Spectrum of Activity Flashcards
What penicillins have activity against staphlococcus aureus?
penicillinase-resistant penicillins (MSSA only); beta-lactamase inhibitor combinations (MSSA only)
Nafcillin is drug of choice
What penicillins have activity against enterococcus spp?
natural penicillins; aminopenicillins (better than natural); ureidopenicillins have some activity against;
Aminopenicillins (ampicillin) drug of choice for infections due to enterococcus spp.
What penicillins have activity against pseudomonas aeruginosa?
carboxypenicillins (1st group of penicillins with activity against); ureidopenicillins (piperacillin is drug of choice, most active against); piperacillin-tazobactam treats polymicrobial infections involving pseudomonas aeruginosa
What penicillins have activity against bacteroides fragilis?
ureidopenicillins have some activity against; beta-lactamase inhibitor combinations have enhanced activity against beta-lactamase producing strains of Bacteroides fragilis and B. fragilis group (DOT) organisms
What cephalosporins have activity against staphylococcus aureus?
1st generation cephalosporins (MSSA); 2nd generation cephalosporins have less activity against MSSA; 3rd and 4th generation cephalosporins has even less activity against MSSA; Ceftaroline (only beta-lactam to cover MRSA)
What cephalosporins have activity against pseudomonas aeruginosa?
3rd generation cephalosporins (ONLY ceftazidime and cefoperazone); 4th generation cephalosporins; ceftolozane-tazobactam; ceftazidime-avibactam
What cephalosporins have activity against resistant gram-negative bacteria (ESBL, AmpC, KPC)
cefiderocol; ceftolozane-tazobactam; ceftazidime-avibactam
What cephalosporins have activity against anaerobes (bacteroides fragilis, etc.)?
cephamycins (Bacteroides spp.); 2nd generation cephalosporins (only cefoxitin, cefotetan, and cefmetazole) are active against Bacteroides fragilis
3rd generation cephalosporins were the 1st set of drugs with activity against what?
activity against penicillin-resistant streptococcus pneumoniae (PRSP) – ceftriaxone and cefotaxime; ceftaroline also has activity against PRSP
What carbapenems/aztreonam have activity against staphylococcus aureus?
imipenem and doripenem exhibit best activity against MSSA; NO activity against MRSA
What carbapenems/aztreonam have activity against pseudomonas aeruginosa?
all carbapenems EXCEPT ertapenem; aztreonam
What carbapenems/aztreonam have activity against resistant gram-negative bacteria (ESBL, AmpC, KPC)?
carbapenems are the DRUG of CHOICE for ESBL and AmpC-producing bacteria (doripenem and meropenem are best); meropenem-vaborbactam and imipenem-relebactam have activity against KPC-producing entrerobacterales
What carbapenems/aztreonam have activity against bacteroides spp?
all carbapenems display excellent activity against
What FQs have activity against staphylococcus aureus?
all for MSSA; ONLY delafloxacin for MRSA
What FQs have activity against streptococcus pneumoniae?
levofloxacin, moxifloxacin, delafloxacin including PRSP (NOT ciprofloxacin)
What FQs have activity against pseudomonas aeruginosa?
ciprofloxacin >/= levofloxacin > delafloxacin, NOT moxifloxacin or Gemifloxacin
Only oral agents available to potentially treat pseudomonas infections
What FQs have activity against atypical bacteria?
all extremely active against Legionella, Chlamydia, Mycoplasma, and Ureaplasma
What FQs have activity against anaerobes?
moxifloxacin has some activity; trovafloxacin had activity against Bacteroides fragilis (now removed from market)
What macrolides have activity against atypical bacteria?
Narrow spectrum of activity: streptococcus pneumoniae (PSSP); methicillin-susceptible S. aureus (MSSA)
use macrolides to cover our atypical bacteria; Legionella pneumophila; Mycobacterium avium complex (azithromycin and clarithromycin)
What vancomycin/GP agents have activity against S. aureus?
vancomycin (both MSSA and MRSA – DRUG of CHOICE for MRSA); quinupristin-dalfopristin (both MSSA and MRSA); oxazolidinones (MS, MR, VI, VR); daptomycin (MS, MR, VI, VR, LR); lipoglycopeptides (MS, MR, VI; oritavancin also display activity against VRSA)
What vancomycin/GP agents have activity against penicillins resistant S. pneumoniae (PRSP)?
vancomycin; quinupristin-dalfopristin; oxazolidinones; daptomycin
What vancomycin/GP agents have activity against vancomycin-resistant enterococcus (VRE)?
vancomycin (enterococcus faecalis AND faecium); quinupristin-dalfopristin (enterococcus faecium ONLY, including VRE); oxazolidinones (enterococcus faecium AND faecalis including VRE); daptomycin (enterococcus faecium AND faecalis including VRE); lipoglycopeptides (enterococcus faecium AND faecalis, some strains of VRE display resistance to telavancin and dalbavancin)
What vancomycin/GP agents have activity against C. difficile?
vancomycin (DRUG of CHOICE)
What aminoglycosides have activity against staphylococcus aureus?
all, but ALWAYS used in low doses with cell-wall active agents to provide synergy, primarily gentamicin
Use with beta-lactams or vancomycin
What aminoglycosides have activity against enterococcus spp?
all, but ALWAYS used in low doses with cell-wall active agents to provide synergy, primarily gentamicin
Use with ampicillin, penicillin, or vancomycin
What aminoglycosides have activity against pseudomonas aeruginosa?
gentamicin, tobramycin, amikacin, plazomicin NOT streptomycin; often used with cell-wall active agents to provide synergy, higher doses are used
Use with beta-lactams
What aminoglycosides have activity against MDR gram-negative aerobes?
Plazomicin has activity against ESB, AmpC, and KPC producing bacteria
What aminoglycosides have activity against tuberculosis?
streptomycin
What miscellaneous drugs have activity against S. aureus?
minocycline, doxycycline (MSSA only); tetracycline analogs (MSSA and MRSA); Bactrim (MRSA, especially CA-MRSA); clindamycin (MSSA and CA-MSSA)
What miscellaneous drugs have activity against P. aeruginosa?
polymyxins
What miscellaneous drugs have activity against MDR GNR?
Eravacycline has some activity against ESBL, AmpC, and KPC producing bacteria; polymyxins active against Acinetobacter spp.
What miscellaneous drugs have activity against atypical bacteria?
tetracyclines (Legionella pneumophila, Chlamydophila pneumoniae, psittaci; eravacycline and omadacycline; Bactrim is DRUG of CHOICE for pneumocystis carinii/jirovecii
What miscellaneous drugs have activity against C. difficile?
metronidazole
What miscellaneous drugs have activity against bacteroides spp?
tetracycline analogs; clindamycin; metronidazole (Bacteroides fragilis, B. fragilis group DOT organisms)
Which drugs should NOT be used in pregnancy?
fluoroquinolones, telavancin, tetracyclines and tetracycline analogs, sulfamethoxazole-trimethoprim, metronidazole
What are the drugs that interact with warfarin?
clarithromycin, erythromycin, fluoroquinolones, sulfamethoxazole-trimethoprim, metronidazole
What drugs cause QTc prolongation?
fluoroquinolones, macrolides, telavancin
