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Amikacin
AG w/ broadest antimicrobial activity
Kanamycin
Used to decrease bacterial content of the bowel
Gentamicin
More active against Acinetobacter and Serratia than Tobramycin
Netilmicicn
Least ototoxiv AG
Tobramycin
More active agins P. Aeruginosa than Gentamicin
Streptomycin
Active against enterococci, streptococci, mycobacteria, and some gram negative anaerobes. Only used as adjunct agent d/t resistant bacterial isolates abundance. Should only be administered IM

AG target serum [ ]

  • Amikacin peak: 15-30 mcg/ml, through: <5 mcg/ml
  • Gentamicin peak: 4-10 mcg/ml, through: <2 mcg/ml

 

Nafcillian and Oxacillin
Primarily biliary excretion. Do not have to adjust for renal dysfunction
PO AGs
Kanamycin, Neomycin
PO PCNs
PCN G, PCN V K
Oxacillin, Cloxacillin, Dicloxacillin
Amoxicillin, Ampicillin, Bacampicillin
Augmentin


PO Cephalosporins
1st generation
- Cefadroxil (Duricef)
- Cephalexin (Keflex)
- Cephradine (Anspor)

2nd generation
- Cefaclor (Ceclor)
- Cefprozil (Cefzil)
- Loracarbef (Lorabid)

3rd generation
- Cefixime (Suprax)
- Cefnidir (Omnicef)
- Cefpodoxime (Vantin)
- Ceftibuten (Cedax)







SPACE bugs
Serratia
Pseudomonas
Acinetobacter
Citrobacter
Enterobacter
Atypical pathogens
Chlamydia trachomatis
Chlamydia pneumonia
Legionella pneumonia
Mycoplasma pneumoniae
Cefoperazone (Cefobid)
IV
3rd gen cephalosporin w/ p. aeruginosa cob=verage and only one hepatically eliminated

Cephalosporin that cause bleeding/hypoprothombinemia

Cefoperazone- 3rd(Cefobid), Cefmetazole-2nd (Zefazone), Cefotetan 2nd (Cefotan)
MRSA
Linezolid
Vancomycin
Synercid
Septra
Linezolid (Zyvox)
Bacteriostatic against enterococci and staphylococci and bactericidal against streptococci.
Active against Enterococcus faecium, including VRE.


Linezolid (Zyvox)

weak MOAI. May cause hematologic effects.

Quinupristin-dalfopristin
(Synercid)
Bactericidal against Staph and Strep. Bacteriostatic against Enterococcus faecium
Vancomycin
(Vancocin)
Glycopeptide antibiotic. Bactericidal for all susceptible isolates except bacteriostatic for enterococci. Acts synergistically w/ aminoglycosides against enterococci.


FQ
Ciprofloxacin (Cipro)
Enoxacin (Penetrex)
Gatifloxacin (Tequin)
Lavofloxacin (Levaquin)
Lomefloxacin (Maxaquin)
Norfloxacin (Noroxin)
Ofloxacin (Floxin)
Sparfloxacin (Zagam)
Trovafloxacin (Trovan)
Bactericidal agents
Cephalosporins
FQ
AG
Penicillins
Imipenem


Bacteriostatic agents
Macrolides
Tetracyclines
Sulfonamides
Capreomycin (Capasat)
Clindamycin (Cleocin)
Active against most aerobic G (+) and most anaerobic G(-).
Has induced C. difficile
Carbapenems
Imipenem-Cilastin (Primaxin)
Meropenem (Merrem)
Aminosalicylic acid, Pyrazinamide
Active against Mycobacterium tuberculosis only

Agents agains mycobacterium species

Capreomycin (Capasat), Cycloserine (Seromycin), Ethambutol (Myambutol), Ethionamide (Trecator-SC), Isoniazid, Rifampin
Concentration dependant bacterial killing
AG, FQ,
Agents effecttive against systemic fungal infections
Amphoteracin B (Fungizone), Caspofungin (Cancidas), Fluconazole (Diflucan), Itraconazole (Sporanox), Voriconazole (Vfend)
Time dependent bacterial killing
Penicillins, Cephalosporins
Tetracyclines
DOC for atypical pneumonias
Atypical coverage
Macrolides, 3rd generation FQ
Meningitis
Empiric Tx
Newborn- 1 month
 Ampicillin + AG or Cefotaxime or Ceftriaxone

Coverage for:
GNB (E.coli)
Group B strep
L. monocytogenes

Meningitis
Empiric Tx
1 month- 60 y/o
Cefotaxime or Ceftriaxone AND Vancomycin

Coverage for:
H. influenzae
N meningitidis
S. pneumoniae
Meningits
Empiric Tx
>60 y/o
Ampicillin and AG/Vancomycin or Cefotaxime or Ceftriaxone

Coverage for:
S. pneumoniae
GNB (E.coli)
L. monocytogenes
Endocarditis Tx
Coverage for:
Strep and Staph species

Strep:
PCN G alone or w/ gentamicin or Ceftriaxone alone or Vanc (if PCN allergy)

Staph (Not MRSA):
W/ prosthetic: Nafcillin or Oxacillin or Cefazolin or Vanc

MRSA: Vanc


Bronchitis bacterial pathogens
Mycoplasma pneumoniae, S. pneumoniae, H. influenzae, M. catarrhalis, Chlamydia pneumoniae
Hepatitis B
Lamivudine + Interferon alpha-2b
Hepatitis C
Chronic- IF alpha-2b + Ribavirin

Acute- IF aplpha-2b
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