Spectrum Flashcards by Piotr J

Natural Penicillins
Penicillin G, V
Spectrum
Good

Treponema pallidum 
most Streptococci (including S. pneumoniae)

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Natural Penicillins
Penicillin G, V
Spectrum
Moderate

Enterococci

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Natural Penicillins
Penicillin G, V
Spectrum
Poor

Almost everything else

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Antistaphylococcal Penicillins
Spectrum
Good

MSSA

Streptococci

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Antistaphylococcal Penicillins Spectrum

Poor

GNRs
Enterococci
Anaerobes
MRSA

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Aminopenicillins
Amoxicillin, Ampicillin
Spectrum
Good

Streptococci

Enterococci

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Aminopenicillins
Amoxicillin, Ampicillin
Spectrum
Moderate

enteric GNRs

Haemophilus

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Aminopenicillins
Amoxicillin, Ampicillin
Spectrum
Poor

Staphylococci
Anaerobes
Pseudomonas

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Antipseudomonal Penicillins
Spectrum
Good

P. aeruginosa
Streptococci
Enterococci

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Antipseudomonal Penicillins
Spectrum
Moderate

enteric GNRs

Haemophilus

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Antipseudomonal Penicillins
Spectrum
Poor

Staphylococci

Anaerobes

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Penicillin/BL-inhibitor Combos
Spectrum
Good

MSSA
Streptococci 
Enterococci 
many Anaerobes
enteric GNRs
P. aeruginosa 
-only piperacillin/tazobactam

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Penicillin/BL-inhibitor Combos
Spectrum
Moderate

GNRs with advanced betalactamases

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Penicillin/BL-inhibitor Combos
Spectrum
Poor

MRSA

ESBL-producing GNRs

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1G Cephalosporins
Spectrum
Good

MSSA

Streptococci

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1G Cephalosporins
Spectrum
Moderate

some enteric GNRs

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1G Cephalosporins
Spectrum
Poor

Enterococci
Anaerobes
MRSA
Pseudomonas

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2G Cephalosporins
Spectrum
Good

some enteric GNRs
H. influenzae
N. gonorrhoeae

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2G Cephalosporins
Spectrum
Moderate

Streptococci
Staphylococci
Anaerobes
-only cefmetazole, cefotetan, cefoxitin

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2G Cephalosporins
Spectrum
Poor

Enterococci
MRSA
Pseudomonas

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3G Cephalosporins
Spectrum
Good

Streptococci 
-except ceftazidime (poor)
Enteric GNRs
Pseudomonas 
-only ceftazidime

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3G Cephalosporins
Spectrum
Moderate

MSSA

-except ceftazidime (poor)

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3G Cephalosporins
Spectrum
Poor

Enterococci 
Anaerobes 
MRSA
Pseudomonas 
-except ceftazidime

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4G Cephalosporins
Cefepime
Spectrum
Good

MSSA
Streptococci
Pseudomonas
Enteric GNRs

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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