Antibiotic spectrum index: Difference between revisions

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* Measures the spectrum of an antibiotic, with a range from 0 to 14
* Measures the spectrum of an antibiotic, with a range from 0 to 14
* One point for activity against each of the following:
* One point for activity against each of the following:
** Methicillin-sensitive Staphylococcus aureus (MSSA)
** Methicillin-sensitive [[Staphylococcus aureus]] (MSSA)
** Methicillin-resistant S. aureus (MRSA)
** [[Methicillin-resistant Staphylococcus aureus]] (MRSA)
** Enterococcus faecalis
** [[Enterococcus faecalis]]
** Vancomycin-resistant Enterococcus faecalis (VRE)
** Vancomycin-resistant [[Enterococcus faecalis]] (VRE)
** Escherichia coli and Klebsiella
** [[Escherichia coli]] or [[Klebsiella]]
** [[AmpC β-lactamase|AmpC producers]] ([[Enterobacter]], [[Serratia]], and [[Citrobacter]])
** ampC producers
** Extended-spectrum β-lactamase (ESBL) E. coli/Klebsiella
** [[Extended-spectrum β-lactamases|Extended-spectrum β-lactamase]] (ESBL) [[Escherichia coli|E. coli]]/[[Klebsiella]]
** Pseudomonas aeruginosa
** [[Pseudomonas aeruginosa]]
** Penicillin-resistant pneumococcus (PRP)
** Penicillin-resistant [[pneumococcus]] (PRP)
** Moraxella and Haemophilus influenzae
** [[Moraxella]] and [[Haemophilus influenzae]]
** Mycoplasma and Chlamydophila
** [[Mycoplasma]] and [[Chlamydophila]] (atypicals)
** Anaerobes (1 point; 2 points for Bacteriodes fragilis)
** [[Anaerobes]] (in general)
** [[Bacteriodes fragilis]] (specifically)
** Multidrug-resistant organisms
* For each patient, the number of points for every antibiotic is added to give a total daily ASI

== Working Ranking ==

* The following is a reasonable list of commonly-used antibiotics, order from broadest to narrowest, not based on the ASI
* [[Cefiderocol]], [[Colistin]], [[Polymyxin B]], [[Meropenem-vaborbactam]], [[Imipenem-relebactam]], [[Ceftazidime-avibactam]], [[Ceftolozane-tazobactam]], [[Tigecycline]], [[Meropenem]], [[Doripenem]], [[Ertapenem]], [[Piperacillin-tazobactam]], [[Ticarcillin-clavulanate]], [[Fosfomycin]], [[Moxifloxacin]], [[Levofloxacin]], [[Ciprofloxacin]], [[Doxycycline]], [[Amikacin]], [[Tobramycin]], [[Gentamicin]], [[Cefipime]], [[Ceftazidime]], [[Trimethoprim-sulfamethoxazole]], [[Ampicillin-sulbactam]], [[Amoxicillin-clavulanate]], [[Ceftaroline]], [[Ceftriaxone]], [[Cefuroxime]], [[Cefazolin]], [[Ampicillin]], [[Amoxicillin]]

