Coverage and Unique SEs Flashcards
Rifamycins
TB
Staph, HaN, Mycobacterium.
Rifaximin: traveler’s diarrhea
Orange/red fluid discoloration. Hepatitis, rashes.
Aminoglycosides
Aerobic Gram Neg (synergy G+)
Enterobacter, Pseudomonas, Mycobacterium (TB/MAC)
Tobramycin, Amikacin: No activity vs. enterococcus
Ototoxicity, nephrotoxicity
Macrolides and Ketolides
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
Tetracyclines
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
Chloramphenicol
Strep.
HaN, Salmonella, Shigella
Anaerobes
Atypicals: Mycoplasma, chlamydia, rickettsia
Gray baby syndrome. Reversible bone marrow suppression, irreversible aplastic anemia, optic neuritis.
Clindamycin
Gram Pos only; reduces toxins
Staph (MSSA, CA-MRSA), Strep
Anaerobes: but not C. Diff
Can induce C. diff colitis
Streptogramins
Staph, Strep, Enterococcus
Arthralgia, myaglia
Linezolid
Reserved for MRSA, VRE
Do not give with MAOI or SSRI. Decreased platelets, RBCs, WBCs
Nitrofurantoin
Uncomplicated UTIs
Contraindicated if creatinine clearance less than 60.
Rash, hepatitis, hemolytic anemia, neuropathy.
Sulfas
Strep, Staph, Listeria.
H. flu, enterobacteriacae (NOT enterococcus)
Minimally useful against anaerobes and atypicals.
Dapsone: Leprosy
Sulfadiazine: Rheumatic fever, toxoplasmosis
Quinolones
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
Metronidazole
Anaerobes only
No ETOH, metallic taste, furring of tongue, dizziness/neuropathy
Carbapenems
Imi/Mero: Staph, Strep, Listeria, HEN, Pseudomonas, Anaerobes.
Dori: Best in pseudomonas
Erta: less active v. G+, no psuedomonas/actineobacter, once a day
Monobactams AKA Aztreonam
Gram Neg Only
Excellent vs HaN
Intermediate vs. pseudomonas
No cross reactions with PCN alelrgy, rare TEN
Glycopeptides
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
Daptomycin
Gram Pos Only
No PNA
MRSA, some VRE. SSTI, endocarditis, bacteremia.
Reversible myopathy at high levels
Colistin
Gram Neg Only
H. flu, E. Coli, Klebsiella
Pseudomonas
Nephro/neurotoxicity
3rd Gen Cephalosporins
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
VRE
Linezolid
Daptomycin
Tigecycline
Covers MRSA
Clindamycin Ceftaroline Linezolid Vancomycin Tigecycline Daptomycin Bactrim
Mupirocin
Pseudomonas
Mero/Imi/Doripenems Aztreonam Fluoroquinolones (Cipro/Levo) Aminoglycosides Piperacillin/tazobactam Cefepime/Ceftazidime
UTI (Cystitis)
Nitrofurantoin x 5 days
Bactrim x 3 days
Fosfomycin x1 dose
Fluoroquinolone (not Moxi) x 3 days
UTI (Pyelonephritis)
Fluoroquinolones x 7 days
Bactrim 7-10 days
Ceftriaxone x1 followed by 5 days fluoroquinolone
First line MRSA/MSSA
MRSA PO: Bactrim, clindamycin, doxycycline
MRSA IV: Vanco, daptomycin, linezolid
MSSA PO: Cephalexin
MSSA IV: Cefazolin
PNA/CAP
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
