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123 Cards in this Set
- Front
- Back
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Antibiotics that don't need renal adjustments
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Anti-Staph PCNs:
- Nafcillin - Oxacillin - Dicloxacillin 2nd Gen Cephalosporins: - Cefoxitin - Cefotetan 3d Gen Cephalosporin: - Ceftriaxone FQ: - Moxifloxacin Linezolid Doxycycline Metronidazole Clindamycin Quinupristin/Dalfopristin *Linda quickly nods at her cousins for trying to mow down the line at the docks for the metro |
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Anti-Enterococci Antibiotics
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Amoxicillin
Piperacillin Ticarcillin Pip/Tazo Tic/Clav Amox/Clav Vancomycin Daptomycin Linezolid Quinupristin/Dalfopristin Tigecycline *1,3,4,5 PCN; VANC; VRE |
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Febrile Neutropenia Antibiotics
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Cefepime
Imipenem Doripenem Meropenem B-Lactam + Aminoglycoside Ceftazidime |
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Anti-VRE Antibiotics
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Daptomycin
Quinupristin/Dalfopristin (faecium) Tigecycline Linezolid *Tiger adapted to quick lines |
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Anti-MRSA Antibiotics
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Ceftaroline
Gentamycin Tobramycin Amikacin Telavancin Vancomycin Daptomycin Linezolid Quinupristin/Dalfopristin Clindamycin TMP/SMX Tigecycline *Caroline and Linda went back to the Ag Center to televise VRE |
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Anti-Atypicals Antibiotics
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FQs:
- Ciprofloxacin - Levofloxacin - Moxifloxacin - Gemifloxacin Macrolides/Ketolides: - Clarithromycin - Azithromycin - Telithromycin - Erythromycin TCNs: - Tetracycline - Doxycycline - Minocycline - Tigecycline *Macro Floor Tetris is atypical |
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Anti-pseudomonal Antibiotics
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Piperacillin
Pip/Taz Ticarcillin Tic/Clav Ceftazidime Cefepime Imipenem Meropenem Doripenem Aztreonam Ciprofloxacin Levofloxacin Gentamicin Tobramycin Amikacin Colistimethate *Pip/tic taz Pime Penem Az FQ AG Coli |
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Anti-anaerobe Antibiotics
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Amox/Clav
Amp/Sulb Pip/Taz Tic/Clav Imipenem Meropenem Doripenem Ertapenem Metronidazole Clindamycin Cefoxitin Cefotetan Moxifloxacin *Billy Penem uses the metro to see cousin Linda. |
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Tick-borne disease Antibiotics
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Rickettsia - Doxycycline
Lyme - Ceftriaxone |
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Necrotizing fasciitis Antibiotics
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B-Lactam + Clindamycin
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DOC: Susceptible Enterococci
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Ampicillin + Gentimicin
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DOC: Syphilis
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Benzathine PCN G
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Meningitis: Drug and dose
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Ceftriaxone: 2g IV q12h
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Pseudomonas: Drugs and doses
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Ciprofloxacin: 400mg IV q8h
750mg po q12h Levofloxacin: 750mg IV/po q24h |
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Empiric Therapy: Nosocomial Infections
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Piperacillin/Tazobactam
Ticarcillin/Clavulanate Cefepime Imipenem Doripenem Meropenem |
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DOC/Empiric Treatment:
MRSA |
Vancomycin
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DOC: Right-sided endocarditis
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Daptomycin
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DOC: C.diff
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Vancomycin (PO)
Metronidazole |
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DOC: H. pylori
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Clarithromycin + Lansoprazole + Amoxicillin
Metronidazole |
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Empiric Therapy: Non-severe infections of skin and oral cavitiy
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Clindamycin
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AE: B-Lactams
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GI - diarrhea
Rash Antistaph PCNs: Interstitial nephritis |
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AE: 2nd Gen Cephalosporins:
- Cefuroxime - Cefoxitin - Cefotetan - Cefprozil - Cefaclor |
GI
Rash Cefotetan: Inhibits VitK Disulfuram Rxn |
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AE: Cephalosporins
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GI
Rash 2nd Gen: Disulfuram Rxn 3rd Gen: C. Diff Diarrhea |
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AE: 3rd Gen Cephalosporins
- Ceftriaxone - Cefotaxime - Ceftazidime - Cefdinir |
GI
Rash C.dif Diarrhea |
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AE: Aztreonam
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GI
Rash Low incidence of hypersensitivity Safe to administer w/ PCN allergy unless patient is allergic to ceftazidime |
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AE: Fluoroquinolones
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Chelate Cations
Photosensitivity GI Headache Hyper/hypoglycemia Seizures Prolong QT Tendon Rupture C/I: Pregnancy, Children |
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AE: Macrolides/Ketolides
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GI - worst w/ Erythromycin
Hepatic - esp. Telithromycin Prolong QT CYP450 Inhibitors (except azithromycin) |
