Antibiotic spectrum index: Difference between revisions
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** Penicillin-resistant [[pneumococcus]] (PRP) |
** Penicillin-resistant [[pneumococcus]] (PRP) |
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** [[Moraxella]] and [[Haemophilus influenzae]] |
** [[Moraxella]] and [[Haemophilus influenzae]] |
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** [[Mycoplasma]] and [[Chlamydophila]] |
** [[Mycoplasma]] and [[Chlamydophila]] (atypicals) |
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** [[Anaerobes]] (in general) |
** [[Anaerobes]] (in general) |
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** [[Bacteriodes fragilis]] (specifically) |
** [[Bacteriodes fragilis]] (specifically) |
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* For each patient, the number of points for every antibiotic is added to give a total daily ASI |
* 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]] |
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== Sample Spectrum Index == |
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| ⚫ | |||
!Antibiotic |
!Antibiotic |
||
!MSSA |
!MSSA |
||
!E.faeca |
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!Enterococcus |
|||
!Anaerobes |
!Anaerobes |
||
!Bacteroides |
!Bacteroides |
||
!M/H.flu |
|||
!Moraxella/Haemophilus |
|||
!E/K |
|||
!Escherichia/Klebsiella |
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!AmpC |
!AmpC |
||
!ESBL |
!ESBL |
||
!Pseudo |
|||
!Pseudomonas |
|||
!MRSA |
!MRSA |
||
!PRP |
|||
!Pen-R pneumococcus |
|||
!VRE |
!VRE |
||
!Atypicals |
|||
!Atypical |
|||
!MDRO |
!MDRO |
||
!ASI |
!ASI |
||
|- |
|- |
||
|Dicloxacillin |
|[[Dicloxacillin]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
| Line 53: | Line 58: | ||
|1 |
|1 |
||
|- |
|- |
||
|Oxacillin |
|[[Oxacillin]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|1 |
|1 |
||
|- |
|- |
||
|Amoxicillin |
|[[Amoxicillin]] |
||
|0 |
|0 |
||
|1 |
|1 |
||
| Line 87: | Line 92: | ||
|2 |
|2 |
||
|- |
|- |
||
|Ampicillin |
|[[Ampicillin]] |
||
|0 |
|0 |
||
|1 |
|1 |
||
| Line 104: | Line 109: | ||
|2 |
|2 |
||
|- |
|- |
||
|Cephalexin |
|[[Cephalexin]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|2 |
|2 |
||
|- |
|- |
||
|Erythromycin |
|[[Erythromycin]] |
||
|0 |
|0 |
||
|0 |
|0 |
||
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|2 |
|2 |
||
|- |
|- |
||
|Erythromycin |
|[[Erythromycin]] |
||
|0 |
|0 |
||
|0 |
|0 |
||
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|2 |
|2 |
||
|- |
|- |
||
|Metronidazole |
|[[Metronidazole]] |
||
|0 |
|0 |
||
|0 |
|0 |
||
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|2 |
|2 |
||
|- |
|- |
||
|Penicillin |
|[[Penicillin]] |
||
|0 |
|0 |
||
|1 |
|1 |
||
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|2 |
|2 |
||
|- |
|- |
||
|Aztreonam |
|[[Aztreonam]] |
||
|0 |
|0 |
||
|0 |
|0 |
||
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|3 |
|3 |
||
|- |
|- |
||
|Cefazolin |
|[[Cefazolin]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|3 |
|3 |
||
|- |
|- |
||
|Cefdinir |
|[[Cefdinir]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|3 |
|3 |
||
|- |
|- |
||
|Cefixime |
|[[Cefixime]] |
||
|0 |
|0 |
||
|0 |
|0 |
||
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|3 |
|3 |
||
|- |
|- |
||
|Cefpodoxime |
|[[Cefpodoxime]] |
||
|1 |
|1 |
||
|0 |
|0 |
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|3 |
|3 |
||
|- |
|- |
||
|Rifampin |
|[[Rifampin]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|3 |
|3 |
||
|- |
|- |
||
|Azithromycin |
|[[Azithromycin]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|4 |
|4 |
||
|- |
|- |
||
|Cefprozil |
|[[Cefprozil]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|4 |
|4 |
||
|- |
|- |
||
|Ceftazidime |
|[[Ceftazidime]] |
||
|0 |
|0 |
||
|0 |
|0 |
||
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|4 |
|4 |
||
|- |
|- |
||
|Cefuroxime |
|[[Cefuroxime]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|4 |
|4 |
||
|- |
|- |
||
|Chloramphenicol |
|[[Chloramphenicol]] |
||
|0 |
|0 |
||
|0 |
|0 |
||
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|4 |
|4 |
||
|- |
|- |
||
|Clarithromycin |
|[[Clarithromycin]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|4 |
|4 |
||
|- |
|- |
||
|Clindamycin |
|[[Clindamycin]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|4 |
|4 |
||
|- |
|- |
||
|Piperacillin |
|[[Piperacillin]] |
||
|0 |
|0 |
||
|1 |
|1 |
||
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|4 |
|4 |
||
|- |
|- |
||
|[[TMP-SMX]] |
|||
|Trimethoprim- sulfamethoxazole |
|||
|1 |
|1 |
