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Antibiotics - Coggle Diagram
Antibiotics
Cell Wall Synthesis
PCN, Cephalosporins, Carbapenems, Aztreonam, Vancomycin, Televancin, Oritavancin, Dalbavancin
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Aminoglycosides, Tetracyclines
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Erythromycin, Clindamycin, Linezolid, Tedizolid, Telithromycin
Cell Wall Synthesis
PCN, Cephalosporins, Carbapenems, Aztreonam, Vancomycin, Televancin, Oritavancin, Dalbavancin
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-
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-
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Aminoglycosides, Tetracyclines
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Erythromycin, Clindamycin, Linezolid, Tedizolid, Telithromycin
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- Pip/Tazo (Zosyn) 4.5 g IV q6h
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- Aztreonam β only covers Gram (-) and pseudomonas
- If MRSA risk then ADD β Vancomycin, Linezolid, Tedizolid
- Greater activity for Gram (-)
- HENPEKS β H. Influenzae, Enterobacter, Neisseria, Proteus, E. Coli, Klebsiella, Strep. Pneumonia
- 2nd Line for Otitis media (1st line is Amoxicillin)
- Cefuroxime (Ceftin) PO/IM/IV
- Anaerobic coverage β B. Fragilis
- Side chain that can cause increased bleeding risk and disulfiram reaction
-
- Anaerobic coverage β B. Fragilis
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- Pip/Tazo (Zosyn) 4.5 g IV q6h
-
-
-
-
- Aztreonam β only covers Gram (-) and pseudomonas
- If MRSA risk then ADD β Vancomycin, Linezolid, Tedizolid
- Greater activity for Gram (-)
- HENPEKS β H. Influenzae, Enterobacter, Neisseria, Proteus, E. Coli, Klebsiella, Strep. Pneumonia
- 2nd Line for Otitis media (1st line is Amoxicillin)
- Cefuroxime (Ceftin) PO/IM/IV
- Anaerobic coverage β B. Fragilis
- Side chain that can cause increased bleeding risk and disulfiram reaction
-
- Anaerobic coverage β B. Fragilis
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- Streptococcus β pairs/ chains
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-
- Pyogenes (Group A Strep β GAS)
- Agalactine (Group B Strep β GBS)
1 Cause of Neonatal Meningitis
- Pneumoniae (Pneumococcus) β Strep pneumoniae
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- E. Coli β most common cause
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- Penicillinase Resistant PCN β (DON)
- Used for Staphylococcus Aureus MSSA
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- Dicloxacillin PO EMPTY STOMACH
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- Hepatic elimination, No renal dose adjustment needed
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- Ophthalmic solution (Eyes)
-
- Discontinue if patient gets RASH
-
-
-
- Vigamox β ophthalmic solution TID
- Ophthalmic suspension (SHAKE)
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- Covers MRSA, Strep, E. Coli, Klebsiella, Pseudomonas, Enterobacter, CAP
- Bone Marrow β Anemia, Leukopenia, Thrombocytopenia
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- SJS (Rash), Photosensitivity
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-
- Crystal formation β drink water
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-
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- E. Coli β most common cause
-
-
-
-
- Penicillinase Resistant PCN β (DON)
- Used for Staphylococcus Aureus MSSA
-
-
- Dicloxacillin PO EMPTY STOMACH
-
- Hepatic elimination, No renal dose adjustment needed
-
- Ophthalmic solution (Eyes)
-
- Discontinue if patient gets RASH
-
-
-
- Vigamox β ophthalmic solution TID
- Ophthalmic suspension (SHAKE)
-
- Covers MRSA, Strep, E. Coli, Klebsiella, Pseudomonas, Enterobacter, CAP
- Bone Marrow β Anemia, Leukopenia, Thrombocytopenia
-
- SJS (Rash), Photosensitivity
-
-
- Crystal formation β drink water
-
-
-
-
1 Cause of Neonatal Meningitis
- Screening during pregnancy at 35-37 weeks