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AE: Aminoglycosides
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Dose Related:
- Nephrotoxicity (high troughs) - Ototoxicity (high peaks) Neuromuscular blockade w/ high doses or w/ paralytic agents |
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AE: Telavacin
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Renal toxicity
Taste disturbances Foamy urine Red Man Syndrome QT Prolongation C/I: Pregnancy |
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AE: Vancomycin
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Red Man Syndrome
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AE: Daptomycin
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Muscle pain, weakness
Rhabdomyolysis Check CK levels weekly (esp. w/ statin) *Cannot be used to treat pneumonia |
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AE: Oxazolidinones (Linezolid)
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Bone marrow suppression (esp. thrombocytopenia) w/ tx > 2wks
Peripheral neuropathy due to mitochondrial damage Serotonin Syndrome w/ SSRIs |
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AE: Quinupristin/Dalfopristin
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Phlebitis
Myalgias Arthralgias Inhibits CYP450 *Must be mixed w/ D5W only |
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AE: TCNs
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GI
Photosensitivity Esophageal Irritation Discoloration of teeth Chelates cations C/I: pregnancy, children < 8yo |
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AE: Metronidazole
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N/V/D
Metallic Taste Hepatitis Pancreatitis Peripheral neuropathy Disulfuram Rxn *Warfarin interaction |
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AE: Carbapenems
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GI
Rash Higher risk of seizures (esp. w/ Imipenem) |
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AE: Clindamycin
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Diarrhea
C.diff Disease |
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AE: Nitrofurantoin
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N/V
Acute pneumonitis Chronic pulmonary fibrosis Peripheral neuropathy C/I: CrCl < 50mL/min |
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AE: TMP/SMX
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Rash
Toxic epidermal necrolysis Stevens-Johnson Bone marrow suppression Renal failure Crystalluria Hyperkalemia *Interacts with Warfarin |
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AE: Colistimethate
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Nephrotoxicity
Ototoxicity *Renal function must be checked daily |
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List: Natural PCNs
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PCN G (IV)
PCN VK (PO) Procaine PCN (IM) Benzathine PCN (IM) |
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List: Anti-staph PCNs
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Naficillin (IV)
Oxacillin (IV) Dicloxacillin (PO) |
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List: Amino-PCNs
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Amoxicillin (PO)
Ampicillin (PO, IV) |
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List: Anti-pseudomonal PCNs
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Piperacillin (IV)
Ticarcillin (IV) |
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List: B-Lactam/B-Lactamase Inhibitors
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Amox/Clav (PO)
Amp/Sulbac (IV) Pip/Tazo (IV) Tic/Clav (IV) |
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List: 1st Gen Cephalosporins
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Cephalexin (PO)
Cefazolin (IV) Cefadroxil (PO) |
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List: 2nd Gen Cephalosporins
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Cefuroxime (PO, IV)
Cefoxitin (IV) Cefotetan (IV) Cefprozil (PO) Cefaclor (PO) |
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List: 3rd Gen Cephalosporins
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Ceftriaxone (IV)
Cefotaxime (IV) Ceftazidime (IV) Cefdinir (PO) |
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List: 4th Gen Cephalosporin
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Cefepime (IV)
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List: 5th Gen Cephalosporin
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Ceftaroline (IV)
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List: Carbapenems
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Imipenem/Cilostatin
Meropenem Doripenem Ertapenem |
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List: Monobactam
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Aztreonam
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List: Fluoroquinolones
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Ciprofloxacin
Levofloxacin Moxifloxacin Gemifloxacin |
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List: Macrolides & Ketolides
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Erythromycin
Clarithromycin Azithromycin Telithromycin (ketolide) |
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List: Aminoglycosides
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Gentamicin
Tobramycin Amikacin |
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List: Glycopeptides
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Vancomycin
Telavancin |
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List: Cyclic Lipopeptide
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Daptomycin (IV)
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List: Oxazolidinone
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Linezolid (IV, PO)
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List: Streptogramin
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Quinupristin/Dalfopristin (IV)
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List: TCNs & Glycylcyclines
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Tetracycline
