Spectrums Flashcards
Imipenem
Carbapenem (P) (Needs to be paired with Cilastatin to inhibit dehydropeptidase)
G+:
- Staph (not MRSA)
- Strep (including PRSP)
- Listeria
- Enterococcus
G-:
- H. Influ
- Neisseria
- Enterobacteriaceae
- Pseudomonas
- Acinetobacter
Anaerobes:
- Most (except C diff)
SMAC are RESISTANT
Spirochete, MRSA, Atypicals, C diff
Meropenem
Carbapenem (P)
G+:
- Staph (not MRSA)
- Strep (including PRSP)
- Listeria
- Enterococcus
G-:
- H. Influ
- Neisseria
- Enterobacteriaceae
- Pseudomonas
- Acinetobacter
Anaerobes:
- Most (except C diff)
SMAC are RESISTANT
Spirochete, MRSA, Atypicals, C diff
Ertapenem
Carbapenem (P)
G+:
- Staph (not MRSA)
- Strep (including PRSP)
- Listeria
G-:
- H. Influ
- Neisseria
- Enterobacteriaceae
Anaerobes:
- Most (except C diff)
SMAC APE are RESISTANT
Spirochete, MRSA, Atypicals, C diff, Acinetobacter, Pseudomonas, Enterococcus
Aztreonam
Monobactam (P)
G- (ONLY):
- Pseudomonas
- Serratia
- Enterobacteriaceae
Alternative for AG’s in G- infections
NO GRAM POS OR ANAEROBE ACTIVITY
Vancomycin
Vancomycin (P) (ORAL FORMULATION FOR C DIFF)
Bacteriocidal: Prevent Transglycosylation and subsequent transpeptidation reaction
G+:
- MRSA
- VRSA (w/ an aminoglycoside)
- PRSP (w/ a G3 Cephalosporin)
- Enterococci (NOT VRE)
Anaerobes:
- C diff (GIVEN ORALLY FOR THIS)
Televancin
Televancin (P) (reserve for resistant gram positives)
Bacteriocidal: Like vancomycin (prevents transglycosylation) but also disrupts bacterial membane
G+:
- MRSA
- VRSA
- VRE
- PRSP
Anaerobes:
- C Diff
*
Bacitracin
Bacitracin (T) (often combined with Neomycin or Polymixin topically)
Topically for Skin and Occular (Oral for C Diff Colitis RARELY)
Block step 2 of CWS with Blocking Bactoprenol Phosphate
G+:
- Streptococcus
- Staphylococcus
- Enterococcus (INCLUDING VRE)
G-:
- Some
Anaerobes:
- ALL (INCLUDING C DIFF)
Fosfomycin
Fosfomycin (O)
Similar to Phosphoenolpyruvate structurally; ireversibly inhibits Enolpyruvate transferase- blocks synthesis of UDP MurNAc (step 1)
Used Primarily for UTIs (good distribution to bladder, kidneys, prostate and seminal vess)
- Enterobacteriaceae
- Serratia
- Proteus
- Ecoli
- Citrobacter
- Klebsiella
Tobramycin
Aminoglycoside (poorly absorbed in stomach and intestines) (more expensive then Genta)
Bactericidal: Irreversible binding to the 30S subunit to inhibit INITIATION
Reserved for serious G- infections resistant to less toxic drugs (Aminoglycosides have best action against aerobic gram - but are also often more toxic)
G+:
- MRSA (w/ Vancomycin)
- Listeria (w/ Ampicillin)
- Streptococcus
G-:
- Pseudomonas (w/ piperacillin)
- Enterobacteriaceae
- H Influenza
- Mycobacteria
INEFECTIVE AGAINST ANAEROBES and ENTEROCOCCI
Amikicin
Aminoglycoside
Reserved for organisms resistant to other AGs (more resistant to drug modifying enz)
G+:
- MRSA
- Listeria (w/ Ampicillin)
- Streptococcus
G-:
- Pseudomonas (w/ piperacillin)
- Enterobacteriaceae
- H Influenza
- Mycobacteria (MDR- TB) (better than Genta or Tobra)
INEFECTIVE AGAINST ANAEROBES and ENTEROCOCCI
Neomycin
Aminoglycoside (T) (Most Nephrotoxic so limited to Topical use w/ bacitracin and polymixin)
Used as PROPHYLAXIS FOR COLORECTAL SURGERY (HSR with long term use)
Gram + and Gram -
BUT NO ANAEROBES
Gentamicin
Aminoglycoside
G+:
- Enterococci (w/B-Lac or Vanc)
- MRSA (w/ Vancomycin)
