Antibiotic spectrum index: Difference between revisions

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(Created page with "* 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 S. aureus (MRSA) ** Enterococcus faecalis ** Vancomycin-resistant Enterococcus faecalis (VRE) ** Escherichia coli and Klebsiella ** ampC producers ** Extended-spectrum β-lactamase (ESBL) E. coli/Klebsiella ** Pseudomonas aeruginosa ** Penicillin-resistant pneumococcus (P...")
 
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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
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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
   
 
==Further Reading==
  
==Further Reading==

Latest revision as of 14:34, 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.
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