Doxycycline Minocycline Tigecycline |
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List: Nitromidazole
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Metronidazole
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List: Lincosamide
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Clindamycin
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List: Nitrofuran
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Nitrofurantoin
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Organisms that cause:
CNS < 1month old |
Group B Strep (S. agalactiae)
E. coli Listeria monocytogenes Klebsiella spp. |
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Organisms that cause:
CNS 1-23 months old |
S. pneumoniae
N. meningitides S. agalactiae H. influenzae (rare) E. coli |
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Organisms that cause:
CNS 2-50 yo |
S. pneumoniae
N. meningitides |
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Organisms that cause:
CNS > 50 yo |
S. pneumoniae
N. meningitides L. monocytogenes Aerobic GNRs |
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Organisms that cause:
CNS post-neurosurgery |
GNRs (including P. aeruginosa)
S. aureus Coagulase-negative Staph (esp. S. epidermidis) |
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Organisms that cause:
Pharyngitis |
Virus
Group A Strep (S. pyogenes) S. viridans |
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Organisms that cause:
Bronchitis, otitis, epiglottitis, acute sinusitis |
Virus
H. influenzae S. pneumoniae M. catarrhalis |
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Organisms that cause:
Chronic sinusitis |
Virus
H. influenzae S. pneumoniae M. catarrhalis Anaerobes S. aureus |
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Organisms that cause:
CAP - Normal host |
S. pneumoniae
H. influenzae M. catarrhalis Virus Atypicals |
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Organisms that cause:
CAP - Aspiration |
S. pneumoniae
H. influenzae M. catarrhalis Virus Atypicals Anaerobic mouth flora |
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Organisms that cause:
HAP - General |
S. aureus (MRSA > MSSA)
GNRs (including MDR Klebsiella spp., Pseudomonas spp., Acinetobacter spp.) Mouth anaerobes |
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Organisms that cause:
HAP - Aspiration |
S. aureus
GNRs Mouth anaerobes |
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Organisms that cause:
HAP - Neutropenic |
S. aureus
GNRs Fungi |
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Organisms that cause:
HAP - HIV host |
Pneumocystis
Fungi GNRs Legionella Nocardia |
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Organisms that cause:
Endocarditis - pre-existing valvular disease |
Viridans group streptococci
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Organisms that cause:
Endocarditis - IV drug abuser |
S. aureus
GNRs Enterococci Fungi |
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Organisms that cause:
Endocarditis - Prosthetic valve |
S. aureus
S. epidermidis |
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Organisms that cause:
Intra-abdominal infections |
Bacteroides fragilis
E. coli GNRs Enterococci |
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Organisms that cause:
Gastroenteritis |
Salmonella
Shigella Helicobacter Campylobacter C.diff Amoeba Giardia Virus Enterotoxigenic-hemorrhagic E. coli |
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Organisms that cause:
CA UTI |
E. coli
GNRs Enterococci S. saprophyticus |
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Organisms that cause:
HA UTI |
Resistant GNRs
Enterococci |
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Organisms that cause:
Cellulitis |
S. aureus
S. viridans S. pyogenes |
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Organisms that cause:
IV catheter site infections |
S. aureus
S. epidermidis |
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Organisms that cause:
Surgical wound infections |
S. aureus
Coagulase-negative staph GNRs |
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Organisms that cause:
Diabetic ulcers |
S. aureus
GNRs Anaerobes Streptococci |
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Organisms that cause:
Furuncles |
S. aureus
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Organisms that cause:
Osteomyelitis/Septic Arthritis |
S. aureus
Coagulase-negative staph Streptococci GNRs |
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Utility: Natural PCNs
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- Syphilis
- Susceptible strep infections (pharyngitis or endocarditis) |
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Utility: Anti-Staph PCNs
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MSSA infections (endocarditis, skin/soft tissue infections)
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Utility: Amino-PCNs
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- Ampicillin is DOC for susceptible enterococci (needs to be combined w/ aminoglycoside)
- Susceptible GNRs, strep - Amoxicillin - URIs (pharyngitis, otitis media) |
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Utility: Anti-pseudomonal PCNs
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GNR infections (including pseudomonas)
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Utility: B-Lactam/B-Lactamase Inhibitors
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- Empiric therapy for nosocomial infections (esp. pip/taz and tic/clav)
- Mixed infections due to their anaerobic activity (intra-abdominal, diabetic ulcers, aspiration) |
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Don't Forget! Natural PCNs
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Natural PCNs are available as narrow spectrum coverage for susceptible infections.
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Don't Forget! Anti-Staph PCNs
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Beta-lactams kill staph quicker than vancomycin. Patients with MSSA infections who lack serious beta-lactam allergies should be switched to anti-staph PCN when possible.
