Shreiber ABs Flashcards
7 bugs in resp. cluster
- pneumococcus
- H. influenzae
- Moraxella catarrhalis
- meningococcus
- chlamydophylae pneumoniae
- mycoplasma pneumonaie
- Group A strep
5 resp. syndromes
- otitis media
- sinusitis
- pharynigitis
- pneumonia
- meningitis
3 bugs in intra-abdo cluster
- Gr- bacilli
- anaerobes
- enterococci
6 abdo syndromes
- diverticoutis
- intra-abdo abscess
- cholecyctitis
- pyelonephritis
- PID
- diabetic foot infection
2 bugs in skin
- Group A strep
2. S. aureus
3 syndromes in skin
- cellulitis
- erysipelas
- abscess
what are 3 big AM families
- penicillins
- cephalosporins
- FQs
4 “pretty big” families
outpatients 1. macrolides 2. tetracyclines inpatients 1. carbapenems 2. aminoglycosides
5 individuals
- vancomycin
- trimethoprim-sulfa
- nitrofuenatoin
- metronidazole
- clindamycin
bugs for penicillin
strep, pneumococcus, treponium pallidium
bugs for ampi/amoicillin
amino group
-strep, pneumococcus, treponium pallidium + some Gr-
what are 2 add-ons for penicillins
clavulanate or tazo - give broader spectrum
coverage for cloxacillin
same as penicillin, but with S. Aureus
2 important groups of cephalosporins and names
1st gen - cephalexin and cefazolin
3rd gen - cefixime, ceftriaxone, cefrazidime
what do 2 generations cover
1st - Gr+
3rd - Gr-
2 keys FQs and their coverage
- ciprofloxacin - aerobic Gr- rods
2. respiratory FQs (levofloxacin, moxifloxacin) - aerobic Gr- rods, bacteria causing pneumonia, aerobic Gr- cocci
coverage by macrolides
Gr+ cocci, bacteria causing pneumonia, some Gr- including those causing gon and traveller diarrhea
coverage by tertacyclines
pneumonia bacteria, chlamydia, broad spectrum including MRSA
coverage by aminoclycocides
aerobic Gr-
coverage by carbapenems
everything but MRSA
coverage by trimethoprim-sulfa
broad spectrum, esp Gr- , MRSA
coverage by nitrofurantoin
Gr- bacillis, enterococcus (BOTH only for CYSTITIS)
coverage by metronidazole
anaerobes, C.diff
coverage by clindamycin
Gr+ cocci (yes MRSA, no enterococci), anaerobes
coverage by vancomycin
aerobic Gr+ cocci
1st and 2nd choice for Strep A
- penicillin
2. 1st gen cephalosporin, macrolide, resp. FQ
1st and 2nd choice for Strep pneumoniae
- penicillin
2. 2 or 3 gen cephal, macrolide, resp FQ, vanco
1st and 2nd choice for entercoccus
- amoxicillin
2. vanco, linolizid
1st and 2nd choice for s. aureus (non-MRSA)
- cloxacillin
2. 1st gen. cephalo, vanco
1st and 2nd choice for MRSA
- blood - vanco, skin- clindamycin
Choices for typical enteric pathos (E.coli, proteus, klebsiella)
- FQ
- 3rd gen cephalo
- amoxicillin-clav
choices for H. influenzae, moraxella
- amoxicillan
- cephalo - 3rd gen
- resp FQ
choices for neisseria meningitidis and gonorrhea
- 3rd gen cephalo (ceftriaxone)
2. add azithromycin or doxicylin for gon
drugs for chlamydia trachomatis and mycoplasma pneumoniae
- azithromycin
2. doxicycline
drugs for bacteroides and other oral and gut anaerobes
metronidazole
drugs for C.diff
metronidazole
8 issues to think about when choosing the meds
- local resistance patterns
- recent AB use
- co-morbidities that may alter
- if the patient is very sick
- cost
- safety issues
- tissue penetration
- cidal vs .static
- evidence from randomized trials
what to do when culture is returned
narrow the spectrum
go through the samples
now