- Tx: Ampicillin or Penicillin G during contractions to prevent baby sepsis
- Mild PCN Allergy: IV Cefazolin
- Severe PCN Allergy: IV Clindamycin
- Pneumoniae (Pneumococcus)
1 Cause of many infections above the diaphragm β CAP, Otitis Media (middle ear infection), Bacterial Sinusitis, Meningitis
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- Normal Flora, can cause effective endocarditis and dental procedures
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- Used in VRE, MRSA, and other Gram (+)
- ADR: Thrombocytopenia (βPlatelets), Peripheral neuropathy, optic neuropathy
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-
-
-
-
-
1 Cause of Neonatal Meningitis
- Screening during pregnancy at 35-37 weeks
- Tx: Ampicillin or Penicillin G during contractions to prevent baby sepsis
- Mild PCN Allergy: IV Cefazolin
- Severe PCN Allergy: IV Clindamycin
- Pneumoniae (Pneumococcus)
1 Cause of many infections above the diaphragm β CAP, Otitis Media (middle ear infection), Bacterial Sinusitis, Meningitis
-
- Normal Flora, can cause effective endocarditis and dental procedures
-
- Used in VRE, MRSA, and other Gram (+)
- ADR: Thrombocytopenia (βPlatelets), Peripheral neuropathy, optic neuropathy
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-
-
-
-
-
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- Normal GI flora β large intestine
- Traditional: Ampicillin + Gentamicin
- Newer: Ampicillin + Ceftriaxone
- Ampicillin Resistant: Vancomycin + Gentamicin
- VRE: Daptomycin, Linezolid, Televancin, Ortivancin
-
- Pseudomonas β gram (-) and lactose (-)
- Bladder β Acute Cystitis
- Kidney β Pyelonephritis
- Cystic Fibrosis Pneumonia, Swimmers ear
-
- Antipseudomonal PCN: Pip/Tazo (Zosyn)
- Antipseudomonal Cephalosporin: Ceftazidime (Fortaz, Tizicet), Cefepime (Maxipime), Cefiderocol (Fetroja)
- Ceftazidime + Avibactam β Avycaz
- Ceftolozane + Tazobactam β Zebrax
- Carbapenems: Doripenem, Meropenem, Imipenem
- Fluoroquinolones: Ciprofloxacin, Levofloxacin
-
- Treponema Pallidum: β Syphilis
-
- Testing: Rapid Plasma Reign (RPR), VDRL
- Primary: Painless genital ulcer (early)
- Secondary: Rash on palms and soles
-
- Tertiary: Heart or CNS effects (neurosyphilis)
- Primary, Secondary, Latent
- Parental PCN G β Benzathine (Bicillin-LA) IM once 2.4 mill/units
- PCN ALLERGY: Doxycycline 100 mg PO BID 21d (or Ceftriaxone)
- Desensitize to PCN: if pregnant or HIV+ with poor compliance
- Heart: Bicillin-LA IM weekly for 3 weeks
- CNS (neurosyphilis): Penicillin G IV q4hrs for 10-14d
- Borrelia Burgdorferi: Lyme disease
-
- Deer ticks β north west and north eastern areas
- Prophylaxis: Doxycycline 200 mg PO once
- Tx: Doxycycline, Amoxicillin or Cefuroxime (Ceftin)
- Early localized β 10-14d
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-
- Neurological β Doxycycline PO or Ceftriaxone IV 14-21d
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- PO: 500 mg q8hr empty stomach
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- PEK β Proteus, E. Coli (UTI), Klebsiella
- Good for UTI and pregnancy 500 mg BID
- DOC for surgical prophylaxis
- Doxycycline (Vibramycin, Adoxa, Oracea)
- WITH FOOD and 8 oz water, sit up for 30 min
- Great in renal impairment
- Used in CAP and Lyme Disease (14d for lyme disease)
- Dosing: 100-200 mg PO qd-BID
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-
-
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- Streptococcus β pairs/ chains
- Pyogenes (Group A Strep β GAS)
- Agalactine (Group B Strep β GBS)
1 Cause of Neonatal Meningitis
- Pneumoniae (Pneumococcus) β Strep pneumoniae
-
-
-
-
- Normal GI flora β large intestine
- Traditional: Ampicillin + Gentamicin
- Newer: Ampicillin + Ceftriaxone
- Ampicillin Resistant: Vancomycin + Gentamicin
- VRE: Daptomycin, Linezolid, Televancin, Ortivancin
-
- Pseudomonas β gram (-) and lactose (-)
- Bladder β Acute Cystitis
- Kidney β Pyelonephritis
- Cystic Fibrosis Pneumonia, Swimmers ear
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- Antipseudomonal PCN: Pip/Tazo (Zosyn)
