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Created by Bennett WaxseGram PositiveGram NegativeAnaerobesEmpiric TherapyAdverse Effects (precautions)Other infoPKPDDosing
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Updated 7/10/2021MRSAMSSAS. epiVGSS. pneuGABSGBBSEnterocListeriaPsArStenoAcinetSerrCitrobEnterobProviProtE. coliKlebsH. influM. cat.Neiss.Legion.B. fragPrevo.C. diffPeptos.Actino.
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For corrections or comment, contact meGPCGPCGPCGPCGPCGPCGPCGPCGPRGNRGNRGNRGNRGNRGNRGNRGNRGNRGNRGNCBGNDCGNDCGNRGNRGNRGPRGPCGPR
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More med school reference docs herefacfacfacfacfacfacfacaerotolfacfacfacfacfacfacfacfacfacfacaerfacobobobobfac
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nitroimidazolemetronidazole-----------------------+++±-BV, PID, mild CDI, Trich, Giardia, Entam.NVD, metallic taste, neuropathy, QTc prolongationGI flora disturbance (VRE risk)
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lincosamideclindamycin+*++±+++-----------------+-++TSS, nec fac, SSTI, oral ifn, Plasm., PJP, toxoD, hyperbilirubinemia, rash, ↑ CDI risk
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cyclic lipopeptide
daptomycin+*++++++VRE-----------------++-SSTI, R-sided IE (S. aureus), VRE, PNAHTN, edema, muscle pain (check CK), rhabdoStandard MIC not definedconc
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glycopeptidevanc, telavancin+*++*+*++++*+----------------+*+-Sepsis, CAP, MRSA, IE, SSTI, OM, CDIVFS, nephrotoxicity, linear IgA bullous dematosisHigh troughs a/w nephrotoxicityAUC
load 20-25 mg/kg, maint. 15-20 mg/kg q8-12h
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oxazolidinonelinezolid, tedizolid+*++++*++VRE+-----------------++MRSA, VRE, SSTI, UTI, MDR TB, NocardiaCN I damage, p. neuropathy, SS, BM suppressionHepatic clearanceIV/PV 600 mg q12h
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streptograminsquinu-/dalfopristin++++++VRE----------MRSA, VRE (not first line)myalgia, althralgia, phlebitis (central line only)
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macrolidefidaxomicin---------------------+CDIN, V, abd painSpares GI floraAUC
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erythromycin-±-+++-+-------±+++±+Colorectal decontaminationNVD (prokinetic), hepatic effects, P450 inhibitors (azithro), QTc prolongation (less dramatic)Poor CNS penetration
Minimal renal clearance
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azithro, clarithromycin-±-±++-+-------++++±+URT, CAP, atypicals, PID, GU, MAC, H. pylori
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rifamycinrifampin, rifabutin++++++++++++MTB, MAC, PJI, AcinetobacterOrange urine/tears, OCPs don't work, 3A4 inducerBiofilms
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tetracyclinedoxy, minocycline+++±+++-+-----+±++++++URT, atypicals, NTM, Rickettsia, spirochetes, QF, Plasmodium, SSTI/bioterrorism alt.Photosensitivity, esophageal irritation (swallow w/ water, standing), bone development & discoloration of developing teeth (tetracycline), dizziness (mino)Chelate cation, tetracycline renal clearance, doxy hepatic and renalAUC
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tetracycline+*++------+±++++++
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glycylcyclinetigecycline+++++++VRE+-+----+±+++++Atypicals, complicated polymicrobial ifn, VRELarge Vd (low bloodstream conc.)
