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Clinically Useful Antibiotics -- Beta-Lactams

Organism G+ G+ G- G- G- Enteric G- Pseudomonas Anaerobes


Drug S. aureus Strep H. flu Neisseria M. catarrhalis Oral Gut
(E. coli, Kleb, Strep, Staph,
(non MRSA) B Pneumo Entero B-lac + B-lac - Mening CG B-lac + Prot, etc.) Bacteroides B. fragilis
Penicillin
Ampicillin PO/IV
1/2+
Amoxicillin PO (better absorption)
Ampicillin + Sulbactam (Unasyn)
+ + + + + 1+ + +
Penicillins

Amoxicillin + Clavulanate (Augmentin)


Nafcillin
Oxacillin +
Dicloxacillin
Piperacillin
+ + + + 3-4+ +
Ticarcillin (less active vx. Pseudomonas)
Piperacillin + Tazobactam (Zosyn)
+ + + + + + + 4+ + + +
Ticarcillin + Clavulanate (Timentin)
1 IV Cefazolin (Kefzol) 1+
PO Cephalexin (Keflex)
1+
Cefadroxil (Duracef)
2 IV Cefuroxime (Zinacef) + + 2+
PO Cefuroxime (Ceftin)
Loracarbef (Lorabid)
Cefprozil (Cefzil) + + 2+
Cephalosporins

Cefaclor (Ceclor) (last choice --


rash, decr. Activity)
IV Cefotetan (Cefotan)
2+ +
Cefoxitin (Mefoxin)
3 IV Ceftriaxone (Rocephin)
+ + + + + 3+
Cefotaxime (Claforan)
PO Cefpodoxime (Vantin)
Ceftibuten (Cedax) + + + + + 3+
Cefdinir (Omnicef)
PO Cefixime (Suprax) + + + 3+
Ceftazidime (Fortaz, Tazicef,
IV + + 3+
Tazidime)
4 IV Cefepime (Maxipime) + + + + + + 4+ +
Monobactams

Aztreonam (Azactam) + + + 3-4+ +


Carbapenems

Imipenem/Cilastatin (Primaxin)
+ + + + + + 4+ + + +
Meropenem (Merrem)
+ Generally clinically useful Potentially clinically useful Drug of choice

No handout would be complete without its disclaimer This brief summary should not replace clinical judgment. Refer to primary sources for more detailed information. Blah blah blah

From J. Durbin (2000) and The Sanford Guide (2005) Updated 3/6/2006
Clinically Useful Antibiotics -- Non-Beta-Lactams
Organism G+ G+ G- G- G- Enteric G- Pseudomonas Anaerobes
Drug S. aureus Strep H. flu Neisseria M. catarrhalis Oral Gut
(E. coli, Kleb, Strep, Staph,
(non MRSA) B Pneumo Entero B-lac + B-lac - Mening CG B-lac + Prot, etc.) Bacteroides B. fragilis
glycosides

Gentamycin
Amino-

Tobramycin 4+ +
Amikacin
Erythromycin
Macrolides

(Bacteriostatic, mostly used for Legionella, Pertussis, Mycoplasma, Genital Mycoplasma, Chlamydia, Lyme dz; SE include GI upset, phlebitis)

Azithromycin (Zithromax) +/- + +/-


Clarithromycin (Biaxin)
(used for same organisms as Erythro; also toxo & MAI; good w/ AIDS; chlamydia PID - one dose)

Ciprofloxadin (Cipro)
+/- +/- + + + + 3+
(cartilage damage in baby beagles)

Ofloxacin (Floxin)
Fluoroquinolones

+/- +/- + + + 3+ +/-


(not as good for Pseudomonas)

Levofloxacin (Levaquin)
+/- + + + + + 3+
(good for gm+, QD dosing)

Moxifloxacin (Avelox) +/ + + + + + 3+
Gatifloxacin (Tequin) +/- + + + + + 3+
Norfloxadin (Noroxin)
+/- 3+
(UTI and diarrhea use)
Tetracyclines

Tetracycline
Doxycycline (Vibramycin, Doryx) +/ + + + 2+
Minocycline (Minocin)
Vancomycin (Vancocin)
+ + + +/-
(not absorbed PO, good for MRSA and SNA, C. diff)

Clindamycin
Miscellaneous

+ + +
(bacteriostatic, not for endocarditis, not good for SNA, C. diff)

Trimethoprim-Sulfamethoxazole (Bactrim, Septra)


+/- +/- + + 2+
(for outpt UTI, OM, PCP)

Chloramphenicol (Chloromycetin)
+/- + + +/- + + + 2-3+ + +
(idiosyncratic rare irreversible aplastic anemia, dose-related toxicity causing reversible BM suppression)

Metronidazole (Flagyl) +/-


+ Generally clinically useful Potentially clinically useful Drug of choice

No handout would be complete without its disclaimer This brief summary should not replace clinical judgment. Refer to primary sources for more detailed information. Blah blah blah

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