- Antipseudomonal Cephalosporin: Ceftazidime (Fortaz, Tizicet), Cefepime (Maxipime), Cefiderocol (Fetroja)
- Ceftazidime + Avibactam β Avycaz
- Ceftolozane + Tazobactam β Zebrax
- Carbapenems: Doripenem, Meropenem, Imipenem
- Fluoroquinolones: Ciprofloxacin, Levofloxacin
-
- Treponema Pallidum: β Syphilis
-
- Testing: Rapid Plasma Reign (RPR), VDRL
- Primary: Painless genital ulcer (early)
- Secondary: Rash on palms and soles
-
- Tertiary: Heart or CNS effects (neurosyphilis)
- Primary, Secondary, Latent
- Parental PCN G β Benzathine (Bicillin-LA) IM once 2.4 mill/units
- PCN ALLERGY: Doxycycline 100 mg PO BID 21d (or Ceftriaxone)
- Desensitize to PCN: if pregnant or HIV+ with poor compliance
- Heart: Bicillin-LA IM weekly for 3 weeks
- CNS (neurosyphilis): Penicillin G IV q4hrs for 10-14d
- Borrelia Burgdorferi: Lyme disease
-
- Deer ticks β north west and north eastern areas
- Prophylaxis: Doxycycline 200 mg PO once
- Tx: Doxycycline, Amoxicillin or Cefuroxime (Ceftin)
- Early localized β 10-14d
-
-
- Neurological β Doxycycline PO or Ceftriaxone IV 14-21d
-
-
-
- PO: 500 mg q8hr empty stomach
-
-
- PEK β Proteus, E. Coli (UTI), Klebsiella
- Good for UTI and pregnancy 500 mg BID
- DOC for surgical prophylaxis
- Doxycycline (Vibramycin, Adoxa, Oracea)
- WITH FOOD and 8 oz water, sit up for 30 min
- Great in renal impairment
- Used in CAP and Lyme Disease (14d for lyme disease)
- Dosing: 100-200 mg PO qd-BID
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-
-
-
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- Staphylococcus β clusters
- Tx: Dicloxacillin PO, Nafcillin IM/IV, Oxacillin IM/IV
- PO: Bactrim, Doxycycline, Clindamycin
- Others: Linezolid (Zyvox), Tedizolid (Sivextro), Delafloxacin (Baxdela)
- IV: Vancomycin (1st Line), Clindamycin, Linezolid, Tedizolid, Delafloxacin, Daptomycin (Cubicin), Ceftaroline (Teflaro), Vancins (Telavancin)
- MRSA Pneumonia Tx: Vancomycin, Linezolid, Televancin
- Impetigo β skin infection with honey colored crust (superficial, on face)
- Tx: Mupirocin (Bactroban) Ointment/Cream
- Also used in MRSA Colonization Eradication
- Epidermidis β coagulase (-)
-
- Saprophyticus β coagulase (-)
-
- Airborne droplets, contact, tissue damage from toxin
- Toxin β Pseudomembrane back to tonsils
- Tx: Antitoxin + Antibiotic
-
- Close contact prophylaxis
- Contaminated dairy or vegetables
- Infection spreads to blood and causes Sepsis or Meningitis (Neonatal Meningitis)
- Tx: Ampicillin + Gentamicin
- PCN Allergy: Bactrim, Vancomycin, Quinolones
- Bladder β Acute Cystitis
- Kidney β Pyelonephritis
- Urosepsis (from kidneys into the bloodstream) β Septic Shock
- E. Coli Diarrhea, most abundant in colon and feces
- Causes Neonatal Meningitis
Note PPI dosed BID and watch for clarithromycin resistance. What would you use with clarithromycin resistance?
- Triple Therapy: Clarithromycin + Amoxicillin (PCN Allergy: Metronidazole) + PPI-BID (Lansoprazole, Omeprazole, Pantoprazole) β Prevpac
- Bismuth Quadruple Therapy: Metronidazole + Tetracycline + Bismuth + PPI-BID β Pylera
- Contamination Therapy: Clarithromycin + Amoxicillin + Metronidazole + PPI-BID
- Otitis Media, Meningitis, Pneumonia
-
- Tx: Ceftriaxone or Cefotaxime
- Chlamydiae Trachomatis: β Genital Chlamydia
- Intracellular Gram (-) Bacterium. Less discharge than gonorrhea
- Tx: Doxycycline 100 mg PO BID 7d
- Alternative: Azithromycin 1g PO ONCE β Preferred in pregnancy
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-
- Prevention of Neonatal Blindness: Erythromycin Ophthalmic Ointment
- No cell wall, can't use a gram stain
-
- Tx: Macrolides or Doxycycline
- Alternative: 3rd/4th Generation Quinolones
- Bicillin-LA (Benzathine PCN)
-
- Indication: GAS, Syphilis
- Not used in Neurosyphilis
- Only drug used in patients with Syphilis and Pregnant
- Amoxicillin + Clavulanate (Augmentin)
- PO, Chewable, Suspension β RF 10d, RT 6 hrs
-
- Antibiotic with the most ADR of Diarrhea
