Spectrum Flashcards
Natural Penicillins
Penicillin G, V
Spectrum
Good
Treponema pallidum most Streptococci (including S. pneumoniae)
Natural Penicillins
Penicillin G, V
Spectrum
Moderate
Enterococci
Natural Penicillins
Penicillin G, V
Spectrum
Poor
Almost everything else
Antistaphylococcal Penicillins
Spectrum
Good
MSSA
Streptococci
Antistaphylococcal Penicillins Spectrum
Poor
GNRs
Enterococci
Anaerobes
MRSA
Aminopenicillins
Amoxicillin, Ampicillin
Spectrum
Good
Streptococci
Enterococci
Aminopenicillins
Amoxicillin, Ampicillin
Spectrum
Moderate
enteric GNRs
Haemophilus
Aminopenicillins
Amoxicillin, Ampicillin
Spectrum
Poor
Staphylococci
Anaerobes
Pseudomonas
Antipseudomonal Penicillins
Spectrum
Good
P. aeruginosa
Streptococci
Enterococci
Antipseudomonal Penicillins
Spectrum
Moderate
enteric GNRs
Haemophilus
Antipseudomonal Penicillins
Spectrum
Poor
Staphylococci
Anaerobes
Penicillin/BL-inhibitor Combos
Spectrum
Good
MSSA Streptococci Enterococci many Anaerobes enteric GNRs P. aeruginosa -only piperacillin/tazobactam
Penicillin/BL-inhibitor Combos
Spectrum
Moderate
GNRs with advanced betalactamases
Penicillin/BL-inhibitor Combos
Spectrum
Poor
MRSA
ESBL-producing GNRs
1G Cephalosporins
Spectrum
Good
MSSA
Streptococci
1G Cephalosporins
Spectrum
Moderate
some enteric GNRs
1G Cephalosporins
Spectrum
Poor
Enterococci
Anaerobes
MRSA
Pseudomonas
2G Cephalosporins
Spectrum
Good
some enteric GNRs
H. influenzae
N. gonorrhoeae
2G Cephalosporins
Spectrum
Moderate
Streptococci
Staphylococci
Anaerobes
-only cefmetazole, cefotetan, cefoxitin
2G Cephalosporins
Spectrum
Poor
Enterococci
MRSA
Pseudomonas
3G Cephalosporins
Spectrum
Good
Streptococci -except ceftazidime (poor) Enteric GNRs Pseudomonas -only ceftazidime
3G Cephalosporins
Spectrum
Moderate
MSSA
-except ceftazidime (poor)
3G Cephalosporins
Spectrum
Poor
Enterococci Anaerobes MRSA Pseudomonas -except ceftazidime
4G Cephalosporins
Cefepime
Spectrum
Good
MSSA
Streptococci
Pseudomonas
Enteric GNRs
4G Cephalosporins
Cefepime
Spectrum
Moderate
Acinetobacter
4G Cephalosporins
Cefepime
Spectrum
Poor
Enterococci
Anaerobes
MRSA
Ceftaroline
Spectrum
Good
MSSA
MRSA
Streptococci
Enteric GNRs
Ceftaroline
Spectrum
Moderate
E. faecalis
Ceftaroline
Spectrum
Poor
P. aeruginosa
E. faecium
Acinetobacter
Anaerobes
Cephalosporins/BL-inhibitor combinations
Spectrum
Good
Pseudomonas
Enteric GNRs
-ceftazidime/avibactam > ceftolozane/tazobactam)
Cephalosporins/BL-inhibitor combinations
Spectrum
Moderate
Some streptococci
-ceftolozane/tazobactam
Cephalosporins/BL-inhibitor combinations
Spectrum
Poor
Most anaerobes
MRSA
MSSA
Acinetobacter
Carbapenems
Spectrum
Good
MSSA Streptococci Anaerobes Enteric GNRs Pseudomonas -not ertapenem Acinetobacter -not ertapenem ESBL producing GNRs
Carbapenems
Spectrum
Moderate
Enterococci
-not ertapenem
Carbapenems
