Cpb-us-w2.wpmucdn.com
|Penicillins |Penicillin |IV/PO |G+ only, All GAS/GBS, syphilis, oral anaerobes (but not gut), |exudative pharyngitis, erysipelias |
| | | |clostridium | |
| |Nafcillin (IV)/oxacillin(po)/dicloxacillin(po) |IV/PO |G+ only DOC MSSA, can use for strep, (no MRSA), no G neg |Cellulitis, s. aureus cutaneous abscess |
| | | | | |
| |B lactamase resistant penicillins | | | |
| |Ampicillin(IV)/amoxicillin(po) |IV/PO |G+ and some G- DOC for enterococcus, strep like pen, no staph, only a |1st line acute otitis media, acute sinusitis, neonatoal meningitis |
| | | |little G neg (some H.flu, some e. coli), listeria |with gentamicin |
| |aminopenicillins | | | |
| |Piperacillin |IV |Like amp + G-, so good for strep, enterococcus and G neg incl | |
| | | |pseudomonas + anaerobes, but NO MSSA | |
|Pen + B lactamase inhib (adds |Amp/sulbactam (unasyn) IV |IV |Like amp + MSSA and anaerobes, NO MRSA, H.flu, most anaerobes, listeria|Failed tx of otitis media |
|MSSA) | | | | |
| |Amox/clavulanate (augmentin) po |PO | | |
| |Pipercillin/tazobactam (zosyn) |IV |All except MRSA, including pseudomonas and enteric G- | |
| | | | | |
| |Ticarcillin/tazo? (Timentin) | | | |
|Cephalosporin |All | |No enterococci, NO MRSA, no listeria | |
| |1st gen: Cefazolin (ancef) IV |IV |Staph and strep in pen allergic pt (10% cross react), G pos, few G neg | |
| | | |(ex ecoli), few anaerobes | |
| |Cephalexin (Keflex) PO |PO | | |
| |2nd gen: Cefoxitan (Mefoxin) iv |IV |Above + H.flu, more G neg, anaerobes |gut surg prophylaxis, otitis failed augmentin, |
| | |PO | | |
| |Cefpodoxime (Vantin) iv | | | |
| | | | | |
| |Cefuroxime (Ceftin) po/iv | | | |
| |3rd gen: Ceftriaxone (Rocephin) im/iv |IV |A lot of G neg (no pseudomonas), not as good for staph as first and |Comm acquired Meningitis in all except neonates – crosses BBB, also |
| | | |second gen, still good for GAS/GBS and s.pneumo |for pyelo in kids and adults |
| |Cefotaxime (Omnicef) po | | |Rocephin, bad in neonates – biliary sludging/Ca++ precipitation, can|
| | | | |use cefotaxime |
| | | | |Omnicef – otitis failed augmentin |
| |4th gen: Cefipime |IV |G pos, most G neg, incl pseudomonas, limited anaerobes, no enterococcus| |
| | | | | |
| |Ceftazidime | | | |
| | | |Nosocomial meningitis, pseudomonas | |
|Carbapenem |Meropenem (kids) |IV |Gram pos incl. entero, gram neg, pseudomonas, anaerobes, ESBL gram neg,|Imipenem – decreases seizure threshold |
| | | |NO MRSA, no acinetobacter | |
| |Imipenem (Primaxin) | | | |
| | |IV |Like imipenem but no pseudomonas |Q day, no CNS penetration |
| |Ertapenem (Invanz) | | | |
|Macrolides |Erythromycin |IV/PO |Gram pos, some anaerobes, atypicals, NO gram neg |Can cause pyloric stenosis so CI in neonates |
| |Azithromycin |IV/PO |Above + H.flu, MAC tx, prophylaxis, more G- than erythro |Pretty good resp drug, Pen allergic for strep throat, otitis media, |
| | | | |DOC outpatient community acquired pneumonia in teenagers/adults, |
| |Clarithromycin (Biaxin) | | |pertussis |
| |Tetracycline |PO |Some gram neg, gram pos, SOME MRSA, some anaerobes, atypicals - Kill |Use if MRSA or e. coli known to be sensitive b/c cheap |
| | | |some of everything |Relative CI in kids ................
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