== Sample Spectrum Index ==
{| class="wikitable sortable"
!Antibiotic
!MSSA
!E.faeca
!Anaerobes
!Bacteroides
!M/H.flu
!E/K
!AmpC
!ESBL
!Pseudo
!MRSA
!PRP
!VRE
!Atypicals
!MDRO
!ASI
|-
|[[Dicloxacillin]]
|1
|0
|0
|0
|0
|0
|0
|0
|0
|0
|0
|0
|0
|0
|1
|-
|[[Oxacillin]]
|1
|0
|0
|0
|0
|0
|0
|0
|0
|0
|0
|0
|0
|0
|1
|-
|[[Amoxicillin]]
|0
|1
|0
|0
|0
|1
|0
|0
|0
|0
|0
|0
|0
|0
|2
|-
|[[Ampicillin]]
|0
|1
|0
|0
|0
|1
|0
|0
|0
|0
|0
|0
|0
|0
|2
|-
|[[Cephalexin]]
|1
|0
|0
|0
|0
|1
|0
|0
|0
|0
|0
|0
|0
|0
|2
|-
|[[Erythromycin]]
|0
|0
|0
|0
|1
|0
|0
|0
|0
|0
|0
|0
|1
|0
|2
|-
|[[Erythromycin]]
|0
|0
|0
|0
|1
|0
|0
|0
|0
|0
|0
|0
|1
|0
|2
|-
|[[Metronidazole]]
|0
|0
|1
|1
|0
|0
|0
|0
|0
|0
|0
|0
|0
|0
|2
|-
|[[Penicillin]]
|0
|1
|1
|0
|0
|0
|0
|0
|0
|0
|0
|0
|0
|0
|2
|-
|[[Aztreonam]]
|0
|0
|0
|0
|1
|1
|0
|0
|1
|0
|0
|0
|0
|0
|3
|-
|[[Cefazolin]]
|1
|0
|0
|0
|1
|1
|0
|0
|0
|0
|0
|0
|0
|0
|3
|-
|[[Cefdinir]]
|1
|0
|0
|0
|1
|1
|0
|0
|0
|0
|0
|0
|0
|0
|3
|-
|[[Cefixime]]
|0
|0
|1
|0
|1
|1
|0
|0
|0
|0
|0
|0
|0
|0
|3
|-
|[[Cefpodoxime]]
|1
|0
|0
|0
|1
|1
|0
|0
|0
|0
|0
|0
|0
|0
|3
|-
|[[Rifampin]]
|1
|0
|0
|0
|1
|0
|0
|0
|0
|1
|0
|0
|0
|0
|3
|-
|[[Azithromycin]]
|1
|0
|1
|0
|1
|0
|0
|0
|0
|0
|0
|0
|1
|0
|4
|-
|[[Cefprozil]]
|1
|0
|1
|0
|1
|1
|0
|0
|0
|0
|0
|0
|0
|0
|4
|-
|[[Ceftazidime]]
|0
|0
|1
|0
|1
|1
|0
|0
|1
|0
|0
|0
|0
|0
|4
|-
|[[Cefuroxime]]
|1
|0
|1
|0
|1
|1
|0
|0
|0
|0
|0
|0
|0
|0
|4
|-
|[[Chloramphenicol]]
|0
|0
|1
|1
|1
|1
|0
|0
|0
|0
|0
|0
|0
|0
|4
|-
|[[Clarithromycin]]
|1
|0
|1
|0
|1
|0
|0
|0
|0
|0
|0
|0
|1
|0
|4
|-
|[[Clindamycin]]
|1
|0
|1
|1
|0
|0
|0
|0
|0
|1
|0
|0
|0
|0
|4
|-
|[[Piperacillin]]
|0
|1
|1
|0
|0
|1
|0
|0
|1
|0
|0
|0
|0
|0
|4
|-
|[[TMP-SMX]]
|1
|0
|0
|0
|1
|1
|0
|0
|0
|1
|0
|0
|0
|0
|4
|-
|[[Cefotaxime]]
|1
|0
|1
|0
|1
|1
|0
|0
|0
|0
|1
|0
|0
|0
|5
|-
|[[Cefoxitin]]
|1
|0
|1
|1
|1
|1
|0
|0
|0
|0
|0
|0
|0
|0
|5
|-
|[[Ceftriaxone]]
|1
|0
|1
|0
|1
|1
|0
|0
|0
|0
|1
|0
|0
|0
|5
|-
|[[Colistin]]
|0
|0
|0
|0
