Spectrum of Activity Flashcards
Narrow Spectrum PCN (Natural PCNs) - Gram (+)
Streptococcus (Group A and B; pneumoniae); Enterococcus (limited)
Narrow Spectrum PCN (Natural PCNs) - Gram (-)
Neisseria meningitidis (PCN G)
Narrow Spectrum PCN (Natural PCNs) - Anaerobes
Peptostreptococcus, Clostridium (not difficile)
Narrow Spectrum PCN (Natural PCNs) - Other
Treponema pallidum, Listeria (PCN G)
Penicillinase-Resistant PCN (Anti-Staph PCNs) - Gram (+)
MSSA, Streptococcus (group A and B; pneumoniae), MSSE (only about 50% of Staph epi is MSSE)
Penicillinase-Resistant PCN (Anti-Staph PCNs) - Gram (-)
None
Penicillinase-Resistant PCN (Anti-Staph PCNs) - Anaerobes
Peptostreptococcus
Amino-PCNs - Gram (+)
Streptococcus (Group A and B; pneumoniae); Enterococcus (with aminoglycoside)
Amino-PCN - Gram (-)
H. flu (+/-), Neisseria, Proteus
Amino-PCN - Anaerobes
Peptostreptococcus; Clostridium (not difficile)
Amino-PCN - Other
Listeria; H. pylori
Amino-PCN + Beta-Lactamase Inhibitor - Gram (+)
Staph; Strep; Enterococcus (w/ aminoglycoside)
Amino-PCN + Beta-Lactamase Inhibitor - Gram (-)
H. flu; Neisseria; M. cat; E. coli; Klebsiella; Proteus
Amino-PCN + Beta-Lactamase Inhibitor - Anaerobes
Peptostreptococcus; Clostridium (not difficile); B. fragilis
Anti-Pseudomonal PCN - Gram (+)
Staph; Strep (weaker than Amino-PCN); Enterococcus (Limited)
Anti-Pseudomonal PCN - Gram (-)
H. flu; Neisseria, M. cat; E. coli; Klebsiella; Proteus (many can produce B-Lactamase); Pseudomonas
Anti-Pseudomonal PCN - Anaerobes
Peptostreptococcus; Clostridium (not difficile)
Anti-Pseudomonal PCN + B-Lactamase Inh - Gram (+)
Staph; Strep; Enterococcus (limited)
Anti-Pseudomonal PCN + B-Lactamase Inh - Gram (-)
H. flu; Neisseria; M. cat; E. coli; Klebsiella; Proteus; Serratia; Enterobacter; Pseudomonas
Anti-Pseudomonal PCN + B-Lactamase Inh - Anaerobes
Peptostreptococcus; Clostridium (not difficile); B. fragilis
1st Gen Cephalosporin - Gram (+)
Staph (good activity vs MSSA + some activity vs MSSE); Strep (except pneumoniae). Best Gram (+) Cephalosporin.
1st Gen Cephalosporin - Gram (-)
E. coli; Klebsiella, Proteus Worst Gram (-) Cephalosporin
1st Gen Cephalosporin - Anaerobes
No activity vs Anaerobic bacteria
2nd Gen Cephalosporin - Gram (+)
Staph; Strep (weaker than 1st Gen)
2nd Gen Cephalosporin - Gram (-)
H. flu; Neisseria; M. cat; E. coli; Klebsiella; Proteus
2nd Gen Cephalosporin - Anaerobes
B. fragilis; Clostridium (not difficile); Peptostreptococcus
Cefoxitin better than Cefotetan (primarily)
3rd/4th Gen Cephalosporin - Gram (+)
Staph; Strep (weaker than 1st/2nd gen) - PO agents weaker than Ceftriaxone/Cefotaxime
MRSA - Ceftaroline only
3rd/4th Gen Cephalosporin - Gram (-)
H. flu; Neisseria; M. cat; E. coli; Klebsiella; Proteus; Serratia; Enterobacter (good activity)
Pseudomonas - ceftazidime, cefepime only
Best Cephalosporin against Gram (-)
Carbapenem - Gram (+)
Staph, Strep
Broad spectrum ICU coverage
Little/No coverage of MRSA, DRSP, VRE, Enterococcus, “atypical” pneumonia pathogens
Ertapenem - has no MRSA or Enterococcus coverage
Carbapenem - Gram (-)
Good activity including Pseudomonas
Broad spectrum ICU coverage
Ertapenem - has no pseudomonas coverage.
