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Antibiotics (Protein Synthesis Inhibitors (Aminoclycosides (Streptomycin,…

- - - - Natural
        
        Penicillin G (IV), Penicillin V (Oral)
        
        (-) Treponema, (+) GAS (incl. pneumococci)
        
        SX: anaphylactic shock, serum sickness, rashes, interstital nephritis, oral lesions
      - AntiStaph
        
        Nafcillin, Oxacillin (iv), Dicloxacillin (oral)
        
        (+) MSSA, (+) Streptococci
        
        Listeria and enterococci are resistant
        
        SX: Naf: neutropenia; Ox: hepatitis
      - Amino
        
        Ampicillin (iv) , Amoxicillin (oral)
        
        More Water soluble, passes through porins
        
        beta lactamase negative Gram + and Gram - Strep,Entero,Helicobacter,Salmonella,ChlamydiamBorrelia,Shigella, Listeria
        
        Does not act against Staph or Pseudomonas
        Used as Empirical therapy with beta lactamase inhibitor
        Augmentin (amox), Unasyn (amp)
        
        SX: skin rash
      - AntiPseu
        
        Piperacillin (iv), Ticarcillin (iv)
        
        aminopenicillin spectrum +
        Pseudomonas,Klebsiella,Bacteroides
        Mainly for Pseu and gram(-)
        
        Zosyn (piper+tazobactam), broadest spectrum
    - - First
        
        Cefazolin (iv), Cephalexin (oral)
        
        Mostly Gram (+) except for MRSA
        
        For surgery prophylaxis
      - Second
        
        Cefoxitin (iv), Cefotetan (iv), Cefprozil (po), Cefuroxime (b)
        
        Gram (-) coverage
        Haemophilus, Neisseria, Klebsiella
        
        Cefoxitin/Cefotetan for anaerobes and B. fragilis
        Cefuroxime for CAP (active against most Strep pneumoniae, and H influenzae
      - Third
        
        Cetriaxone(iv), Cefotaxime(iv), Ceftazidime(iv)
        
        Extended Gram(-) with little (ceftriaxone, cefotaxime) or no (ceftazidime) Gram (+) coverage; poor coverage of S. aureus
        
        Ceftriaxone/Cefotaxime: penicillin-resistant pneumonia
        Cetriaxone for Neisseria
        Ceftazidime for Pseudomonas
        
        All cross BBB except for Cefoperanzone
      - Fourth/Fifth
        
        Cefepime (iv/im), Ceftaroline (iv) [gen V]
        
        Cefepime broad spectrum except for enterococci, Listeria, anaerobes, MRSA
        Ceftaroline MRSA, drug-res Staph, Strep, otherwise like Cetriaxone (III)
        
        NB only 4/5 gen to MRSA
      - Not effective against Listeria and enterococci (ex. Ceftaroline)
        Bacterialcidal
    - - Meropenem (iv), Ertapenem (iv/im)
      - Broad spectrum.
        MRSA and E. faecium, other atypicals, are resistant
      - Bacterialcidal
      - Crosses BBB, short half life as secreted in prox. tub
      - Mostly used for nosocomial infections
        Meropenem for Pseudomonas