||
|0 |
|0 |
||
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|4 |
|4 |
||
|- |
|- |
||
|Cefotaxime |
|[[Cefotaxime]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|5 |
|5 |
||
|- |
|- |
||
|Cefoxitin |
|[[Cefoxitin]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|5 |
|5 |
||
|- |
|- |
||
|Ceftriaxone |
|[[Ceftriaxone]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|5 |
|5 |
||
|- |
|- |
||
|[[Colistin]] |
|||
|Colistimethate |
|||
|0 |
|0 |
||
|0 |
|0 |
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|5 |
|5 |
||
|- |
|- |
||
|Daptomycin |
|[[Daptomycin]] |
||
|1 |
|1 |
||
|1 |
|1 |
||
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|5 |
|5 |
||
|- |
|- |
||
|Doxycycline |
|[[Doxycycline]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|5 |
|5 |
||
|- |
|- |
||
|Gentamicin |
|[[Gentamicin]] |
||
|1 |
|1 |
||
|0 |
|0 |
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|5 |
|5 |
||
|- |
|- |
||
|Minocycline |
|[[Minocycline]] |
||
|1 |
|1 |
||
|0 |
|0 |
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|5 |
|5 |
||
|- |
|- |
||
|Telavancin |
|[[Telavancin]] |
||
|1 |
|1 |
||
|1 |
|1 |
||
| Line 597: | Line 602: | ||
|5 |
|5 |
||
|- |
|- |
||
|Tobramycin |
|[[Tobramycin]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|5 |
|5 |
||
|- |
|- |
||
|Vancomycin |
|[[Vancomycin]] |
||
|1 |
|1 |
||
|1 |
|1 |
||
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|5 |
|5 |
||
|- |
|- |
||
|Amikacin |
|[[Amikacin]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|6 |
|6 |
||
|- |
|- |
||
|Amoxicillin- |
|[[Amoxicillin-clavulanic acid]] |
||
|1 |
|1 |
||
|1 |
|1 |
||
| Line 665: | Line 670: | ||
|6 |
|6 |
||
|- |
|- |
||
|Ampicillin-sulbactam |
|[[Ampicillin-sulbactam]] |
||
|1 |
|1 |
||
|1 |
|1 |
||
| Line 682: | Line 687: | ||
|6 |
|6 |
||
|- |
|- |
||
|Cefepime |
|[[Cefepime]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
| Line 699: | Line 704: | ||
|6 |
|6 |
||
|- |
|- |
||
|Linezolid |
|[[Linezolid]] |
||
|1 |
|1 |
||
|1 |
|1 |
||
| Line 716: | Line 721: | ||
|6 |
|6 |
||
|- |
|- |
||
|Ticarcillin-clavulanate |
|[[Ticarcillin-clavulanate]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
| Line 733: | Line 738: | ||
|6 |
|6 |
||
|- |
|- |
||
|Ceftaroline |
|[[Ceftaroline]] |
||
|1 |
|1 |
||
|1 |
|1 |
||
| Line 750: | Line 755: | ||
|8 |
|8 |
||
|- |
|- |
||
|Ciprofloxacin |
|[[Ciprofloxacin]] |
||
|1 |
|1 |
||
|1 |
|1 |
||
| Line 767: | Line 772: | ||
|8 |
|8 |
||
|- |
|- |
||
|Piperacillin-tazobactam |
|[[Piperacillin-tazobactam]] |
||
|1 |
|1 |
||
|1 |
|1 |
||
| Line 784: | Line 789: | ||
|8 |
|8 |
||
|- |
|- |
||
|Ertapenem |
|[[Ertapenem]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
| Line 801: | Line 806: | ||
|9 |
|9 |
||
|- |
|- |
||
|Levofloxacin |
|[[Levofloxacin]] |
||
|1 |
|1 |
||
|1 |
|1 |
||
| Line 818: | Line 823: | ||
|9 |
|9 |
||
|- |
|- |
||
|Meropenem |
|[[Meropenem]] |
||
|1 |
|1 |
||
|0 |
|0 |
||
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|10 |
|10 |
||
|- |
|- |
||
|Moxifloxacin |
|[[Moxifloxacin]] |
||
|1 |
|1 |
||
|1 |
|1 |
||
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|10 |
|10 |
||
|- |
|- |
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|Imipenem-cilastatin |
|[[Imipenem-cilastatin]] |
||
|1 |
|1 |
||
|1 |
|1 |
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|11 |
|11 |
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|- |
|- |
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|Tigecycline |
|[[Tigecycline]] |
||
|1 |
|1 |
||
|1 |
|1 |
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|13 |
|13 |
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|} |
|} |
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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 |
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==Further Reading== |
==Further Reading== |
||
Latest revision as of 18:34, 4 April 2024
- Measures the spectrum of an antibiotic, with a range from 0 to 14
- One point for activity against each of the following:
- Methicillin-sensitive Staphylococcus aureus (MSSA)
- Methicillin-resistant Staphylococcus aureus (MRSA)
- Enterococcus faecalis
- Vancomycin-resistant Enterococcus faecalis (VRE)
- Escherichia coli or Klebsiella
- AmpC producers (Enterobacter, Serratia, and Citrobacter)
- Extended-spectrum β-lactamase (ESBL) E. coli/Klebsiella
- Pseudomonas aeruginosa
- Penicillin-resistant pneumococcus (PRP)
- Moraxella and Haemophilus influenzae
- Mycoplasma and Chlamydophila (atypicals)
- 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
| 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.