Carbapenem - Anaerobes
Good activity except C. difficile
Broad spectrum ICU coverage
Vancomycin - Gram (+)
Very active against Gram (+) organisms - Staph; MRSA and MRSE - DOC for both; Strep (including all strains of Strep pneumoniae); Enterococcus (w/ aminoglycoside)
Vancomycin - Gram (-)
no coverage
Monobactam - Gram (+)
no coverage
Monobactam - Gram (-)
Gram (-) specialist. Good activity against Gram (-) anaerobes including Pseudomonas
Oxazolidinone - Linezolid
Staph; Strep; Enterococcus; MRSA; MRSE; VRE; DRSP
Oxazolidinone - Tidizolid
MRSA; Streptococcus; E. faecalis
Streptogramin
Staph; Strep; Enterococcus (faecium only); MRSA; MRSE; DRSP; VRE (faecium only)
Cyclic Lipopeptide
Gram (+) specialist - MRSA, VSE, some strains of VRE
Lipoglycopeptide - Telavancin
Gram (+) bacteria including MRSA
Lipoglycopeptide - Dalbavancin
MRSA and Streptococcus species
Lipoglycopeptide - Oritavancin
MRSA; Streptococcus species and VRE (faecalis)
Glycylcycline
MRSA and VRE
2nd Gen Fluoroquinolone - Cipro - Exc/Good coverage
E. coli; Klebsiella; Proteus; Enterobacter; Serratia
2nd Gen Fluoroquinolone - Cipro Good coverage
H. flu; Neisseria; M. cat; Pseudomonas
Best Pseudomonas activity of Fluoroquinolones.
2nd Gen Fluoroquinolone - Cipro Mod/Poor coverage
Staph; Strep; Enterococcus
Poor coverage for S. pneumoniae
2nd Gen Fluoroquinolone - no coverage
B. fragilis
3rd Gen Fluoroquinolone - Levofloxacin - Exc/Good coverage
E. coli; Klebsiella; Proteus; Enterobacter; Serratia
3rd Gen Fluoroquinolone - Levofloxacin - Good coverage
H. flu; Neisseria; M. cat
3rd Gen Fluoroquinolone - Levofloxacin - Good/Mod/Poor Coverage
Staph; Strep
3rd Gen Fluoroquinolone - Levofloxacin - Mod/Poor coverage
Enterococcus; Pseudomonas
3rd Gen Fluoroquinolone - Levofloxacin - no coverage
B. fragilis
4th Gen Fluoroquinolone - Moxifloxacin - Exc/Good coverage
Enterobacter; Serratia
4th Gen Fluoroquinolone - Moxifloxacin - Good coverage
Staph; Strep; H. flu; Neisseria; M. cat; E. coli; Klebsiella; Proteus; B. fragilis
Best Respiratory Fluoroquinolone (Gram (+))
4th Gen Fluoroquinolone - Moxifloxacin - Good/Mod/Poor
Enterococcus
4th Gen Fluoroquinolone - Moxifloxacin - Mod/Poor coverage
Pseudomonas
Fluoroquinolone - Other coverage
Chlamydia; Legionella; Mycoplasma; Mycobacterium TB and Avium (alt); H. pylori (in combo with Metronidazole, Amoxicillin, Tetracycline + Bismuth)
Trimethoprim-Sulfamethoxazole Gram (+)
Strep Pneumoniae (50% resistant); Staph (MSSA, MRSA, CA-MRSA)
Trimethoprim-Sulfamethoxazole Gram (-)
H. flu; M. cat; E. coli; Klebsiella; Serratia (variably susceptible for all of these)
Trimethoprim-Sulfamethoxazole - Other
GI pathogens - Enterotoxigenic E. coli; Salmonella; Shigella; Vibrio cholerae; Yersinia enterocolitica
Listeria; Nocardia; Mycobacterium marinum
Pneumocystis (carinii) jiroveci
Aminoglycosides - Gram (+)
None
Aminoglycosides - Gram (-)
Good activity against all Gram (-) anaerobes including Pseudomonas.
Tobramycin is the best Aminoglycoside at Pseudomonas
Gentamicin is the best Aminoglycoside at Serratia
Tetracyclines Gram (+)
Strep (avoid for highly resistant S. pneumoniae); Staph.