Spectrum
Poor
MRSA
Penicillin resistant streptococci
Monobactams
Aztreonam
Spectrum
Good
Pseudomonas
Most GNRs
Monobactams
Aztreonam
Spectrum
Moderate
Acinetobacter
Monobactams
Aztreonam
Spectrum
Poor
Gram+ organisms
Anaerobes
Glycopeptides and Short Acting Lipoglycopeptides Vancomycin, Telavancin Spectrum Good
MSSA
MRSA
Streptococci
C. difficile
Glycopeptides and Short Acting Lipoglycopeptides Vancomycin, Telavancin Spectrum Moderate
Enterococci
Glycopeptides and Short Acting Lipoglycopeptides Vancomycin, Telavancin Spectrum Poor
Anything Gram-
Long Acting Glycopeptides
Dalbavancin, Oritavancin
Spectrum
Good
MSSA MRSA Streptococci Enterococci -oritavancin
Long Acting Glycopeptides
Dalbavancin, Oritavancin
Spectrum
Moderate
Enterococci
-dalbavancin
Long Acting Glycopeptides
Dalbavancin, Oritavancin
Spectrum
Poor
Anything Gram-
Fluoroquinolones
Ciprofloxacin
Spectrum
Good
Enteric GNRs
-E. coli, Proteus, Klebsiella, etc.
H. influenzae
Fluoroquinolones
Ciprofloxacin
Spectrum
Moderate
Pseudomonas
Atypicals
-mycoplasma, chlamydia, legionella
Fluoroquinolones
Ciprofloxacin
Spectrum
Poor
Staphylococci
S. pneumoniae
Anaerobes
Enterococci
Fluoroquinolones
Levo/Moxi/Gemifloxacin
Spectrum
Good
Enteric Gram-
S. pneumoniae
Atypicals
H. influenzae
Fluoroquinolones
Levo/Moxi/Gemifloxacin
Spectrum
Moderate
Pseudomonas
-only levofloxacin
MSSA
Fluoroquinolones
Levo/Moxi/Gemifloxacin
Spectrum
Poor
Anaerobes
-moxifloxacin has moderate activity
Enterococci
Aminoglycosides
Gent/Tobramycin, Amikacin
Spectrum
Good
Gram negatives
- E. coli
- Klebsiella
- Pseudomonas
- Acinetobacter
- Most others
Aminoglycosides
Gent/Tobramycin, Amikacin
Spectrum
Moderate
In combination with a beta lactam or glycopeptide: Staphylococci (MRSA) Viridans streptococci Enterococci -gentamicin and streptomycin are best
Aminoglycosides
Spectrum
Poor
Atypicals
Anaerobes
Gram+ organisms
-as monotherapy
Tetracyclines
Doxy/Mino/Tetracycline
Spectrum
Good
Atypicals Rickettsia Spirochetes -Borrelia burgdorferi -H. pylori Plasmodium species (malaria)
Tetracyclines
Doxy/Mino/Tetracycline
Spectrum
Moderate
Staphylococci
-including MRSA
S. pneumoniae
Tetracyclines
Doxy/Mino/Tetracycline
Spectrum
Poor
Most GNRs
Anaerobes
Enterococci
Glycylcyclines
Tigecycline
Spectrum
Good
Atypicals Enterococci -including VRE Staphylococci -including MRSA S. pneumoniae
Glycylcyclines
Tigecycline
Spectrum
Acceptable
Most GNRs
Anaerobes
Glycylcyclines
Tigecycline
Spectrum
Poor
Pseudomonas
Proteus
Providencia
Macrolides and Ketolides
Spectrum
Good
Atypicals H. influenzae Moraxella catarrhalis H. pylori Mycobacterium avium
Macrolides and Ketolides
Spectrum
Moderate
S. pneumoniae
-telithromycin > macrolides
S. pyogenes
Macrolides and Ketolides
Spectrum
Poor
Staphylococci Enteric GNRs -azithromycin > clarithromycin Anaerobes Enterococci
