Coverage and Unique SEs

Question 1

Rifamycins

Answer 1

TB
Staph, HaN, Mycobacterium.

Rifaximin: traveler’s diarrhea

Orange/red fluid discoloration. Hepatitis, rashes.

Question 2

Aminoglycosides

Answer 2

Aerobic Gram Neg (synergy G+)
Enterobacter, Pseudomonas, Mycobacterium (TB/MAC)

Tobramycin, Amikacin: No activity vs. enterococcus

Ototoxicity, nephrotoxicity

Question 3

Macrolides and Ketolides

Answer 3

Staph, Step.
HaN, Pertussis

?All? Atypicals: Mycoplasma, Legionella, Mycoplasma, Mycobacterium, Chlamydia, Spirochetes, Rickettsia

QT prolongation, blurred vision/diplopia, severe liver damage.

Erythromycin/Clarithrymycin: inhibit 3A4

Question 4

Tetracyclines

Answer 4

Strep, Staph.
HaN

Atypicals: Rickettsia, Chlamydia, Mycoplasma, Borrelia, Treponema

Tigecycline: MRSA, Enterococci/VRE, anaerobes. Less v. atypicals.

Gray/yellow teeth/skin, photosensitivity, hepatotoxicity. NO Preggos/under 8y

Question 5

Chloramphenicol

Answer 5

Strep.
HaN, Salmonella, Shigella
Anaerobes
Atypicals: Mycoplasma, chlamydia, rickettsia

Gray baby syndrome. Reversible bone marrow suppression, irreversible aplastic anemia, optic neuritis.

Question 6

Clindamycin

Answer 6

Gram Pos only; reduces toxins

Staph (MSSA, CA-MRSA), Strep
Anaerobes: but not C. Diff

Can induce C. diff colitis

Question 7

Streptogramins

Answer 7

Staph, Strep, Enterococcus

Arthralgia, myaglia

Question 8

Linezolid

Answer 8

Reserved for MRSA, VRE

Do not give with MAOI or SSRI. Decreased platelets, RBCs, WBCs

Question 9

Nitrofurantoin

Answer 9

Uncomplicated UTIs

Contraindicated if creatinine clearance less than 60.

Rash, hepatitis, hemolytic anemia, neuropathy.

Question 10

Sulfas

Answer 10

Strep, Staph, Listeria.
H. flu, enterobacteriacae (NOT enterococcus)

Minimally useful against anaerobes and atypicals.

Dapsone: Leprosy
Sulfadiazine: Rheumatic fever, toxoplasmosis

Question 11

Quinolones

Answer 11

Staph, Strep
HEN
Anaerobes: clostridium, bacteriodies
Atypicals: Chlamydia, mycoplasma, legionella, Mycobacteria

Cipro: Weak G+, Good G-, covers pseudomonas
Levofloxacin: Better vs G+, covers pseudomonas

Dela: pseudomonas

Moxi/gemi: No pseudomonas, less active v. G-

QT prolongation, tendon rupture, inc. C. Diff, cartilage abnormal
NO Preggos or under 18y

Question 12

Metronidazole

Answer 12

Anaerobes only

No ETOH, metallic taste, furring of tongue, dizziness/neuropathy

Question 13

Carbapenems

Answer 13

Imi/Mero: Staph, Strep, Listeria, HEN, Pseudomonas, Anaerobes.

Dori: Best in pseudomonas

Erta: less active v. G+, no psuedomonas/actineobacter, once a day

Question 14

Monobactams AKA Aztreonam

Answer 14

Gram Neg Only

Excellent vs HaN
Intermediate vs. pseudomonas

No cross reactions with PCN alelrgy, rare TEN

Question 15

Glycopeptides

Answer 15

Gram Pos Only
Nearly all staph inc. MRSA, strep

Good vs anaerobe G+ (inc. C. diff, orally)

Vanco: Red man, oto/nephrotoxicity.

Telavancin: QT prolongation

Oritavancin (long half life): Contraindicated with osteomyelitis and heparin use

Question 16

Daptomycin

Answer 16

Gram Pos Only
No PNA

MRSA, some VRE. SSTI, endocarditis, bacteremia.

Reversible myopathy at high levels

Question 17

Colistin

Answer 17

Gram Neg Only
H. flu, E. Coli, Klebsiella
Pseudomonas

Nephro/neurotoxicity

Question 18

3rd Gen Cephalosporins

Answer 18

Gram +
PEK (Proteus, E. Coli, Klebsiella)
HEN (H. Flu, Enterobacter, Neisseria)

Ceftazidime: Weak pseudomonas activity

Ceftriaxone: eliminated by biliary excretion, can result in biliary sludge

Question 19

VRE

Answer 19

Linezolid
Daptomycin
Tigecycline

Question 20

Covers MRSA

Answer 20

Clindamycin
Ceftaroline
Linezolid
Vancomycin
Tigecycline
Daptomycin
Bactrim

Mupirocin

Question 21

Pseudomonas

Answer 21

Mero/Imi/Doripenems 
Aztreonam
Fluoroquinolones (Cipro/Levo)
Aminoglycosides
Piperacillin/tazobactam
Cefepime/Ceftazidime

Question 22

UTI (Cystitis)

Answer 22

Nitrofurantoin x 5 days
Bactrim x 3 days
Fosfomycin x1 dose
Fluoroquinolone (not Moxi) x 3 days

Question 23

UTI (Pyelonephritis)

Answer 23

Fluoroquinolones x 7 days
Bactrim 7-10 days
Ceftriaxone x1 followed by 5 days fluoroquinolone

Question 24

First line MRSA/MSSA

Answer 24

MRSA PO: Bactrim, clindamycin, doxycycline
MRSA IV: Vanco, daptomycin, linezolid

MSSA PO: Cephalexin
MSSA IV: Cefazolin

Question 25

PNA/CAP

Answer 25

Non-severe outpt: Azithromycin

Moderate/low severity outpt: Beta-lactam + Doxycyline OR levo/moxi floxacins

Nonsevere inpt: Beta lactam + Macrolide, or levo/moxi

Sevre: Beta lactam + Macrolide or Beta Lactam + fluoroquinolone