Broad spectrum bacteriostatic drugs- inhibit the growth of many Gram (+) and Gram (-) organisms and Rickettsiae, Spirochetes, Mycoplasmas and Chlamydiae
Tetracyclines Gram (-)
H. flu; Neisseria; M. cat; E. coli; +/- Klebsiella
Broad spectrum bacteriostatic drugs- inhibit the growth of many Gram (+) and Gram (-) organisms and Rickettsiae, Spirochetes, Mycoplasmas and Chlamydiae
Tetracyclines Anaerobes
+/- B. fragilis; Clostridium (not difficile)
Broad spectrum bacteriostatic drugs- inhibit the growth of many Gram (+) and Gram (-) organisms and Rickettsiae, Spirochetes, Mycoplasmas and Chlamydiae
Tetracyclines - Other
Listeria; Mycoplasma; Chlamydia; Rickettsia; Borrelia burgdorferi
Broad spectrum bacteriostatic drugs- inhibit the growth of many Gram (+) and Gram (-) organisms and Rickettsiae, Spirochetes, Mycoplasmas and Chlamydiae
Macrolides - Erythromycin - Gram (+)
Staph (mod to poor); Strep (group A - good (alt if PCN allergic) - S. pneumoniae - good (alt to PCN)
Same as Clarithromycin.
Macrolides - Erythromycin - Gram (-)
+/- H. flu; +/- Neisseria; + M. cat
Macrolides - Erythromycin - Anaerobes
Clostridium (not difficile)
Macrolides - Erythromycin - Other
Good coverage. Mycoplasma pneumoniae; Legionella pneumophila; Chlamydia species (atypical RTI pathogens)
Bordetella pertussis; Treponema pallidum; Ureaplasma urealyticum; Campylobacter jejuni; some Rickettsia
Macrolides - Clarithromycin - Gram (+)
Staph (mod to poor); Strep (group A - good (alt if PCN allergic) - S. pneumoniae - good (alt to PCN).
Same as Erythromycin.
Macrolides - Clarithromycin - Gram (-)
H. flu (better than Erythromycin but still moderate); +/- Neisseria; + M. cat.
Macrolides - Clarithromycin - Anaerobes
Clostridium (not difficile)
Macrolides - Clarithromycin - Other
Good coverage. Mycoplasma pneumoniae; Legionella pneumophila; Chlamydia species (atypical RTI pathogens)
Bordetella pertussis; Treponema pallidum; Ureaplasma urealyticum; Campylobacter jejuni; some Rickettsia.
Same as Erythromycin but add - Mycobacterium avium intracellulare complex; Toxoplasma gondii; Borrelia burgdorferi (deer tick); Babesia microti (Ixodes tick)
Macrolides - Azithromycin - Gram (+)
Staph; Strep (same as Erythromycin and Clarithromycin)
S. pyogenes resistance has emerged in other countries with high usage. Pen-R S. pneumoniae also may be resistant to macrolides
Macrolides - Azithromycin - Gram (-)
H. flu (improved activity vs Erythromycin and Clarithromycin but recently reported bacteriologic failures up to 71%); Neisseria; M. cat
Macrolides - Azithromycin - Anaerobes
Peptostreptococcus; Clostridium (not difficile)
Macrolides - Azithromycin - Other
Mycoplasma pneumoniae and Chlamydia - good coverage.
STIs - Chlamydia trachomatis; Ureaplasma urealyticum; N. gonorrhoeae; Treponema pallidum
Clindamycin - Gram (+)
Staph; Strep including Pen-R S. pneumoniae
Clindamycin - Gram (-)
none
Clindamycin - Anaerobes
B. fragilis (Clindamycin or Metronidazole is DOC); Other Bacteroides; Clostridia; Peptostreptococcus; Propionibacterium acnes; Fusobacterium
Clindamycin - Other
Parasites- Gardnerella, Toxoplasmosis. PCP.
Metronidazole - Gram (+)
none
Metronidazole - Gram (-)
none
Metronidazole - Anaerobes
Gram (-) anaerobes - bacteroides and some Gram (+) anaerobes - Clostridium
Metronidazole - Other
Various protozoa - Trichomonas, Giardia, Entamoeba
H. pylori - often combined with Tetracycline, Amoxicillin and Bismuth.