia, right sided infective endocarditis - do not use for pneumonia
Lipoglycopeptide
Strictly reserved for serious infections due to resistant organisms
Glycylcycline
MRSA and VRE. Avoid using for serious infections - not as effective. Risk of death and tx failure higher than with other options.
Fluoroquinolones
UTI - pyelonephritis, uncomplicated cystitis, prostatitis
Osteomyelitis due to Gram (-) like pseudomonas
CAP
M. tb alternative
Complicated Gram (-) and anaerobic abd and gyn infections
Trimethoprim-Sulfamethoxazole
Resp Tract Infections - pneumocystic pneumonia (DOC), Actute exacerbations of Chronic Bronchitis, Acute Sinusitis
UTI - uncomplicated cystitis (DOC when E. coli sen), Prostatitis, Orchitis, Epididymitis
GI infections - Travelers diarrhea (enterotoxic E. coli), Shigellosis
Others - B. cepacia, S. maltophelia, Serratia, Nocardia, Typhoid Fever
Aminoglycosides
Serious hosp acquired infections caused by Enterobacteriaceae and Pseudomonas aeruginosa
Enterococcal endocarditis (with amp, pen or vanco)
Serious Staph infections (for synergy w/ other agents)
Usually used in combo with Beta-Lactam
Tetracyclines
Resp Infections - CA-Pneumonia; Atypical Pneumonia; AECB; Legionella (alt to Erythromycin)
Genital Infections - Chlamydia trachomatis, NGU, PID, epididymitis, prostatitis, lymphogranuloma venereum, Granuloma inguinale, Syphilis (alt to PCN)
Systemic Infections - Rickettsiae, Brucellosis, Lyme disease, Ehrlichiosis, Vibrio cholera, Tularemia (alt)
Other - Pasteurella multocida (alt to Amox/Clav), H. pylori (with Bismuth, Metronidazole or Clarithromycin), Propionibacterium acnes
Macrolides - Erythromycin
DOC for Diphtheria and Bordetella Pertussis
Macrolides - Clarithromycin
Similar to Erythromycin
Macrolides - Azithromycin (pediatrics)
Pharyngitis/Tonsillitis (alt to PCN and Erythro)
Acute Otitis Media (not DOC)
Macrolides - Azithromycin (adults)
STIs - Urethritis/Cervicitis/Proctitis (tx with Ceftriaxone)
Upper Resp Infect - Sinusitis, Pharyngitis
Lower Resp Infect - CA-Pneumonia
Clindamycin
Tx of Staph and Strep in PCN allergic - good for retropharyngeal abscess and Staph osteomyelitis
Anaerobic infections (used with Amp, Gent, Clinda)
Topical Tx of Acne
Topical (vaginal) tx of Gardnerella Vaginosis
Toxoplasmosis in pts with AIDS (alt to Sulfonamides)
PID (Chlamydia) in combo with Gent
Metronidazole
Tx of serious anaerobic infections in peritoneum, liver, skin, CNS, bone and joints, lower resp tact (Bacteroides)
Px prior to abd, gyn or colorectal surgery
C. difficile colitis DOC
Bacterial vaginosis (Trichomonas, Gardnerella)
Hepatic encephalopathy
Crohns disease - rectal disease only
PUD due to H. pylori