Oxazolidinones
Linezolid, Tedizolid
Spectrum
Good
MSSA MRSA Streptococci -including multidrug resistant S. pneumoniae Enterococci -including VRE Nocardia
Oxazolidinones
Linezolid, Tedizolid
Spectrum
Moderate
Some atypicals
M. tuberculosis
Oxazolidinones
Linezolid, Tedizolid
Spectrum
Poor
All Gram-
Anaerobes
Nitroimidazoles
Metronidazole
Spectrum
Good
Gram- and Gram+ anaerobes -Bacteroides -Fusobacterium -Clostridium species Protozoa -Trichomonas -Entamoeba -Giardia
Nitroimidazoles
Metronidazole
Spectrum
Moderate
H. pylori
Nitroimidazoles
Metronidazole
Spectrum
Poor
Anything aerobic Anaerobes that reside in the mouth -Peptostreptococcus -Actinomyces -Propionibacterium
Nitrofurans (nitrofurantoin)
and Fosfomycin
Spectrum
Good
E. coli
Staphylococcus saprophyticus
Nitrofurans (nitrofurantoin)
and Fosfomycin
Spectrum
Moderate
Citrobacter Klebsiella Proteus Enterococci Pseudomonas -fosfomycin Serratia -fosfomycin
Nitrofurans (nitrofurantoin)
and Fosfomycin
Spectrum
Poor
Acinetobacter
Streptogramins
Quinupristin/Dalfopristin
Spectrum
Good
MSSA MRSA Streptococci E. faecium -including VRE strains
Streptogramins
Quinupristin/Dalfopristin
Spectrum
Poor
E. faecalis
Anything Gram-
Cyclic Lipopeptides
Daptomycin
Spectrum
Good
MSSA
MRSA
Streptococci
Cyclic Lipopeptides
Daptomycin
Spectrum
Moderate to Good
Enterococci
-including VRE
Cyclic Lipopeptides
Daptomycin
Spectrum
Poor
Anything Gram-
Folate Antagonists
Trimethoprim/Sulfamethoxazole
Spectrum
Good
S. aureus -including many MRSA strains H. influenzae Stenotrophomonas maltophilia Listeria Pneumocystis jirovecii -formerly known as P. carinii Toxoplasma gondii -pyrimethamine and sulfadiazine
Folate Antagonists
Trimethoprim/Sulfamethoxazole
Spectrum
Moderate
Enteric GNRs S. pneumoniae Salmonella Shigella Nocardia S. pyogenes
Folate Antagonists
Trimethoprim/Sulfamethoxazole
Spectrum
Poor
Pseudomonas
Enterococci
Anaerobes
Lincosamides
Clindamycin
Spectrum
Good
Many Gram+ anaerobes
Plasmodium species
-malaria
S. pyogenes
Lincosamides
Clindamycin
Spectrum
Moderate
S. aureus -including many MRSA strains Gram negative anaerobes Chlamydia trachomatis P. jirovecii Actinomyces Toxoplasma
Lincosamides
Clindamycin
Spectrum
Poor
Enterococci
C. difficile
Gram- aerobes
Polymixins
Colistin (colistimethate sodium); polymixin B
Spectrum
Good
Many GNRs including multi drug resistant:
- A. baumannii
- P. aeruginosa
- K. pneumoniae (carbapenem resistant Enterobacteriaceae)
Polymixins
Colistin (colistimethate sodium); polymixin B
Spectrum
Moderate
Stenotrophomonas maltophilia
Polymixins
Colistin (colistimethate sodium); polymixin B
Spectrum
Poor
All Gram+ organisms Anaerobes Proteus Providencia Burkholderia Serratia Gram- cocci
Fidaxomicin
Spectrum
Good
C. difficile
Fidaxomicin
Spectrum
Poor
Anything else including
- Bacteroides spp
- Enteric GNRs