- Listeria (w/ Ampicillin)
- Streptococcus
G-:
- Pseudomonas (+ piperacillin)
- Enterovacteriaceae
- H Influenza
- Mycobacteria:various
INEFFECTIVE AGAINST ANAEROBES
Streptomycin
Aminoglycoside
Least toxiv but also least active against G- and resistance is developed quickly
G+:
- Enterococci
G-:
- Francisella Tularensis
- Yersinia Pestis
- Brucellosis
- Mycobacterial TB
INEFFECTIVE AGAINST ANAEROBES AND PSEUDOMONAS
Tetracycline
Tetracyclines (O) (food decreases absorption)
Broad Spectrum
Bacteriostatic: reversibly binds to the a site of 3Os inhibiting ELONGATION
Absorption is decreased by Polyvalent cations
G+:
- Streptococcus (PRSP
- Staphylococcus (CA-MRSA)
- Enterococcus
- Listeria
G-:
- H. Influenza
- Neisseria Meningitides
- Enterobacteriaceae
Anaerobes:
- Most (except C. Diff)
- PROPRIONIBACTERIUM (ACNE)
Biological Warfare:
- Brucellosis
- Y Pestis
- F. Tularensis (w/ an aminoglycoside
- Bacilus anthracis
Spirochetes:
- Treponema Pallidum
- Borrelia Burgdorferi
Atypicals
- Mycoplasma Pneumonia
- Chlamydia Trachomatis
- Erlichia
Rickettsiae:
- RMSF
Mycobacteria:
- Mycobacteria (TB, M. Leprae)
PSEUDOMONAS AERUGINOSA (HAS INTRINSIC RESISTANCE)
Doxycycline
Tetracyclines (O,P) (Hepatic) (Food does NOT decrease absorption)
Broad Spectrum
Bacteriostatic: reversibly binds to the a site of 3Os inhibiting ELONGATION
Absorption is decreased by Polyvalent cations
G+:
- Streptococcus (PRSP
- Staphylococcus (CA-MRSA)
- Enterococcus
- Listeria
G-:
- H. Influenza
- Neisseria Meningitides
- Enterobacteriaceae
Anaerobes:
- Most (except C. Diff)
- PROPRIONIBACTERIUM (ACNE)
Biological Warfare:
- Brucellosis
- Y Pestis
- F. Tularensis (w/ an aminoglycoside
- Bacilus anthracis
Spirochetes:
- Treponema Pallidum
- Borrelia Burgdorferi
Atypicals
- Mycoplasma Pneumonia
- Chlamydia Trachomatis
- Erlichia
Rickettsiae:
- RMSF
Mycobacteria:
- Mycobacteria (TB, M. Leprae)
PSEUDOMONAS AERUGINOSA (HAS INTRINSIC RESISTANCE)
Minocycline
Tetracyclines (O,P) (food does NOT decrease absorption)
Broad Spectrum
Bacteriostatic: reversibly binds to the a site of 3Os inhibiting ELONGATION
Absorption is decreased by Polyvalent cations
G+:
- Streptococcus (PRSP
- Staphylococcus (CA-MRSA)
- Enterococcus
- Listeria
G-:
- H. Influenza
- Neisseria Meningitides
- Enterobacteriaceae
Anaerobes:
- Most (except C. Diff)
- PROPRIONIBACTERIUM (ACNE)
Biological Warfare:
- Brucellosis
- Y Pestis
- F. Tularensis (w/ an aminoglycoside
- Bacilus anthracis
Spirochetes:
- Treponema Pallidum
- Borrelia Burgdorferi
Atypicals
- Mycoplasma Pneumonia
- Chlamydia Trachomatis
- Erlichia
Rickettsiae:
- RMSF
Mycobacteria:
- Mycobacteria (TB, M. Leprae)
PSEUDOMONAS AERUGINOSA (HAS INTRINSIC RESISTANCE)
Tigecycline
Tetracyclines (P) (Biliary)
Broad Spectrum
Bacteriostatic: reversibly binds to the a site of 3Os inhibiting ELONGATION BUT IT BINDS WITH 5X THE AFFINITY OF TETS
Additional coverage to tetracyclines
- PRSP
- MRSA (CA+HA)
- VRSA
- VRE
SAME AS TETRACYCLINES BELOW
G+:
- Streptococcus (PRSP
- Staphylococcus (CA-MRSA)
- Enterococcus
- Listeria
G-:
- H. Influenza
- Neisseria Meningitides
- Enterobacteriaceae
Anaerobes:
- Most (except C. Diff)
- PROPRIONIBACTERIUM (ACNE)
Biological Warfare:
- Brucellosis
- Y Pestis
- F. Tularensis (w/ an aminoglycoside
- Bacilus anthracis
Spirochetes:
- Treponema Pallidum