- DO NOT take 2 of the lower doses to make a higher dose β Calvulanate Acid will accumulate causing severe Diarrhea
- Enhanced Gram (-) activity
- RT β do not RF the suspension
- Seperate antacids/multivitamins/iron by >2 hrs
-
-
- Ceftazidime (Fortaz, Tazicef) IM/IV
- Antipseudomonal (Pseudomonas), intraabdominal, and HAP, UTI
- Ceftazidime + Avibactam (B-lactamase) β Avycaz IV
-
- Ceftriaxone (Rocephin) IM/IV
- Meningitis/Endocarditis β 2 g IV q12h
- Gonorrhea β 500 mg IM, give 1 g if >150 kg
- IM in glutes β with lidocaine to decrease pain
- Do not reconstitute with Ca products β like lactated ringers
-
- Cephalosporins that cover Pseudomonas
- Ceftazidime (Fortaz, Tazicef) β 3rd gen IM/IV
- Cefepime β 4th gen IM/IV
- Ceftolozane + Tazobactam (Zerbaxa) β 5th gen β given with Metronidazole
-
- Primaxin (Imipenem + Cilastatin)
- Imipenem causes most seizures
-
- Cilastin prevents renal metabolism of Imipenem
-
-
- No activity against Pseudomonas or Enterococcus
- AUC/Trough: AUC dependent (time dependent) killing MIC
-
-
- Trough: 10-20 mcg/mL β Trough is more important than peak
- Trough is drawn at steady state 30 min before 4th dose
- If a patient has Bacteremia, endocarditis, osteomyelitis, meningitis, HAP (from Staph. Aureus) trough levels should be 15-20 mcg/mL
-
-
- Ciprofloxacin (Cipro, Cipro XR, ProQuin XR)
- PO, IV, Otic (ear), Ointment (eye)
- Oral Suspension β NEVER through NG tube
- NG Tube β Crush IR for use
- PO β 250-500 mg q12h β XR qd dosing
-
-
-
- CrCl <30 β 200-500 mg q18-24h
- Can increase levels of Theophylline and Warfarin
- Respiratory quinalone β good for pneumonia
- Clarithromycin (Biaxin, Biaxin XL)
-
- Dose: 250-500 BID or 1000 mg qd (XL β WITH FOOD)
-
- βLevels of Carbamazepine, Digoxin, Lovastatin, Simvastatin, Theophylline
-
- 200 mg once, then 100 mg BID WITH FOOD and 8 oz water
- ADR: Hepatotoxicity, Lupus
-
- ADR: Photosensitivity, avoid Ca products and antacids
- AVOID: PREGNANCY (teeth staining), Children <8 yo (temporary stunting of growth)
-
- Bactrim β SULFA ALLERGY
- Nitrofurantoin β CrCl <60
- Uncomplicated UTI (Cystitis only)
-
- Dose: Complicated SSTI, Abdominal Infections
- IV β RF 45 hr, reconstitute at RT 24 hr
-
- <8 yo β tooth discoloration
- Monitor INR (βINR) β warfarin
-
- Double Strength β 800/160 (SMX/TMP)
-
-
-
-
- Tx: 15-20 mg/kg/d TMP q6h 14-21d
- Prophylaxis (CD4 <200): 1 DS BID
-
Voriconazole (VFend)
-
Inhibits glucan synthesis inhibit glucan synthase activity disrupting Ξ²-(1,3)-d-glucan synthesis, leading to fungal cell death caused by cell wall instability.
-
-
-
- Oral and esophageal candidiasis
-
- Dandruff, Tinea Versicolor β Shampoo
-
-
- Zanamivir (Relenza Diskhaler)
- Caution in asthma/COPD and Milk protein allergy
-
-
-
-
- Staphylococcus β clusters
- Tx: Dicloxacillin PO, Nafcillin IM/IV, Oxacillin IM/IV
- PO: Bactrim, Doxycycline, Clindamycin
- Others: Linezolid (Zyvox), Tedizolid (Sivextro), Delafloxacin (Baxdela)
- IV: Vancomycin (1st Line), Clindamycin, Linezolid, Tedizolid, Delafloxacin, Daptomycin (Cubicin), Ceftaroline (Teflaro), Vancins (Telavancin)
- MRSA Pneumonia Tx: Vancomycin, Linezolid, Televancin
- Impetigo β skin infection with honey colored crust (superficial, on face)
- Tx: Mupirocin (Bactroban) Ointment/Cream
- Also used in MRSA Colonization Eradication
- Epidermidis β coagulase (-)
-
- Saprophyticus β coagulase (-)
-
- Airborne droplets, contact, tissue damage from toxin
- Toxin β Pseudomembrane back to tonsils
- Tx: Antitoxin + Antibiotic
-
- Close contact prophylaxis
- Contaminated dairy or vegetables
- Infection spreads to blood and causes Sepsis or Meningitis (Neonatal Meningitis)
- Tx: Ampicillin + Gentamicin
- PCN Allergy: Bactrim, Vancomycin, Quinolones
- Bladder β Acute Cystitis
- Kidney β Pyelonephritis
- Urosepsis (from kidneys into the bloodstream) β Septic Shock
- E. Coli Diarrhea, most abundant in colon and feces
- Causes Neonatal Meningitis
Note PPI dosed BID and watch for clarithromycin resistance. What would you use with clarithromycin resistance?
