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Gram Negative Gram Positive

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Presentation on theme: "Gram Negative Gram Positive"— Presentation transcript:

1 Gram Negative Gram Positive
Two Drug Bugs Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Bacteroides Fragilis – Gut Melanogenicus – Respiratory Bacteroides Oral Anaerobes Clostridium Difficile Anaerobes

2 Penicillin (Pen G, Pen VK) Gram Negative Gram Positive Aerobes MRSA
Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Clostridium Difficile Anaerobes

3 Synthetic Penicillins
Gram Negative Gram Positive Synthetic Penicillins Ampicillin / Amoxicillin Augmentin / Unasyn (w/ beta lactamase inhibitor) Beta Lactamase Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli Beta Lactamase MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Clostridium Difficile Anaerobes

4 Synthetic Penicillins
Gram Negative Gram Positive Synthetic Penicillins Ampicillin / Amoxicillin Nafcillin / Methicillin//Dicloxacillin Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli Beta Lactamase MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Clostridium Difficile Anaerobes

5 Anti-Pseudomonal Penicillins
Gram Negative Gram Positive Anti-Pseudomonal Penicillins Piperacillin Penicillin (Pen G, Pen VK) Zosyn / Timentin (w/ beta lactamase inhibitor) Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella Proteus Mirabilis H. Flu Klebsiella E. Coli Beta Lactamase MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Clostridium Difficile Anaerobes Spotty lines mean spotty coverage, look up individual coverages for SPACE bugs other than Pseudomonas

6 First Generation Cephalosporins
Gram Negative Gram Positive First Generation Cephalosporins Cephalexin, cefazolin, cefadroxil Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Anaerobes

7 Second Generation Cephalosporins
Gram Negative Gram Positive Second Generation Cephalosporins Cefuroxime, Cefotetan, cefoxitin Cephalexin, cefazolin, cefadroxil Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Cefoxitin and Cefotetan only Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Anaerobes

8 Third Generation Cephalosporins
Gram Negative Gram Positive Third Generation Cephalosporins Ceftriaxone, Cefotaxime, Cefdinir Cephalexin, cefazolin, cefadroxil Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Ceftazidime Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Anaerobes

9 Fourth Generation Cephalosporins
Gram Negative Gram Positive Fourth Generation Cephalosporins Cefipime (Maxipime) Cephalexin, cefazolin, cefadroxil Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Anaerobes

10 Carbapenems Meropenem, Imipenem, Ertapenem Gram Negative Gram Positive
Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Ertapenem= No Pseudomonas Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Anaerobes

11 Monobactams Aztreonam Gram Negative Gram Positive Aerobes MRSA MRSE
Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Anaerobes

12 Aminoglycosides Gentamicin, Tobramycin, Amikacin
Gram Negative Gram Positive Aminoglycosides Gentamicin, Tobramycin, Amikacin Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Anaerobes

13 Carbapenems Meropenem, Imipenem, Ertapenem Gram Negative Gram Positive
Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Ertapenem= No Pseudomonas Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Anaerobes

14 Simple Fluroquinolones
Gram Negative Gram Positive Simple Fluroquinolones Ciprofloxacin, Ofloxacin, Norfloxacin Cephalexin, cefazolin, cefadroxil Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Ciproflxoci9n best FQ for Pseudomonas Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Anaerobes Fluroquinolones also cover atypicals like Chlamydia, Legionella and Mycoplasma

15 Simple Fluroquinolones
Gram Negative Gram Positive Simple Fluroquinolones Ciprofloxacin, Ofloxacin, Norfloxacin Cephalexin, cefazolin, cefadroxil Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Ciproflxoci9n best FQ for Pseudomonas Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Anaerobes Fluroquinolones also cover atypicals like Chlamydia, Legionella and Mycoplasma

16 “Respiratory” Fluroquinolones
Gram Negative Gram Positive “Respiratory” Fluroquinolones Levofloxacin Cephalexin, cefazolin, cefadroxil Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE ** Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Anaerobes Fluroquinolones also cover atypicals like Chlamydia, Legionella and Mycoplasma ** Resistance develops quickly

17 “Broad Spectrum” Fluroquinolones
Gram Negative Gram Positive “Broad Spectrum” Fluroquinolones Moxifloxacin Cephalexin, cefazolin, cefadroxil Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Anaerobes Fluroquinolones also cover atypicals like Chlamydia, Legionella and Mycoplasma ** Resistance develops quickly

18 Macrolides Eythromycin, Clarithromycin, Azithromycin
Gram Negative Gram Positive Macrolides Eythromycin, Clarithromycin, Azithromycin Cephalexin, cefazolin, cefadroxil Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Macrolides also cover atypicals like Chlamydia, Legionella and Mycoplasma, Toxoplasmosis

19 Ketolides Telithromyicin Cephalexin, cefazolin, cefadroxil
Gram Negative Gram Positive Ketolides Telithromyicin Cephalexin, cefazolin, cefadroxil Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Macrolides also cover atypicals like Chlamydia, Legionella and Mycoplasma, Toxoplasmosis

20 Tetracyclines Tetracycline, Doxycycline, Minocycline
Gram Negative Gram Positive Tetracyclines Tetracycline, Doxycycline, Minocycline Cephalexin, cefazolin, cefadroxil Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE CA-MRSA Strep Staph VRE Lots of Resistance!! Moderate Activity against anerobes Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Tetracyclines also cover atypicals like Chlamydia, Legionella and Mycoplasma,

21 Gram Negative Gram Positive
Tigecycline Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Tigecylcine also covers atypicals like Chlamydia, Legionella and Mycoplasma,

22 Trimethoprim / Sulfa First Line drug for Community Acquired MRSA
Gram Negative Gram Positive Trimethoprim / Sulfa Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE CA-MRSA Strep Staph VRE Klebsiella/E coli resistance increasing Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile First Line drug for Community Acquired MRSA Also covers Pneumocystis Carinii

23 Vancomycin Gram Negative Gram Positive Aerobes MRSA MRSE CA-MRSA Strep
Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE CA-MRSA Strep Staph VRE Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile

24 Clindamycin Gram Negative Gram Positive Aerobes MRSA MRSE CA-MRSA
Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE CA-MRSA Strep Staph VRE Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile

25 Metronidazole Also Covers Trichomonas Gram Negative Gram Positive
Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE CA-MRSA Strep Staph VRE Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile Also Covers Trichomonas

26 Linezolid Daptomycin Gram Negative Gram Positive Aerobes MRSA MRSE
Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE CA-MRSA Strep Staph VRE Bacteroides Oral Anaerobes Oral Anaerobes Clostridium Difficile

27 Gram Negative Gram Positive
Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Clostridium Difficile Anaerobes

28 Gram Negative Gram Positive
Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Clostridium Difficile Anaerobes

29 Gram Negative Gram Positive
Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Clostridium Difficile Anaerobes

30 Gram Negative Gram Positive
Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Clostridium Difficile Anaerobes

31 Gram Negative Gram Positive
Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Clostridium Difficile Anaerobes

32 Gram Negative Gram Positive
Aerobes Serratia Pseudomonas Acinetobactor Citrobactor Enterobactor Salmonella Shigella H. Flu Klebsiella E. Coli MRSA MRSE Strep Staph VRE Bacteroides Oral Anaerobes Clostridium Difficile Anaerobes


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