- Borrelia Burgdorferi
Atypicals
- Mycoplasma Pneumonia
- Chlamydia Trachomatis
- Erlichia
Rickettsiae:
- RMSF
Mycobacteria:
- Mycobacteria (TB, M. Leprae)
PSEUDOMONAS AERUGINOSA (HAS INTRINSIC RESISTANCE)
Erythromycin
Macrolides (absorption dec by food) (all macrolides billiary)
Bacteriostatic: Binds 50S and blocks translocation (macro slide prevents sliding)
G+:
- Staphylococcus (NOT MRSA)
- Streptococcus (NOT PRSP)
- C diptheria
G-:
- Neisseria Meningitidis
- Bordetella Pertussis
- Campylobacter
- H. INfluenza
Atypicals:
- Chlamydia
- Mycoplasma Pneumonia
- Legionella Pneumophillia
Rickettsieae
Spirochetes:
- Treponema Pallidum
- Borrelia Burgdorferi
Anaerobes:
- PROPRIONIBACTERIUM
- All (EXCEPT C DIFF)
Azitromycin
Macrolides (absorption dec by food) (all macrolides billiary)
Bacteriostatic: Binds 50S and blocks translocation (macro slide prevents sliding)
ERythro (seen below) Plus
- Moraxella
- MAC
G+:
- Staphylococcus (NOT MRSA)
- Streptococcus (NOT PRSP)
- C diptheria
G-:
- Neisseria Meningitidis
- Bordetella Pertussis
- Campylobacter
- H. INfluenza
Atypicals:
- Chlamydia
- Mycoplasma Pneumonia
- Legionella Pneumophillia
Rickettsieae
Spirochetes:
- Treponema Pallidum
- Borrelia Burgdorferi
Anaerobes:
- PROPRIONIBACTERIUM
- All (EXCEPT C DIFF)
Clarithromycin
Macrolides (absorption IS DELAYED BY FOOD NOT DEC) (all macrolides billiary)
Bacteriostatic: Binds 50S and blocks translocation (macro slide prevents sliding)
ERythro (seen below) Plus
- Moraxella
- MAC
- H Pylori (w/ amoxicillin and omeprazole)
G+:
- Staphylococcus (NOT MRSA)
- Streptococcus (NOT PRSP)
- C diptheria
G-:
- Neisseria Meningitidis
- Bordetella Pertussis
- Campylobacter
- H. INfluenza
Atypicals:
- Chlamydia
- Mycoplasma Pneumonia
- Legionella Pneumophillia
Rickettsieae
Spirochetes:
- Treponema Pallidum
- Borrelia Burgdorferi
Anaerobes:
- PROPRIONIBACTERIUM
- All (EXCEPT C DIFF)
Clindamycin
Lincosamide (absorption not affected by food) (Unchanged when renally excreted)
Bacteriostatic: binds 50S to block Initiation complex AND block translocation step
G+:
- Streptococcus (PRSP)
- Staphylococcus (CA-MRSA)
Anaerobes:
- MOST (EXCEPT C DIFF)
NO GRAM NEGATIVE EFFECT DUE TO INEFFICIET PORIN PENETRATION
Chloramphenicol
Chloramphenicol (P) (inactivated by glucuronosyl transferase host enzyme) abosrbed well in gut (last resort drug rarely used in US)
Bacteriostatic: binds to 50S to block Petidyl transferase and prevent peptide bond formation
chloRAMPHEnicol
- Ricettsiae
- Anaerobes and Atypicals
- Meningococci
- Pneumococci
- H Influenza
- Enterobacteriaceae
Sulfamethoxazole
Sulfonamide (O) (broad spectrum) (almost always combo therapy with DHFI) (low solubitiy=Crystalluria)
Competitively inhibits Dihydropteroate Synthase as a structural anolog of PABA to block folate synthesis (needed to synth purines to incorporate into DNA
G+:
- Streptococcus
- Staphylococcus (CA-MRSA)
- Listeria
G-
- Enterobacteriaceae
- Y. Enterocolitica
- E. Coli
- Salmonella
- Shigella
- H. Influenza
- Nocardia
- Pneumocystis Carinii
Sulfisoxazole
Sulfonamide (O) (broad spectrum) (almost always combo therapy with DHFI) (Highly soluble little renal toxicity)
Competitively inhibits Dihydropteroate Synthase as a structural anolog of PABA to block folate synthesis (needed to synth purines to incorporate into DNA