- Triple Therapy: Clarithromycin + Amoxicillin (PCN Allergy: Metronidazole) + PPI-BID (Lansoprazole, Omeprazole, Pantoprazole) β Prevpac
- Bismuth Quadruple Therapy: Metronidazole + Tetracycline + Bismuth + PPI-BID β Pylera
- Contamination Therapy: Clarithromycin + Amoxicillin + Metronidazole + PPI-BID
- Otitis Media, Meningitis, Pneumonia
-
- Tx: Ceftriaxone or Cefotaxime
- Chlamydiae Trachomatis: β Genital Chlamydia
- Intracellular Gram (-) Bacterium. Less discharge than gonorrhea
- Tx: Doxycycline 100 mg PO BID 7d
- Alternative: Azithromycin 1g PO ONCE β Preferred in pregnancy
-
-
- Prevention of Neonatal Blindness: Erythromycin Ophthalmic Ointment
- No cell wall, can't use a gram stain
-
- Tx: Macrolides or Doxycycline
- Alternative: 3rd/4th Generation Quinolones
- Bicillin-LA (Benzathine PCN)
-
- Indication: GAS, Syphilis
- Not used in Neurosyphilis
- Only drug used in patients with Syphilis and Pregnant
- Amoxicillin + Clavulanate (Augmentin)
- PO, Chewable, Suspension β RF 10d, RT 6 hrs
-
- Antibiotic with the most ADR of Diarrhea
- DO NOT take 2 of the lower doses to make a higher dose β Calvulanate Acid will accumulate causing severe Diarrhea
- Enhanced Gram (-) activity
- RT β do not RF the suspension
- Seperate antacids/multivitamins/iron by >2 hrs
-
-
- Ceftazidime (Fortaz, Tazicef) IM/IV
- Antipseudomonal (Pseudomonas), intraabdominal, and HAP, UTI
- Ceftazidime + Avibactam (B-lactamase) β Avycaz IV
-
- Ceftriaxone (Rocephin) IM/IV
- Meningitis/Endocarditis β 2 g IV q12h
- Gonorrhea β 500 mg IM, give 1 g if >150 kg
- IM in glutes β with lidocaine to decrease pain
- Do not reconstitute with Ca products β like lactated ringers
-
- Cephalosporins that cover Pseudomonas
- Ceftazidime (Fortaz, Tazicef) β 3rd gen IM/IV
- Cefepime β 4th gen IM/IV
- Ceftolozane + Tazobactam (Zerbaxa) β 5th gen β given with Metronidazole
-
- Primaxin (Imipenem + Cilastatin)
- Imipenem causes most seizures
-
- Cilastin prevents renal metabolism of Imipenem
-
-
- No activity against Pseudomonas or Enterococcus
- AUC/Trough: AUC dependent (time dependent) killing MIC
-
-
- Trough: 10-20 mcg/mL β Trough is more important than peak
- Trough is drawn at steady state 30 min before 4th dose
- If a patient has Bacteremia, endocarditis, osteomyelitis, meningitis, HAP (from Staph. Aureus) trough levels should be 15-20 mcg/mL
-
-
- Ciprofloxacin (Cipro, Cipro XR, ProQuin XR)
- PO, IV, Otic (ear), Ointment (eye)
- Oral Suspension β NEVER through NG tube
- NG Tube β Crush IR for use
- PO β 250-500 mg q12h β XR qd dosing
-
-
-
- CrCl <30 β 200-500 mg q18-24h
- Can increase levels of Theophylline and Warfarin
- Respiratory quinalone β good for pneumonia
- Clarithromycin (Biaxin, Biaxin XL)
-
- Dose: 250-500 BID or 1000 mg qd (XL β WITH FOOD)
-
- βLevels of Carbamazepine, Digoxin, Lovastatin, Simvastatin, Theophylline
-
- 200 mg once, then 100 mg BID WITH FOOD and 8 oz water
- ADR: Hepatotoxicity, Lupus
-
- ADR: Photosensitivity, avoid Ca products and antacids
- AVOID: PREGNANCY (teeth staining), Children <8 yo (temporary stunting of growth)
-
- Bactrim β SULFA ALLERGY
- Nitrofurantoin β CrCl <60
- Uncomplicated UTI (Cystitis only)
-
- Dose: Complicated SSTI, Abdominal Infections
- IV β RF 45 hr, reconstitute at RT 24 hr
-
- <8 yo β tooth discoloration
- Monitor INR (βINR) β warfarin
-
- Double Strength β 800/160 (SMX/TMP)
-
-
-
-
- Tx: 15-20 mg/kg/d TMP q6h 14-21d
- Prophylaxis (CD4 <200): 1 DS BID
-
Voriconazole (VFend)
-
Inhibits glucan synthesis inhibit glucan synthase activity disrupting Ξ²-(1,3)-d-glucan synthesis, leading to fungal cell death caused by cell wall instability.
