Drug-Bug Associations

Question 1

Staph Aureus (MSSA); Gram+

Answer 1

1st line:
Nafcillin
Oxacillin
Cicloxacillin (oral)

Other: 
Clindamycin(good for PCN allergic patients)
Cefazolin 
Cephalexin (oral)
Cefuroxime
Cefepime 
Carbapenems 
Pip/Tazo
Amp/Sul
Vanco

Question 2

Staph Aureus (MRSA); Gram+

Answer 2

1st line:
Vanco

Other: 
Linezolid 
Daptomycin (poor lung penetration)
Tigecycline
Quinupristin/Dalfopristin
Televancin 
**CA MRSA: Bactrim, doxycycline, levofloxacin, clindamycin

Question 3

Streptococci; Gram +

Answer 3

1st line:
PCN
Aminopenicillins
Azithromycin (Strep pneumo)

Other: 
Extended spectrum PCNs
Clindamycin
Levofloxacin/Moxifloxacin
Vancomycin
Doxycycline

Question 4

Enterococcus; Gram+

Answer 4

1st line:
Aminopenicillins
(Ampicillin is drug of choice)

Other:
Vanco
**Linezolid (for VRE)
**Daptomycin (for VRE)

Question 5

C.Diff; Gram + anaerobe

Answer 5

1st line:
Metronidazole

Other:
Vanco(oral)
Fidaxomicin

Question 6

Other Gram + anerobes

Answer 6

Clindamycin, Metronidazole, Carbapenems

Question 7

E. Coli; Gram -

Answer 7

1st line:
Aminopenicillins
1st gen cephalosporins
Bactrim

Other: 
2nd, 3rd, 4th gen cephalosporins 
Fluroquinolones
Extended spectrum PCNs (ie-zosyn)
**Carbapenems for ESBL E.Coli

Question 8

Klebsiella; Gram -

Answer 8

1st line:
Fluroquinolones
Cephalosporins
Aminopenicillins

Other: Carbapenems
Ext. spectrum PCNs

Question 9

Pseudomonas Aeruginosa, Gram -

Answer 9

**Aminoglycosides (active against all gram neg org)
Aztreonam
Cetazidime (3rd gen)
Cefepime (4th gen)
Ciprofloxacin 
Levofloxacin (high doses)
Imipenem
Meropenem
Zosyn 
Ticarcillin/Clavulanic acid

Question 10

Gram - anaerobes

Answer 10

Metronidazole
Clindamycin
Carbapenems
Cefotetan

Question 11

Atypicals- Mycoplasma, Rickettsia, Chlamydia, Legionella

Answer 11

Macrolides (esp. Azithromycin)
Doxycycline
Fluroquinolones (Cipro, Levo, Moxi