Beta Lactams

Question 1

Penicillin

Answer 1

Use:
Pneumococcus
Strep
Enterococcus
N. meningitides
Syphilis
Listeria
Leptospirosis
Oral anaerobes (peptostreptococcus, prevotella)

Question 2

Amoxicillin

Answer 2

Use:
Covers same as penicillin
+ (E. coli, Proteus, H. flu, H. pylori, N. meningitides, shigella, klebsiella)
Covers most spirochetes including lyme
Clavulanate enhaces gram negative spectrum to include additional anaerobes such as bacteroides

Question 3

Oxacillin/Nafcillin/Dicloxacillin

Answer 3

Only good for staph (not MRSA), pneumococcus and other streptococci

Question 4

Piperacillin and ticarcillin

Answer 4

Pip covers pneumococcus
streptococcal spp including enterococcus
Gram negative including pseudomonas
*no MRSA

Question 5

1st gen cephalosporins

Cefazolin

Answer 5

Use:
Staph
Non-enterococcal strep
Prophylactic in clean surgeries
Cellulitis
Folliculitis

Limitations:
Respiratory tract infections
Animal bites
Surgeries involving the colon

Question 6

2nd gen cephalosporins

Cefuroxime

Answer 6

Use:
Respiratory infections (Strep pneumo, H flu, M cattarhalis)
Menigitis due to pneumococcus, H.flu, N. meningitides

Limitations:
Enteric organisms/abdominal anaerobes

Question 7

2nd gen cephalosporins

Cefoxitin/cefotetan

Answer 7

Use:
Intra-abdominal infections especially anaerobes

Limitations:
Staph and other gram positives

Question 8

3rd gen cephalosporins

Cefotaxime and ceftriaxone

Answer 8

Use:
Staph, non-enterococcal strep
Broad coverage of gram negatives and oral anaerobes
CNS
Pulmonary
Endovascular
GI infections (excluding gut anaerobes)
Sinusitis
Otitis
Head and nec

Limitations:
no pseudomonas
Ceftriaxone can cause biliary sludging

Question 9

3rd gen cephalosporins

Ceftazidime

Answer 9

Use:
Good gram negative
pseudomonas
Febrile neutropenia
CNS infections (pseudomonas meningitis)

Limitations:
reduced activity against gram positives and oral anaerobes

Question 10

4th Gen cephalosporins

Cefepime and cefpirome

Answer 10

Use:
Enterobacter
Citrobacter
Serratia
Pseudomonas
Gram positives
Used in neutropenic fever and CNS infections

Question 11

Carbapenems

Imepenem

Answer 11

More activity against gram positive bacteria than meropenem or ertapenem

Question 12

Carbapenems

Ertapenem

Answer 12

Good for aerobic gram negatives

Poor Pseudomonas, E. faecalis and Nocardia coverage

Question 13

Carbapenems

Meropenem

Answer 13

Good for aerobic gram negatives

Pseudomonas

Question 14

Carbapenems

Doripenem

Answer 14

Good for CNS coverage

Pseudomonas