-
-
-
- Oral and esophageal candidiasis
-
- Dandruff, Tinea Versicolor β Shampoo
-
-
- Zanamivir (Relenza Diskhaler)
- Caution in asthma/COPD and Milk protein allergy
-
-
- Gram (+) β thick cell wall, turn purple (violet)
- Gram-Positive π‘ͺ purPle
- Use catalase test, if positive it is Staph
- If postive then use coagulase test, if coagulase positive it is Staph aureus
- Facium M = More resistant
-
-
- Vaccine for high risk and military
- Tx: Antitoxin + Ciprofloxacin, Doxycycline, Clindamycin, Meopenem, Linezolid
- Clostridium β anaerobes
- Give Tetanus Toxoid Vaccine (Td or Tdap 3 doses 2 weeks apart)
- Soil, enters in wounds and produces toxin
-
-
- Spore forming β clean with soap and water
- Contact Precautions β Wash (soap), Gown, Gloves
- All antibiotics can cause C.Diff
- Vancomycin 125 mg PO QID for 10d
-
- Meningitidis (Meningitis)
- Signs: HA, Neck Rigidity, Fever, N/V, light sensitivity, altered mental status
-
- Tx: Empiric Treatment ASAP
- Adults: Ceftriaxone + Vancomycin (D/C Vanc after 48 hrs)
- If >50 yo + Ampicillin (covers Listeria)
- (+/-) Dexamethasone (decreases inflammation around brain)
- Tx: Ceftriaxone 500 mg IM (glute), if >150 kg give 1000 mg (1 g) IM
- If Chlamydia is not excluded + Doxycycline 100 mg PO BID 7d
- Cephalosporin Allergy: Azithromycin 2 g + Gentamicin (240 mg IM) (320 mg PO)
- Neonatal Blindness Tx: Erythromycin Ophthalmic Ointment
- Diagnosis β Urea Breath Test
-
- Most common below diaphragm, important colon bug
- Other: Carbapenems, B-Lactamase Inhibitor Combos β Amp/Sulbactam, Meropenem, Cefoxitin
- Bacterial: Strep. Pneumo (Pneumococcus β #1 CAUSE), H. Influenza, Moraxella, E.Coli, Klebsiella, Mycoplasma, Chlamydia
- Viral: Influenza, RSV, Rhinovirus
-
- HIVES: Cephalosporin 3rd generation + Doxycycline + Macrolide
- PCN Allergy (not hives): Levofloxacin + Doxycycline + Macrolide
- ER Amox/Clav (Augmentin) + Macrolide
- If Macrolide Allergy: Augmentin + Doxycycline
- PCN Allergy (HIVES): Cephalosporin 3rd generation + Macrolide
- If Macrolide Allergy: Cephalosporin 3rd generation + Doxycycline
-
- Haemophilus Influenzae β type b
-
-
-
- Acute Cystitis β bladder
- Bactrim β Avoid in 1st trimester or at term and SULFA ALLERGY
- Nitrofurantoin (Macrobid) β young healthy female, not pregnant, CrCl <60
-
-
- Cephalexin or amox DOC for pregnancy
-
- Prostatitis (28d), Pyelonephritis (10-14d)
-
- Symptoms: Fever, Chills, N/V, Flank Pain
-
-
- Bicillin C-R (Probenicine + Benzathine)
-
-
-
- Indication: Pneumococcal, Meningitis, Neurosyphilis, Anthrax
- Amoxicillin (Montag ER, Amoxil)
-
- Otitis Media β 90 mg/kg/d
- Strep Throat β Montag ER 775 mg PO qd
- Dental Prophylaxis β 2 g PO (50 mg/kg) 1 hr before
- Piperacillin + Tazobactam (Zosyn)
-
- Covers everything Pseudomonas
-
-
-
- Dosing: Based on total body weight
-
- Severe Staph, Endocarditis
- IV doses are given over 1 hr β 1 g IV q12h
-
- MD: 15-20 mg/kg over 1hr q8-12h
- CrCl 20-49 β 15-20 mg/kg qd
- CrCl <20 Serum concentration
- Peak (highest amount in body): 5-10
- Trough (lowest amount in body): <2
-
- RT 12 hr or RF 48 hr β NS or LR
- Each vial is single use only
- Cant be used in lungs, binds to surfactant in lungsβ not for MRSA Pneumonia
- Can be used in MRSA Skin infections
- Alternatives: for Gram (+)
-
-
- MSSA, Gram (-), atypicals
- Respiratory tract (CAP), SSTI, UTI
-
- ADR: βINR, hypoglycemia, False (+) drug test, confusion
-
- Azithromycin (Zithromax, Z-Pak, ZMAX)
- Z-Pak β 500 mg on day 1, then 250 mg on days 2-5 β 6 pills for 5 days
- ZMAX β RT use within 12hrs, must be mixed at pharmacy
- Chlamydia and Gonorrhea β 1 g once
- MAC Prophylaxis (CD4 <50)β 1200 mg qweek
- ADR: Hearing loss, βQTc
