Antibiotic Basics: Difference between revisions

Revision as of 23:46, 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
Penicilinase-Resistant Penicillins
- Nafcillin, oxacillin, dicloxacillin
  - Agents of 1st choice for treatment of S. aureus and S. epidermidis that are not methicillin-reistant
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
Antipseudomonal Penicillins
- Piperacillin
  - Infection following burns
  - Neutropenia
1st Gen Cephalosporins
- Cefazolin, Cephalexin
  - Skin and soft tissue infections (why is agent of choice before gen sx)
- Cross-reactivity of PCN allergy <10%
2nd Gen Cephalosporins
- Cefuroxime
  - Intestinal anaerobes (why is agent of chioce for colorectal sx)
  - Largely displaced by 3rd gen agents
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)
4th Gen Cephalosporins
- Cefepime
  - Resistant, nosocomial infections
Carbapenems
- Imipenem (+ cilastatin), meropenem
  - Cephalosporin-resistant nosocomial bacteria
  - Empirical treatment of serious infections in patients who recently received other b-lactams
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

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?
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)

Source

Goodman & Gilman's Pharmacology

Authors:

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 * Drug of choice for lung abscess and anaerobic lung and pleural space infections
 * Toxin-mediated disease, i.e. toxic shock syndrome (TSS)
+{{Template:Clinically Utilized Antibiotics}}
 ==See Also==
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 ==Source==
 Goodman & Gilman's Pharmacology
-{{Template:Clinically Utilized Antibiotics}}
 [[Category:ID]]
 [[Category:Drugs]]