(COMBO WITH ERYTHROMYCIN FOR OTITIS MEDIA IN KIDS)
G+:
- Streptococcus
- Staphylococcus (CA-MRSA)
- Listeria
G-
- Enterobacteriaceae
- Y. Enterocolitica
- E. Coli
- Salmonella
- Shigella
- H. Influenza
- Nocardia
- Pneumocystis Carinii
Sulfasalazine
Sulfonamide (O) (broad spectrum) (almost always combo therapy with DHFI) (Poorly absorbable=good for gi and IBD)
Competitively inhibits Dihydropteroate Synthase as a structural anolog of PABA to block folate synthesis (needed to synth purines to incorporate into DNA
Metabolites have further antibiotic and antiinflammatory 5ASA activity
G+:
- Streptococcus
- Staphylococcus (CA-MRSA)
- Listeria
G-
- Enterobacteriaceae
- Y. Enterocolitica
- E. Coli
- Salmonella
- Shigella
- H. Influenza
- Nocardia
- Pneumocystis Carinii
Silver Sulfadiazine
Sulfonamide (TOPICAL) (broad spectrum) (almost always combo therapy with DHFI) (low solubitiy=Crystalluria)
Competitively inhibits Dihydropteroate Synthase as a structural anolog of PABA to block folate synthesis (needed to synth purines to incorporate into DNA
Inhibits NEARLY ALL BACTERIA AND FUNGI USED IN BURN/SKIN INFECTIONS
BUT CAN LEAD TO SUPERINFECTIONS
G+:
- Streptococcus
- Staphylococcus (CA-MRSA)
- Listeria
G-
- Enterobacteriaceae
- Y. Enterocolitica
- E. Coli
- Salmonella
- Shigella
- H. Influenza
- Nocardia
- Pneumocystis Carinii
Trimethoprim
Dihydrofolate Reductase Inhibitor
Competitive inhibitor of dihydrofolate reductase much stronger for bacterial than human
Concentrates in acidic fluid like the prostate and vagina
CAN BE USED ALONE IN UTI AND PROSTATE INFECTIONS BUT USUALLY PAIRED WITH SULFONAMIDES
G+:
- Streptococcus
- Staphylococcus (CA-MRSA)
- Listeria
G-
- Enterobacteriaceae
- Y. Enterocolitica
- E. Coli
- Salmonella
- Shigella
- H. Influenza
- Nocardia
- Pneumocystis Carinii
Nalidixic Acid
Quinolone
Urinary accumulation only: so only used for UTI
Norfloxicin
G1 Fluoroquinolone (Broad Spectrum) (absorption decreases with multivalent cations)
Bactericidal: inhibits DNA topoisomerase II (DNA Gyrase) and Topo IV (seperates circular chromosomes after DNA replication decatenation-fluoros block the religation) , thus damaging DNA
Urinary accumulation only so only used for UTI
G+:
G-:
Atypicals:
Mycobacteria:
*
Ciprofloxacin
G2 Fluoroquinolone
Ofloxacin
G2 Fluoroquinolone
Levofloxacin
G3 Fluoroquinolone
Moxifloxacin
G3 Fluoroquinolone (Biliary)
Gemifloxacin
G3 Fluoroquinolone
Quinupristin-Dalfopristin
Protein Synthesis inhibitor 50S Binding (P) (Biliary)
Linezolid
23S Binding Protein Synthesis inhibitor (O,P)
Daptomycin
Lipo-Peptide (P)
Mupirocin
Mupirocin (T)
Isoniazid
TB Drug First Line CWSI (O)
Ethambutol
TB Drug First Line CWSI (O)
Rifampin
Rifamycin TB First Line Drug (O)
Rifabutin
Rifamycin TB First Line Drug (O)
Rifapentine
Rifamycin TB First Line Drug (O)
Pyrazinamide
TB First Line Drug (O)
TB Second Line Drugs
Aminoglycosides: Streptomycin, Amikacin, Kanamycin, capreomycin Fluoroquinolines: Moxi, Levo, Cipro, Gatifloxacin CWSI: Ethionamide, cycloserine Sulfonamide: PAS
Capreomycin
Aminoglycoside TB 2nd line (IM)
Ethionamide
CWSI TB 2nd line (O)
PAS
inhibits acetylation of INH
Leprosy Drugs
Sulfonamide: Dapsone (O) Clofazimine (O) Thalidomide (O)
Thalidomide
(O)
First Line TB Drugs
(O) CWSI: isoniazid, ethambutol Rifamycins: Rifampin, Rifabutin, Rifapentine Pyrazinamide