-
-
- IV qd over 60 min (to reduce Red Man Syndrome β increased histamine release Tx with Benadryl)
- ADR: fetal risk, nephrotoxicity, N/V, βQTc
- Warfarin β βINR (decrease warfarin dose 25-50%)
- Rifampin β βBactrim levels
-
-
- IV β D5W, Protect from light, RF 1 week, RT 24h
- Lipid β Amphotec, Abelcet, AmBisome
-
- Onychomycosis (infection of nails)
- Finger Nails β 250 mg PO qd for 6 weeks
- Toe Nails β 250 mg PO qd for 12 weeks
- ADR: HA, angina, confusion, N/V/D
-
- 1st episode: 200 mg 5x a day for 10d
- Recurrence: 200 mg 5x a day for 5d
-
- Zoster: 800 mg 5x a day for 7d
- Varicella: 800 mg QID for 5d
- Fecal oral transmission from contaminated food or water (international travel)
- Hep A Vaccine β Vaqta, Havrix, Twinrix (Hep A + Hep B)
- Blood transmission (vertical, sexual)
- Hep B Vaccine β Engerix-B, Recombivax HB, Twinrix (Hep A + Hep B)
- Blood Transmission (IV drug users)
-
- Gram (+) β thick cell wall, turn purple (violet)
- Gram-Positive π‘ͺ purPle
- Use catalase test, if positive it is Staph
- If postive then use coagulase test, if coagulase positive it is Staph aureus
- Facium M = More resistant
-
-
- Vaccine for high risk and military
- Tx: Antitoxin + Ciprofloxacin, Doxycycline, Clindamycin, Meopenem, Linezolid
- Clostridium β anaerobes
- Give Tetanus Toxoid Vaccine (Td or Tdap 3 doses 2 weeks apart)
- Soil, enters in wounds and produces toxin
-
-
- Spore forming β clean with soap and water
- Contact Precautions β Wash (soap), Gown, Gloves
- All antibiotics can cause C.Diff
- Vancomycin 125 mg PO QID for 10d
-
- Meningitidis (Meningitis)
- Signs: HA, Neck Rigidity, Fever, N/V, light sensitivity, altered mental status
-
- Tx: Empiric Treatment ASAP
- Adults: Ceftriaxone + Vancomycin (D/C Vanc after 48 hrs)
- If >50 yo + Ampicillin (covers Listeria)
- (+/-) Dexamethasone (decreases inflammation around brain)
- Tx: Ceftriaxone 500 mg IM (glute), if >150 kg give 1000 mg (1 g) IM
- If Chlamydia is not excluded + Doxycycline 100 mg PO BID 7d
- Cephalosporin Allergy: Azithromycin 2 g + Gentamicin (240 mg IM) (320 mg PO)
- Neonatal Blindness Tx: Erythromycin Ophthalmic Ointment
- Diagnosis β Urea Breath Test
-
- Most common below diaphragm, important colon bug
- Other: Carbapenems, B-Lactamase Inhibitor Combos β Amp/Sulbactam, Meropenem, Cefoxitin
- Bacterial: Strep. Pneumo (Pneumococcus β #1 CAUSE), H. Influenza, Moraxella, E.Coli, Klebsiella, Mycoplasma, Chlamydia
- Viral: Influenza, RSV, Rhinovirus
-
- HIVES: Cephalosporin 3rd generation + Doxycycline + Macrolide
- PCN Allergy (not hives): Levofloxacin + Doxycycline + Macrolide
- ER Amox/Clav (Augmentin) + Macrolide
- If Macrolide Allergy: Augmentin + Doxycycline
- PCN Allergy (HIVES): Cephalosporin 3rd generation + Macrolide
- If Macrolide Allergy: Cephalosporin 3rd generation + Doxycycline
-
- Haemophilus Influenzae β type b
-
-
-
- Acute Cystitis β bladder
- Bactrim β Avoid in 1st trimester or at term and SULFA ALLERGY
- Nitrofurantoin (Macrobid) β young healthy female, not pregnant, CrCl <60
-
-
- Cephalexin or amox DOC for pregnancy
-
- Prostatitis (28d), Pyelonephritis (10-14d)
-
- Symptoms: Fever, Chills, N/V, Flank Pain
-
-
- Bicillin C-R (Probenicine + Benzathine)
-
-
-
- Indication: Pneumococcal, Meningitis, Neurosyphilis, Anthrax
- Amoxicillin (Montag ER, Amoxil)
-
- Otitis Media β 90 mg/kg/d
- Strep Throat β Montag ER 775 mg PO qd
- Dental Prophylaxis β 2 g PO (50 mg/kg) 1 hr before
- Piperacillin + Tazobactam (Zosyn)
-
- Covers everything Pseudomonas
-
-
-
- Dosing: Based on total body weight
-
- Severe Staph, Endocarditis
- IV doses are given over 1 hr β 1 g IV q12h
-
- MD: 15-20 mg/kg over 1hr q8-12h
