Antibiotics advantages/ disadvantages Flashcards
amoxicillin
\+cheap \+suspesnion has better taste than penicillin \+well tolerated \+pregancy class B -narrow spectrum -inferior cure rates for UTIs -resistance is common
amoxicillin/clavulanate
+ bprad pectrum, covers B frag
- does not cover CAPES
- more GI side effects than amoxicillin
- more expensive
trimethprim/sulfamethoxazole
\+covers H PEKCES \+cheap \+covers CA-MRSA \+PO -photosensitivity -current increased in E.Coli Resistance, does not cover pseudomonas -Does not cover st. pyogenes -hypersensitivity/rash -nephrotoxicity -bone marrow suppression
doxycycline
\+covers H.influ, moraxella, S. Pneumo \+cheap, PO \+well tolerated \+good bioavailability \+covers atypicals, s.pneumo, h.flu -not for pediatric patients -limited published data
tigecycline
+active against MRSA
+broad coverage
-expensive
-poorly tolearted
azithromycin
+suspension taste better than penicillin
+short course
+broad spectrum
-more expensive
clarithromycin
+broader spectrum
- drug drug interactions
- more expensive
erythromycin
+for penacillin allergic patients
- poor GI tolerance
- drug interatctions
cefuroxime
+good coverage of H.influ, moraxella
+ok coverage for S. pneumo
-expensive
cephalexin
+safe in pregnancy
-expensive
cefpodoxime
+good coverage of H.influ, moraxella
+ok coverage for S. pneumo
-expensive
levofloxacin
\+broadest spectrum of fluroquinolones \+covers pseudomonas aeroginosa \+well tolerated \+good bioavailability -DDIs: cations and p450 -not for pediatrics -expensive -increasing resistance of E. Coli
moxifloxacin
\+well tolerated \+good bioavailability -DDI's: cations and P450 -does not cover pseudomonas -does not concentrate well in the urine -not for pediatrics -expensive -increasing resistance of E.Coli
penicillin VK
+narrowest spectrum
+cheap
penicillin G benzathine
+good if compliance a problem
-IM painful
ceftriaxone
\+ safe in pregnancy \+excellent coverage of PEK \+low rates of resistance -broad spectrum -IM painful -hypersensitivity reactions
telithromycin
- covers CAP pathogens
- high rates of hepatotoxicity
- expensive
clindamycin
+good coverage for CA-MRSA
+good oral bioavailability
-potential cross resistance with macrocodes
-rash
-GI symptoms
Serous: pseudomembranous enterocolitis, increased LFTs
-BBW C. Dificile diarrhea
metronidazole
+less expensive than vancomycin oral capsules
- nausea/v/
- HA
- peripheral neuropaty
- disulfiram like reaction with ETOH
- metallic taste
- BBW carcinogenic in mice and rats
Ciprofloxacin
\+ good concentation in the urine \+covers pseudomonas aeroginosa \+well tolerated \+good bioavailability -DDIs: cations and p450 -not for pediatrics -expensive -increasing resistance of E.coli -does not concentrate well in the lungs
Nitrofurantoin
+narrow spectrum of activty covering most gram +/- pathogens from the urnie
+lower rates of resistnache even with long-term therapy
+covers enterococcus
-requires multiple daily dosing
-not to be used as short course tehrapy
-ineffeictive and increased toxicity if ClCr< 50ml/min
-cannot be used in upper urinary tract ifnectiosn
-does not achieved adequate systemic concentrations
-Can only be used for UTIs
Ampicillin
\+cheap \+well tolerated \+pregancy class B -narrow spectrum -inferior cure rates for UTIs -resistance is common -not for empiric UTI coverage
fosfomycin
\+single pill treatemtn for uncomplicated cystitis \+pregnancy category B \+ lower rates ofresistance \+Covers PEK \+coveres enterococcus inc VRE -less effeications out hat SMX/TMP -does not cover S. Saprophyticus -inc AE: hA, N/D -Difficult to acqurie -Expensive
ceftazidime
+covers pseudomonas
cefepime
+covers pseudomonas
ceftaroline
+covers pseudomonas
piperacillin/tazobactam
+covers CPES organinisms, not A
imipenem/cilastin
+covers pseudomonas
-highes risk of seizures in carbapenems
meropenem
+covers pseudomonas
-risk of seizures
doripenem
+covers pseudomonas
-risk of seizures, least
aztreonam
+covers pseudomonas
+covers almost all gram -
-does not cover B. fragilis
gentamicin
\+great gram - coverage, including CAPES \+low rates of resistance \+high urine concentration -nephrotoxic (acute tubular necrosis) -ototoxicity (tinnitus) -no gram + coverage
tobramycin
\+great gram - coverage \+low rates of resistance \+high urine concetnration -nephrotoxic (acute tubular necrosis) -ototoxicity (tinnitus) -no gram + coverage
amikacin
\+great gram - coverage \+low rates of resistance \+high urine concetnration -nephrotoxic (acute tubular necrosis) -ototoxicity (tinnitus) -no gram + coverage
Linezolid
+covers MRSA, covers all gram + except listeria
-Expensive