|0
|1
|1
|1
|1
|0
|0
|0
|0
|1
|5
|-
|[[Daptomycin]]
|1
|1
|0
|0
|0
|0
|0
|0
|0
|1
|0
|1
|0
|1
|5
|-
|[[Doxycycline]]
|1
|0
|0
|0
|1
|1
|0
|0
|0
|1
|0
|0
|1
|0
|5
|-
|[[Gentamicin]]
|1
|0
|0
|0
|1
|1
|0
|0
|1
|1
|0
|0
|0
|0
|5
|-
|[[Minocycline]]
|1
|0
|0
|0
|1
|1
|0
|0
|0
|1
|0
|0
|1
|0
|5
|-
|[[Telavancin]]
|1
|1
|0
|0
|0
|0
|0
|0
|0
|1
|1
|0
|0
|1
|5
|-
|[[Tobramycin]]
|1
|0
|0
|0
|1
|1
|0
|0
|1
|1
|0
|0
|0
|0
|5
|-
|[[Vancomycin]]
|1
|1
|0
|0
|0
|0
|0
|0
|0
|1
|1
|0
|0
|1
|5
|-
|[[Amikacin]]
|1
|0
|0
|0
|1
|1
|0
|0
|1
|1
|0
|0
|0
|1
|6
|-
|[[Amoxicillin-clavulanic acid]]
|1
|1
|1
|1
|1
|1
|0
|0
|0
|0
|0
|0
|0
|0
|6
|-
|[[Ampicillin-sulbactam]]
|1
|1
|1
|1
|1
|1
|0
|0
|0
|0
|0
|0
|0
|0
|6
|-
|[[Cefepime]]
|1
|0
|0
|0
|1
|1
|1
|0
|1
|0
|1
|0
|0
|0
|6
|-
|[[Linezolid]]
|1
|1
|0
|0
|0
|0
|0
|0
|0
|1
|1
|1
|0
|1
|6
|-
|[[Ticarcillin-clavulanate]]
|1
|0
|1
|1
|1
|1
|0
|0
|1
|0
|0
|0
|0
|0
|6
|-
|[[Ceftaroline]]
|1
|1
|0
|0
|1
|1
|1
|0
|0
|1
|1
|0
|0
|1
|8
|-
|[[Ciprofloxacin]]
|1
|1
|0
|0
|1
|1
|1
|1
|1
|0
|0
|0
|1
|0
|8
|-
|[[Piperacillin-tazobactam]]
|1
|1
|1
|1
|1
|1
|1
|0
|1
|0
|0
|0
|0
|0
|8
|-
|[[Ertapenem]]
|1
|0
|1
|1
|1
|1
|1
|1
|0
|0
|1
|0
|0
|1
|9
|-
|[[Levofloxacin]]
|1
|1
|1
|0
|1
|1
|1
|1
|0
|0
|1
|0
|1
|0
|9
|-
|[[Meropenem]]
|1
|0
|1
|1
|1
|1
|1
|1
|1
|0
|1
|0
|0
|1
|10
|-
|[[Moxifloxacin]]
|1
|1
|1
|1
|1
|1
|1
|0
|0
|1
|1
|0
|1
|0
|10
|-
|[[Imipenem-cilastatin]]
|1
|1
|1
|1
|1
|1
|1
|1
|1
|0
|1
|0
|0
|1
|11
|-
|[[Tigecycline]]
|1
|1
|1
|1
|1
|1
|1
|1
|0
|1
|1
|1
|1
|1
|13
|}
MSSA = methicillin-susceptible [[Staphylococcus aureus]]; E/K = [[Escherichia coli]]/[[Klebsiella]]; M/H.flu = [[Moraxella]] and [[Haemophilus influenzae]]; Pseudo = [[Pseudomonas aeruginosa]]; MRSA = [[methicillin-resistant Staphylococcus aureus]]; PRP = penicillin-resistant [[pneumococcus]]; VRE = vancomycin-resistant [[Enterococcus]]; atypicals = [[Mycoplasma pneumoniae]] and [[Chlamidophila]]; MDRO = multidrug-resistant organisms


