Study Guide - Bacterial Coverage Flashcards
Focused Gram Positive Coverage
1st generation cephalosporins
Antistaphylococcal penicillins
clindamycin
vancomycin
Focused Gram Negative Coverage
3rd generation cephalosporins
aminoglycosides
aztreonam
quinolones
Excellent Anaerobic Coverage
2nd generation cephalosporins B-lactamase inhibitor combos carbapenems clindamycin metronidazole tigecycline
Broad Spectrum Therapy
B-lactamase inhibitor combos
carbapenems
tigecycline
cefipime (no anaerobic coverage)
Atypical Pathogens
macrolides
quinolones
tetracyclines
Pseudomonal Coverage
aminoglycosides
antipseudomonal penicillins
aztreonam
cefipime –4th generation cephalosporins
ceftazidime (Fortaz) –3rd generation cephalosporins
ciprofloxacin
MRSA - inpatient therapy
*vancomycin
linezolid (Zyvox)
MRSA - community acquired
Bactrim clindamycin minocycline or doxycycline linezolid (Zyvox) rifampin
Treat Clostridium difficile Diarrhea
metronidazole (mild to moderate) oral vancomycin (severe or resistant)
Genital Herpes
acyclovir, valacyclovir, or famciclovir
Systemic Fungal Infections
amphoteracin B & others
fluconazole & other “azoles”
Urinary Tract Infections
Bactrim
quinolones
nitrofurantoin
Prostate Infections
Bactrim
quinolones
Chlamydia trachomatis
doxycycline x 7 days
azithromycin x 1 dose
Pelvic Inflammatory Disease
cefotetan or cefoxitin + doxycycline
clindamycin + gentamicin + doxycycline
ceftriaxone + doxycycline ± metronidazole
Bacterial Vaginosis
metronidazole
clindamycin
Gonorrhea
**ceftriaxone (Rocephin) IM x 1
azithromycin if severe cephalosporin allergy
PLUS chlamydial coverage
Acne
tetracyclines
topical clindamycin
topical macrolides
Group A Strep Throat (strep pyogenes)
benzathine PCN G IM x 1 or oral PCN x 10 days
amoxicillin
macrolides if allergic to PCN
Acute Sinusitis
**amoxicillin x 10 – 14 days
*Bactrim
2nd gen cephalosporins (cefuroxime, cefaclor)
3rd gen cephalosporins (cefpodoxime, cefixime)
doxycycline
macrolides
moxifloxacin
levofloxacin
Otitis Media
**amoxicillin x 10 days
erythromycin / sulfisoxazole
macrolides
2nd gen cephalosporins (cefuroxime, cefaclor)
3rd gen cephalosporins (cefpodoxime, cefixime)
Community Acquired Pneumonia (outpatient)
doxycycline
macrolides
quinolones (levofloxacin, moxifloxacin)
Community Acquired Pneumonia (inpatient)
add ceftriaxone or cefotaxime to CAP therapy
Aspiration Pneumonia
add clindamycin to CAP therapy
add metronidazole to CAP therapy
amoxicillin / clavulanate
if very ill…
carbapenems
piperacillin/tazobactam
ticarcillin/clavulanateHospital Acquired Pneumonia
ceftriaxone
levofloxacin
moxifloxacin
Hospital Acquired Pneumonia
multi-drug resistant
piperacillin/tazobactam
cefepime
carbapenem
\+ gentamicin
\+ vancomycin if suspect MRSABacterial Meningitis (newborn - 1 month)
ampicillin + gentamicin
ampicillin + cefotaxime
ampicillin + ceftriaxone
Bacterial Meningitis (1 month - 60 years old)
cefotaxime ± vancomycin
ceftriaxone ± vancomycin
Bacterial Meningitis (>60 years old)
ampicillin + cefotaxime ± vancomycin
ampicillin + ceftriaxone ± vancomycin
Surgical Prophylaxis
most procedures: cefazolin
abdominal procedures: cefotetan or cefoxitin
Infective Endocarditis (cultures pending)
vancomycin + ceftriaxone ± gentamicin
Intra-Abdominal Infections
cefotetan
ampicillin/sulbactam
clindamycin (…won’t cover gm negatives)
carbapenems
ticarcillin/clavulanate
metronidazole
above ± gentamicin or quinolone