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Don't Forget! Amino PCNs
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To achieve bactericidal activity against enterococci, ampicillin (or any beta-lactam) has to be combined with an aminoglycoside. Should be done in serious infections, endocarditits
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Don't Forget! Anti-pseudomonal PCNs
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These agents are useful step-down agents in pseudomonal infections. They are not a good empiric choice because other GNRs that cause nosocomial infections may be resistant to them. Start with a beta-lactamase-resistant agent, then change to an anti-pseudomonal PCN if possible.
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Don't Forget! B-Lactam/B-Lactamase Inhibitors
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Narrow coverage once culture results return. Know which ones are anti-pseudomonal and which ones aren't - this is a major difference that drives their use
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Utility: 1st Gen Cephalosporins
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Skin and soft tissue infections surgical prophylaxis
staph endocarditis (MSSA) |
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Utility: 2nd Gen Cephalosporins
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URTIs
CAP gonorrhea surgical prophylaxis (cefotetan, cefoxitin) |
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Utility: 3rd Gen Cephalosporins
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LRTIs,
pyelonephritis nosocomial infections (Ceftazidime) Lyme disease (Ceftriaxone) meningitis skin/soft tissue infections febrile neturopenia (Ceftazidime) |
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Utility: 4th Gen Cephalosporin
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Febrile neutropenia
Nosocomial infections |
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Utility: 5th Gen Cephalosporin
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FDA approved for only skin/soft tissue infections
CAP |
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Utility: Carbapenems
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All carbapenems:
- Mixed aerobic/anaerobic infections - Infections caused by ESBL-producing organisms - Intra-abdominal infections Imipenem, Meropenem, Doripenem Only: - Nosocomial infections - Febrile neutropenia |
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Utility: Monobactam (Aztreonam)
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Gram (-) Infections
Pseudomonas patients with PCN allergy |
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Utility: Ciprofloxacin
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UTI
Intra-abdominal infections Systemic Gram (-) infections Pseudomonas Bioterrorism |
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Utility: Levofloxacin
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CAP, CA Sinusitis
UTI Intra-abdominal Systemic Gram (-) infections Skin/soft tissue infections Pseudomonas Bioterrorism |
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Utility: Moxifloxacin
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CAP, CA Sinusitis
Intra-ab Systemic Gram (-) infections Skin/Soft tissue infections |
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Utility: Gemifloxacin
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CAP, CA Sinusitis
Skin/Soft Tissue infections |
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Utility: Macrolides and Ketolides
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Respiratory Tract Infections
Chlamydia Atypical mycobacterial infections Traveler's Diarrhea (azithromycin) H.pylori (clarithromycin) |
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Utility: Aminoglycosides
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W/ Beta-Lactams:
- Gram (-) pathogens - Febrile neutropenia - Sepsis - Cystic Fibrosis - Nosocomial pneumonia W/ Beta-Lactams or Glycopeptides: - Gram (+) infections - Endocarditis - Osteomyelitis - Sepsis In combo w/ others: - Drug-resistant TB, mycobacteria |
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Utility: Glycopeptides
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Vancomycin:
- DOC for MRSA infections - Empiric therapy for nosocomial infections (HAP) - Gram (+) when allergic to B-Lactams Telavancin: - Skin/skin structure infections |
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Utility: Cyclic Lipopeptides (Daptomycin)
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Skin/soft tissue by resistant Gram (+) and staph bacteremia
Right-sided endocarditis Enterococcal bacteremia |
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Utility:Oxazolidinones (Linezolid)
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Gram (+) VRE, MRSA
HAP Skin/Soft tissue |
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Utility: Streptogramins (Q/D)
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E. faecium
MRSA *Not for use as empiric therapy |
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Utility: TCNs, Glycylcyclines
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Uncomplicated respiratory tract infections
Acute exacerbations of chronic bronchitis Sinusitis CAP DOC for tick-borne diseases Malaria prophylaxis Tigecycline - polymicrobial complicated infections |
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Utility: Nitroimidazoles (Metronidazole)
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Abdominal anaerobes
Vaginal Trichomoniasis GI by susceptible protozoa H. pylori |
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Utility: Lincosamides (Clindamycin)
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Skin/Soft tissue infections
Infections of oral cavity Anaerobic intra-ab Acne (topical) |
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Utility: Nitrofurans
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Uncomplicated cystitis in patients with good renal function
Prophylaxis against recurrent uncomplicated lower UTIs |
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Utility: TMP/SMX
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Tx and Px for uncomplicated UTIs
Listeria meningitis Tx and Px for Pneumocystis jirovecii pneumonia MRSA |
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Utility: Colistimethate
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Tx of Gram (-) infections resistant to all other drugs
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