==Further Reading==
==Further Reading==

Latest revision as of 18:34, 4 April 2024

Working Ranking

Sample Spectrum Index

Antibiotic MSSA E.faeca Anaerobes Bacteroides M/H.flu E/K AmpC ESBL Pseudo MRSA PRP VRE Atypicals MDRO ASI
Dicloxacillin 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1
Oxacillin 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1
Amoxicillin 0 1 0 0 0 1 0 0 0 0 0 0 0 0 2
Ampicillin 0 1 0 0 0 1 0 0 0 0 0 0 0 0 2
Cephalexin 1 0 0 0 0 1 0 0 0 0 0 0 0 0 2
Erythromycin 0 0 0 0 1 0 0 0 0 0 0 0 1 0 2
Erythromycin 0 0 0 0 1 0 0 0 0 0 0 0 1 0 2
Metronidazole 0 0 1 1 0 0 0 0 0 0 0 0 0 0 2
Penicillin 0 1 1 0 0 0 0 0 0 0 0 0 0 0 2
Aztreonam 0 0 0 0 1 1 0 0 1 0 0 0 0 0 3
Cefazolin 1 0 0 0 1 1 0 0 0 0 0 0 0 0 3
Cefdinir 1 0 0 0 1 1 0 0 0 0 0 0 0 0 3
Cefixime 0 0 1 0 1 1 0 0 0 0 0 0 0 0 3
Cefpodoxime 1 0 0 0 1 1 0 0 0 0 0 0 0 0 3
Rifampin 1 0 0 0 1 0 0 0 0 1 0 0 0 0 3
Azithromycin 1 0 1 0 1 0 0 0 0 0 0 0 1 0 4
Cefprozil 1 0 1 0 1 1 0 0 0 0 0 0 0 0 4
Ceftazidime 0 0 1 0 1 1 0 0 1 0 0 0 0 0 4
Cefuroxime 1 0 1 0 1 1 0 0 0 0 0 0 0 0 4
Chloramphenicol 0 0 1 1 1 1 0 0 0 0 0 0 0 0 4
Clarithromycin 1 0 1 0 1 0 0 0 0 0 0 0 1 0 4
Clindamycin 1 0 1 1 0 0 0 0 0 1 0 0 0 0 4
Piperacillin 0 1 1 0 0 1 0 0 1 0 0 0 0 0 4
TMP-SMX 1 0 0 0 1 1 0 0 0 1 0 0 0 0 4
Cefotaxime 1 0 1 0 1 1 0 0 0 0 1 0 0 0 5
Cefoxitin 1 0 1 1 1 1 0 0 0 0 0 0 0 0 5
Ceftriaxone 1 0 1 0 1 1 0 0 0 0 1 0 0 0 5
Colistin 0 0 0 0 0 1 1 1 1 0 0 0 0 1 5
Daptomycin 1 1 0 0 0 0 0 0 0 1 0 1 0 1 5
Doxycycline 1 0 0 0 1 1 0 0 0 1 0 0 1 0 5
Gentamicin 1 0 0 0 1 1 0 0 1 1 0 0 0 0 5
Minocycline 1 0 0 0 1 1 0 0 0 1 0 0 1 0 5
Telavancin 1 1 0 0 0 0 0 0 0 1 1 0 0 1 5
Tobramycin 1 0 0 0 1 1 0 0 1 1 0 0 0 0 5
Vancomycin 1 1 0 0 0 0 0 0 0 1 1 0 0 1 5
Amikacin 1 0 0 0 1 1 0 0 1 1 0 0 0 1 6
Amoxicillin-clavulanic acid 1 1 1 1 1 1 0 0 0 0 0 0 0 0 6
Ampicillin-sulbactam 1 1 1 1 1 1 0 0 0 0 0 0 0 0 6
Cefepime 1 0 0 0 1 1 1 0 1 0 1 0 0 0 6
Linezolid 1 1 0 0 0 0 0 0 0 1 1 1 0 1 6
Ticarcillin-clavulanate 1 0 1 1 1 1 0 0 1 0 0 0 0 0 6
Ceftaroline 1 1 0 0 1 1 1 0 0 1 1 0 0 1 8
Ciprofloxacin 1 1 0 0 1 1 1 1 1 0 0 0 1 0 8
Piperacillin-tazobactam 1 1 1 1 1 1 1 0 1 0 0 0 0 0 8
Ertapenem 1 0 1 1 1 1 1 1 0 0 1 0 0 1 9
Levofloxacin 1 1 1 0 1 1 1 1 0 0 1 0 1 0 9
Meropenem 1 0 1 1 1 1 1 1 1 0 1 0 0 1 10
Moxifloxacin 1 1 1 1 1 1 1 0 0 1 1 0 1 0 10
Imipenem-cilastatin 1 1 1 1 1 1 1 1 1 0 1 0 0 1 11
Tigecycline 1 1 1 1 1 1 1 1 0 1 1 1 1 1 13

MSSA = methicillin-susceptible Staphylococcus aureus; E/K = Escherichia coli/Klebsiella; M/H.flu = Moraxella and Haemophilus influenzae; Pseudo = Pseudomonas aeruginosa; MRSA = methicillin-resistant Staphylococcus aureus; PRP = penicillin-resistant pneumococcus; VRE = vancomycin-resistant Enterococcus; atypicals = Mycoplasma pneumoniae and Chlamidophila; MDRO = multidrug-resistant organisms

Further Reading

  • Development and Application of an Antibiotic Spectrum Index for Benchmarking Antibiotic Selection Patterns Across Hospitals. Infect Control Hosp Epidemiol. 2017;38(8):993-997. doi: 10.1017/ice.2017.94.