Antibiotic Basics: Difference between revisions
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==Beta-Lactams== | ==Beta-Lactams== | ||
*''' | *'''[[Penicillins]]''' | ||
** Strep Pharyngitis (including scarlet fever) Streptococcal Toxic Shock and Necrotizing Fascitis | ** Strep Pharyngitis (including scarlet fever) Streptococcal Toxic Shock and Necrotizing Fascitis | ||
*** Penicillin ''plus'' clindamycin (to decrease toxin synthesis) | *** Penicillin ''plus'' clindamycin (to decrease toxin synthesis) | ||
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*** Little allergic cross-reactivity with B-lactam antibiotics | *** Little allergic cross-reactivity with B-lactam antibiotics | ||
==Aminoglycosides== | ==[[Aminoglycosides]]== | ||
* Gentamicin, amikacin, streptomycin (either alone or with B-lactam) | * Gentamicin, amikacin, streptomycin (either alone or with B-lactam) | ||
** Serious gram-negative bacillary infections | ** Serious gram-negative bacillary infections | ||
| Line 64: | Line 64: | ||
* Caution: Use in patients with Myasthenia Gravis, can precipitate crisis | * Caution: Use in patients with Myasthenia Gravis, can precipitate crisis | ||
==Sulfonamides== | ==[[Sulfonamides]]== | ||
* Trimethoprim-sulfamethoxazole | * Trimethoprim-sulfamethoxazole | ||
** 1st line for uncomplicated lower UTI (especially chronic and recurrent infections) | ** 1st line for uncomplicated lower UTI (especially chronic and recurrent infections) | ||
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** Maxillary sinusitis | ** Maxillary sinusitis | ||
==Fluoroquinolones== | ==[[Fluoroquinolones]]== | ||
* UTI (2nd line) | * UTI (2nd line) | ||
* Prostatitis | * Prostatitis | ||
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* Traveler's diarrhea | * Traveler's diarrhea | ||
==Tetracyclines== | ==[[Tetracyclines]]== | ||
* Mycoplasma | * Mycoplasma | ||
* Chlamydia | * Chlamydia | ||
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* Anthrax | * Anthrax | ||
==Macrolides== | ==[[Macrolides]]== | ||
* Erythromycin, Clarithromycin, Azithromycin | * Erythromycin, Clarithromycin, Azithromycin | ||
** Community-acquired PNA | ** Community-acquired PNA | ||
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** Traveler's diarrhea (children and pregnant women) | ** Traveler's diarrhea (children and pregnant women) | ||
==Clindamycin== | ==[[Clindamycin]]== | ||
* Drug of choice for lung abscess and anaerobic lung and pleural space infections | * Drug of choice for lung abscess and anaerobic lung and pleural space infections | ||
* Toxin-mediated disease, i.e. toxic shock syndrome (TSS) | * Toxin-mediated disease, i.e. toxic shock syndrome (TSS) | ||
Revision as of 23:37, 10 February 2014
Beta-Lactams
- Penicillins
- Strep Pharyngitis (including scarlet fever) Streptococcal Toxic Shock and Necrotizing Fascitis
- Penicillin plus clindamycin (to decrease toxin synthesis)
- Meningococcus Meningitis
- Syphilis (Primary, 2ndary, and latent syphilis < 1 year duration)
- Actinomycosis
- Anthrax
- Clostridial infections
- Listeria
- Pasteurella
- Strep Pharyngitis (including scarlet fever) Streptococcal Toxic Shock and Necrotizing Fascitis
- Penicilinase-Resistant Penicillins
- Nafcillin, oxacillin, dicloxacillin
- Agents of 1st choice for treatment of S. aureus and S. epidermidis that are not methicillin-reistant
- Nafcillin, oxacillin, dicloxacillin
- Expanded-Spectrum Penicillins
- Ampicillin, amoxicillin (+ clavulanate)
- Upper Respiratory Infections (due to S. pyogenes, S. pneumoniae, H. influenzae)
- Sinusitis
- Otitis media
- Acute exacerbation of chronic bronchitis
- Listeria
- Upper Respiratory Infections (due to S. pyogenes, S. pneumoniae, H. influenzae)
- Ampicillin, amoxicillin (+ clavulanate)
- Antipseudomonal Penicillins
- Piperacillin
- Infection following burns
- Neutropenia
- Piperacillin
- 1st Gen Cephalosporins
- Cefazolin, Cephalexin
- Skin and soft tissue infections (why is agent of choice before gen sx)
- Cross-reactivity of PCN allergy <10%
- Cefazolin, Cephalexin
- 2nd Gen Cephalosporins
- Cefuroxime
- Intestinal anaerobes (why is agent of chioce for colorectal sx)
- Largely displaced by 3rd gen agents
- Cefuroxime
- 3rd Gen Cephalosporins
- Ceftriaxone, Ceftazidime, Cefixime
- Drug of choice for serious infections due to:
- Klebsiella
- Enterobacter
- Proteus
- Haemophilus
- Gonorrhea
- Lyme disease
- Meningitis (+ vanc and ampicillin)
- Pseudomonas meningitis (+ AG)
- Drug of choice for serious infections due to:
- Ceftriaxone, Ceftazidime, Cefixime
- 4th Gen Cephalosporins
- Cefepime
- Resistant, nosocomial infections
- Cefepime
- Carbapenems
- Imipenem (+ cilastatin), meropenem
- Cephalosporin-resistant nosocomial bacteria
- Empirical treatment of serious infections in patients who recently received other b-lactams
- Imipenem (+ cilastatin), meropenem
- Aztreonam
- Antimicrobial activity more closely resembles AG's (only active against gram -)
- Enterobacter, pseudomonas, H. influenzae, gonococci
- Little allergic cross-reactivity with B-lactam antibiotics
- Antimicrobial activity more closely resembles AG's (only active against gram -)
Aminoglycosides
- Gentamicin, amikacin, streptomycin (either alone or with B-lactam)
- Serious gram-negative bacillary infections
- Ill patient with pyelonephritis
- Meningitis (due to Pseudomonas, Acinetobacter)
- Peritoneal Dialysis–Associated Peritonitis
- Bacterial endocarditis?
- Serious gram-negative bacillary infections
- Caution: Use in patients with Myasthenia Gravis, can precipitate crisis
Sulfonamides
- Trimethoprim-sulfamethoxazole
- 1st line for uncomplicated lower UTI (especially chronic and recurrent infections)
- PCP pneumonia
- Acute exacerbations of chronic bronchitis
- Maxillary sinusitis
Fluoroquinolones
- UTI (2nd line)
- Prostatitis
- Chlamydia
- PID
- Traveler's diarrhea
Tetracyclines
- Mycoplasma
- Chlamydia
- PID (combined with cephalosporin)
- Epididymitis
- Anthrax
Macrolides
- Erythromycin, Clarithromycin, Azithromycin
- Community-acquired PNA
- Mycoplasma
- Legionnaires' Disease
- Chlamydia (single dose)
- H. Pylori
- Traveler's diarrhea (children and pregnant women)
Clindamycin
- Drug of choice for lung abscess and anaerobic lung and pleural space infections
- Toxin-mediated disease, i.e. toxic shock syndrome (TSS)
See Also
Source
Goodman & Gilman's Pharmacology
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