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folate antagonistTMP-SMX+*++-±±±-+*-++±+±±±±++±+-SSTI, PJP, UTI, Listeria, Nocardia, Toxo, Stenorash, BM suppression, renal*, G6PD hemolysisWarfarin interaction, lg vol. IVF
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penicillinpenicillin G/V---++*+*+++------------++Syphilis, nec fac (S. pyogenes)Rash, ↓ seizure thresholdFrequent dosingtime
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antistaph PCNoxacillin, nafcillin, diclox-+*+±+++------------+-MSSA bacteremia/IE, OM, CNS ifnsAIN (urine eosinophils), phlebitisHepatic elimination (not renal)
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aminopenicllinamp, amox---±++++*+*----±±-±-±--+++URT (pharyngitis, AOM)Urticarial mobiliform rash, angioedema, SJS, diarrhea (PO)
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amp/sulb, amox/clav-+-±++++*+*-+---++*+*+++-++++
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1st-gen cephcefazolin, cephalexin-+*-++++----±++±-SSTI, surgical PPx, MSSA bacteremia/IE, OMAll cephalosporins: rash (2% PCN cross-reactivity), cytopenias, mild cholestasisNo CNS penetration
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2nd-gen cephcefuroxime, cefprozil-+-++++---+++++±-URT, CAP, GU, Borrelia
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cephamycincefoxitin, cefotetan-+-++++---+++++±-++Above + abd surgery PPxN-MTT side chains (cefotetan) blocks Vit K prod
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3rd-gen cephcefotax (ctx), cefdinir-++++++--±°++++±-++Sepsis, meningitis, abd ifn, UTI, CAP3rd gen: C. diff risk, GNR resistance
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ceftriaxone (cfo)-+*+++++--±°+++++-+++ gonorrhea, LymeCrystals (lungs, kidney), biliary sludging in neonatesBiliary & renal elimination
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ceftazidime (caz)-±-±+*++--++++±-+++ febrile neutropenia, nosocomial, - meningitis
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BLBLIceftaz/avibactam-±-±+*++--+++++±-++Nosocomial ifn, ESBL, CRE (KPC, NDM)Significant resistance among gut anaerobes
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ceftolozane/tazo-±-±+*++--+++++±-++Nosocomial ifn, ESBL (KPC, NDM)
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antiMRSA cephceftaroline (cpt)+*+*++++++-±+++++++++-+HCAP, SSTI > bacteremia, IE, meningitis, OMPositive Coombs (without hemolysis)
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4th-gen cephcefepime (fep)-++++++--+*+++*++++++--+ab ifn, HCAP, SSTI, pyelo, febrile neutropeniaNeurotoxicity, less GNR resistance than 3rd gen
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siderophore cephcefiderocolclinical cure similar, but ↑ mortality
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antiPsAr PCNticar/clav, pip/tazo-++±++++++*++++++*++++-+++HCAP, intra-abd ifn, diabetic foot ifn, sepsisN, D, Cinferior to meropenem for ESBL
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carbapenammeropenam-++++++±++*-+++++++++++-+++++Aerobe/anaerobe, ESBL, HCAP, febrile neutropenia, nosocomial ifn, Nocardia (V)ok to use with PCN allergymeropenem/vaborbactam (CRE, PsAr)
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imipenem/cilastatin-+++++++++*-++++*--+++++-+++++↑↑ seizure riskimi/cila/relebactam (PsAr, ESBL, CRE)
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ertapenam-++++++-±---+++++++++-+++++Pelvic ifns, CAP, ab ifn, UTI, ESBL
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monobactamaztreonam---------+*+*+*+*+*+*+*+*+*+*------HCAP, CAP, sepsis, gyn, NDMRash, TEN, N, V, D, neutropenia, transaminitisOnly cross-reactive with CTZ
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fluroquinoloneciprofloxacin--+-+++++++++++++±-Abd ifn, GU, PsAr, anthrax, OM, atypicalsTendonitis/rupture, ↑ QTc prolongation, ↑ CDI risk, neuropathy (+ dizziness, confusion, hallucinations), photosensitivity, dev. defects, G6PD hemolysisChelate cations, so do not take with Ca, Fe, antacids, MVI, or milk. Cleared renally (moxi).conc
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levofloxacin-++++*+*+*+*++++++++++++++Everything above and below
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moxifloxacin-++++*+*+*+*+++++++++++++CAP, abd ifn, GU, SSTI, OM, atypicals
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nitrofurantoin & fosfomycin+++++++±+++±-+++ prostatitis, cystitis Tx and PPx (ø CrCl < 50)NV, pneumonitis, pulm. fibrosis, G6PD hemolysis
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aminoglycosideamikacin------++++*+++*+-----Febrile neutropenia, CF exac., IE, OM, UTI, MDR TB, Nocardia (V)Nephrotoxicity, dose-related cochlear/vestibular toxicity↑ urine, ↓ lung, abscess, CNS distribution
HD removes 30-40%
conc
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tobramycin, gentamicin------++++±++*+-----
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polymyxinscolistin, polymyxin B---------+++---+--------ESBL, CFAKI, ATN (colistin > polymyxin B), neurotoxicitydiffering pharmacokinetics