Gram Negative Gram Positive

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Presentation transcript:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“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

“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

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

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

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,

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,

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

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

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

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

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

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

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

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

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

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

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