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) |
** [[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 |
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| − | == |
+ | == Working Ranking == |
| + | |||
| + | * The following is a reasonable list of commonly-used antibiotics, order from broadest to narrowest, not based on the ASI |
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| + | * [[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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{| class="wikitable sortable" |
{| class="wikitable sortable" |
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!Antibiotic |
!Antibiotic |
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!MSSA |
!MSSA |
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| + | !E.faeca |
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| − | !Enterococcus |
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!Anaerobes |
!Anaerobes |
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!Bacteroides |
!Bacteroides |
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| + | !M/H.flu |
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| − | !Moraxella/Haemophilus |
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| + | !E/K |
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| − | !Escherichia/Klebsiella |
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!AmpC |
!AmpC |
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!ESBL |
!ESBL |
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| + | !Pseudo |
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| − | !Pseudomonas |
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!MRSA |
!MRSA |
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| + | !PRP |
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| − | !Pen-R pneumococcus |
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!VRE |
!VRE |
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| + | !Atypicals |
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| − | !Atypical |
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!MDRO |
!MDRO |
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!ASI |
!ASI |
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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== |
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Latest revision as of 14:34, 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.
