coverage of antibiotics

Question 1

What antibiotics cover MSSA? Gram +

Answer 1

Methicillin sensitive staphylococcal aureus
1. anti-staphylococcal penicillins
- nafcillin, oxacillin, dicloxacillin
2. 1st gen cephalosporins
- cephalexin, cefazolin (ancef)
3. fluoroquinolones
- ciprofloxacin, levofloxacin

Question 2

What covers MRSA? Gram +

Answer 2

methicillin resistant staphylococcal aureus
1. 5th gen cephalosporins
- ceftaroline
2. Vacomycin
3. Bactrim (sulfamethoxazole-trimethoprim)
4. clindamycin (50s)
5. linezolid (50s)
6. doxycyclin (tetracycline)
7. daptomycin (only on skin or RIGHT sided endocarditis)

Question 3

What covers strep pneumonia? Gram +

Answer 3

1. Penicillin G
2. aminopenicillins
   - amoxicillin and ampicillin
3. 3rd gen cephalosporins
   - cefotaxime, ceftriaxone, ceftazadime
4. fluoroquinolones
   - levofloxacin
5. Macrolides
   - azithromycin, clarithromycin, erythromycin
6. clindamycin

Question 4

Strep A and B? Gram +

Answer 4

1. penicillin
2. amino-penicillins
   - amoxicillin, ampicillin
3. first gen cephalosporins
   - cephalexin, cefazolin (ancef)
4. Folic acid inhibitors
   - Bactrim (sulfamethoxazole- trimethoprim)
5. Macrolides
   - azithromycin, clarithromycin, erythromycin
6. clindamycin

Question 5

Enterococcus coverage? Gram +

Answer 5

1. Penicillin
2. amino-penicillins
   - amoxicillin, ampicillin
3. Norfloxacin (concentrates in urine)

Question 6

Listeria coverage? Gram +

Answer 6

1. aminopenicillins
   - ampicillin, amoxicillin
2. Folic acid inhibitors
   - Bactrim (TMP-SMX)

Question 7

Vancomycin utilization?

Answer 7

1. if patient is penicillin allergic
2. resistance to other Gram +

Question 8

HENS-PEcK coverage?
1. Haemophilus influenzae
2. Enterobacter
3. N. meningitidis/ N. gonorrhoeae
4. Serratia
5. Proteus
6. Ecoli
7. Klebsiella

Answer 8

1. aminopenicillins (except E,S,N)
2. antipseudomonal
   - piperacillin
3. 1st gen cephalosporins (only PECK)
4. 2nd, 3rd, and 4th cephalosporins for all
5. carbapenems
6. monobactams
   - aztreonam
7. fluoroquinolones not N
8. aminoglycosides (GNATS) not N

Question 9

Pseudomonas and Acinetobacter coverage?

Answer 9

1. Aminopenicillins (only acinetobacter)
2. antipseudomonal
3. 3rd gen ONLY ceftazadime
4. 4th gen cefapime
5. cabapenems
6. monobactams
   - aztreonam
7. Aminoglycosides (GNATS)
   - not acinetobacter
8. polymyxins for last resort

Question 10

ESBL (extended spectrum beta lactamase)
klebsiella
E. coli
enterobacter

Answer 10

1. carbapenems
2. aminoglycosides
3. polymyxins
4. 3rd gen cephalosporin with beta-lactamase inhibitor (like avibactam)

Question 11

Stenotrophomonas

Answer 11

1. Antipseudomonal pens
2. polymyxins
3. bactrim