A Few Antibiotics to Know: Difference between revisions
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* '''Cloxacillin''' (and oxacillin and others) is great against methicillin-sensitive ''Staphylococcus aureus'' (MSSA) |
* '''Cloxacillin''' (and oxacillin and others) is great against methicillin-sensitive ''Staphylococcus aureus'' (MSSA) |
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* '''Amoxicillin/clavulanic acid''' (PO) is broad-spectrum, and works against most Gram-positives and Gram-negatives, as well as some anaerobes |
* '''Amoxicillin/clavulanic acid''' (PO) is broad-spectrum, and works against most Gram-positives and Gram-negatives, as well as some anaerobes |
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− | * '''Piperacillin''' |
+ | * '''Piperacillin'''-tazobactam (IV) adds even better anaerobic coverage, as well as anti-pseudomonal activity |
=== Cephalosporins === |
=== Cephalosporins === |
Revision as of 10:17, 29 October 2019
Beta-lactams
- Our gold-standard class of antibiotics that are extremely effective and very well tolerated
Penicillins +/- Beta-lactamase Inhibitors
- Amoxicillin (PO) and ampicillin (IV) are great against most streptococci, and a few Gram-negatives
- Cloxacillin (and oxacillin and others) is great against methicillin-sensitive Staphylococcus aureus (MSSA)
- Amoxicillin/clavulanic acid (PO) is broad-spectrum, and works against most Gram-positives and Gram-negatives, as well as some anaerobes
- Piperacillin-tazobactam (IV) adds even better anaerobic coverage, as well as anti-pseudomonal activity
Cephalosporins
- Cephalexin (PO) and cefazolin (IV) are first-generation cephalosporins that are fantastic against most Gram-positives, including streptococci and MSSA, as well as many non-resistant Gram-negatives
- Ceftriaxone (IV) is worse for Staph. aureus, but maintains excellent streptococcal coverage and improves the Gram-negative coverage significantly
- Ceftazidime (IV) is like ceftriaxone but adds anti-pseudomonal activity
Carbapenems
- Ertapenem (IV) covers essentially everything except MRSA and some very resistant Gram-negatives
- Meropenem (IV) adds anti-pseudomonal activity
Fluoroquinolones
- Broad-spectrum and great oral bioavailability (PO ~= IV), but low barrier to resistance and many side effects
- Levofloxacin (PO/IV) and moxifloxacin (PO/IV) cover Gram-positives that includes staph. aureus and Gram-negatives
- Ciprofloxacin (PO/IV) has less good Gram-positive coverage but better Gram-negative coverage, including anti-pseudomonal activity
Vancomycin/Daptomycin/Linezolid
- Vancomycin (IV) and daptomycin (IV) work only against Gram-positives, and are reserved for resistant infections such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE)
- Vancomycin has renal toxicity and possibly ototoxicity
- Daptomycin doesn't work for pneumonia (inactivated by surfactant)
- Vancomycin (PO) is not absorbed, and is used only for Clostridium difficile-associated diarrhea
- Linezolid (PO/IV) is another antibiotic that treats only Gram-positives, including MRSA
Aminoglycosides
- Tobramycin (IV) and gentamicin (IV) are reserved for very resistant Gram-negative infections, and have side effects of renal toxicity and ototoxicity
Miscellaneous
- Septra (TMP-SMX) (PO/IV) has good Gram-negative coverage, including many resistant Gram-negatives, as well as MRSA coverage
- Azithromycin (PO) is used for community-acquired pneumonia, covering Strep. pneumoniae and atypicals like Chlamydia, Mycoplasma, and Legionella
- Clindamycin (PO/IV) is used for Gram-positives (including MRSA) and oral anaerobes, as well as streptococcal toxic shock syndrome
- Doxycycline (PO) is used for weird infections, but also includes MRSA coverage
- Metronidazole (PO/IV) treats gut anaerobes and C. difficile