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Sorting Out Antibiotics: A systematic approach to antibiotic selection Kenneth Alexander, M.D., Ph.D. Associate Professor of Pediatrics and Microbiology Duke University Medical Center Durham, North Carolina
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Agents for Infections Due to Gram Positive Bacteria
Staph. epidermidis MRSA Staph. aureus (Group A and Group B) Streptococci GNR RGNR Pseudomonas aeruginosa Penicillin G Penicillin V Methicillin, Oxacillin, Nafcillin, Cloxacillin Dicloxacillin, Cloxacillin Vancomycin Dalfopristin/Quinopristin, Linezolid, Daptomycin Linezolid
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Broad and Extended Spectrum Penicillins
Staph. epidermidis MRSA Staph. aureus (Group A and Group B) Streptococci GNR RGNR Pseudomonas aeruginosa Ampicillin Amoxicillin Carbenicillin, Mezlocillin, Piperacillin, Ticarcillin Ampicillin + Sulbactam = Unasyn® Amoxicillin + Clavulanic Acid = Augmentin® Ticarcillin + Clavulanic Acid = Timentin ®, Piperacillin + Tazobactam = Zosyn®
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Cephalosporins 1st Generation 2nd Generation 3rd Generation
Staph. epidermidis MRSA Staph. aureus (Group A and Group B) Streptococci GNR RGNR Pseudomonas aeruginosa Cefazolin 1st Generation Cephalexin, Cefadroxil Cefuroxime, Cefoxitin Cefaclor, Loracarbef, Ceftibuten Cefprozil, Cefuroxime axetil, Cefpodoxime, Cefdinir 2nd Generation Ceftriaxone, Cefotaxime Cefixime 3rd Generation Ceftazidime Cefepime 4th Generation
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Macrolides, Azalides and Ketolides
Staph. epidermidis MRSA Staph. aureus (Group A and Group B) Streptococci GNR RGNR Pseudomonas aeruginosa Erythromycin Azithromycin Clarithromycin, Azithromycin, Telithromycin
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Broad Spectrum Antibiotics
Staph. epidermidis MRSA Staph. aureus (Group A and Group B) Streptococci GNR RGNR Pseudomonas aeruginosa Gentamicin, Tobramycin, Netilmicin, Amikacin Trimethoprim/Sulfamethoxazole Trimethoprim/Sulfamethoxazole Tetracycline, Doxycycline, Minocycline Tetracycline, Doxycycline, Minocycline, Tigecycline Ciprofloxacin, Levofloxacin, Moxifloxacin, Gatifloxacin Ciprofloxacin, Levofloxacin, Moxifloxacin, Gatifloxicin Imipenem, Meropenem, Ertapenem
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