Antibiotic Basics
Beta-Lactams
- Penicillin
- 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 7% to 18%
- 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 AGs (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