- CrCl 20-49 β 15-20 mg/kg qd
- CrCl <20 Serum concentration
- Peak (highest amount in body): 5-10
- Trough (lowest amount in body): <2
-
- RT 12 hr or RF 48 hr β NS or LR
- Each vial is single use only
- Cant be used in lungs, binds to surfactant in lungsβ not for MRSA Pneumonia
- Can be used in MRSA Skin infections
- Alternatives: for Gram (+)
-
-
- MSSA, Gram (-), atypicals
- Respiratory tract (CAP), SSTI, UTI
-
- ADR: βINR, hypoglycemia, False (+) drug test, confusion
-
- Azithromycin (Zithromax, Z-Pak, ZMAX)
- Z-Pak β 500 mg on day 1, then 250 mg on days 2-5 β 6 pills for 5 days
- ZMAX β RT use within 12hrs, must be mixed at pharmacy
- Chlamydia and Gonorrhea β 1 g once
- MAC Prophylaxis (CD4 <50)β 1200 mg qweek
- ADR: Hearing loss, βQTc
-
-
- IV qd over 60 min (to reduce Red Man Syndrome β increased histamine release Tx with Benadryl)
- ADR: fetal risk, nephrotoxicity, N/V, βQTc
- Warfarin β βINR (decrease warfarin dose 25-50%)
- Rifampin β βBactrim levels
-
-
- IV β D5W, Protect from light, RF 1 week, RT 24h
- Lipid β Amphotec, Abelcet, AmBisome
-
- Onychomycosis (infection of nails)
- Finger Nails β 250 mg PO qd for 6 weeks
- Toe Nails β 250 mg PO qd for 12 weeks
- ADR: HA, angina, confusion, N/V/D
-
- 1st episode: 200 mg 5x a day for 10d
- Recurrence: 200 mg 5x a day for 5d
-
- Zoster: 800 mg 5x a day for 7d
- Varicella: 800 mg QID for 5d
- Fecal oral transmission from contaminated food or water (international travel)
- Hep A Vaccine β Vaqta, Havrix, Twinrix (Hep A + Hep B)
- Blood transmission (vertical, sexual)
- Hep B Vaccine β Engerix-B, Recombivax HB, Twinrix (Hep A + Hep B)
- Blood Transmission (IV drug users)
-
- Gram (-) β thin cell wall, turn pink
-
- Atypicalls β do not have a cell wall and do not stain- use acid fast test
-
-
-
- Dental Prophylaxis β Amoxicillin 2 g PO 30-60 min before
- PCN Allergy β Cephalexin 2 g or Azithromycin 500 mg or Clarithromycin 500 mg or Doxycycline 100 mg
- Cellulitis β Strep and MSSA
-
- Abscess β enclosed sack full of pus that needs to be drained β MRSA
- Tx: Topical β Bactrim, Doxycycline, Clindamycin
- Diverticulosis β Formation of small bulging pouches in the colon wall
-
- Diverticulitis β infection of these small bulging pouches
- Tx: cover E. Coli and B. Fragilis
- Ciproflocacin or Levofloxacin + Metronidazole
-
- Amoxicillin + Clavulanate (Augmentin)
-
-
Cefaclor (Ceclor), Cephalexin (Keflex)
-
- Probenecid β used to prolong PCN Levels
-
- Penicillin V (Pen-Vee K, Veetids)
-
- Ampicillin + Sulbactam (Unysin)
-
-
- Cefepime (Maxipime) IM/IV
- Gram (+), Gram (-), Pseudomonas
-
- Only cephalosporin that covers MRSA Skin infection
-
- Ceftolozane + Tazobactam (Zerbaxa) IV
-
- ADR: Seizures, super-infections (fungal pathogens)
- AVOID with SEIZURES β can decrease Valproic Acid levels (seizure med)
-
- Aztreonam (Azactam) IV/IM
- Use if nephrotoxicity to aminoglycosides
- Spectrum: MRSA, All Gram (+)
-
- ADR: Ototoxicity, Nephrotoxicity, Red Man Syndrome
- Red Man Syndrome β histamine release due to rapid infusion. Treat with Diphenhydramine. Do not discontinue due to Red Man Syndrome.
- MOA: Inhibits protein synthesis, Ribosomal Subunit 30S
- Concentration dependent killing β peaks are more important
- ADR: Nephrotoxicity, Ototoxicity, Neuromuscular Block
- Avoid in patients (kids) that have tubes in their ears due to Ototoxicity
- ADR: Neuropathy, Myopathy
- Stop Statin while using Daptomycin β restart Statin upon discharge due to myopathy
- ADR: HA, dizzy, Seizures, agitation, delirium, Nephrotoxicity (crystalluria), phototoxicity, βQTc, peripheral neuropathy, hyper/hypoglycemia
- BOX: Tendon Rupture (especially if on a corticosteroid)
- Drug-Drug: Avoid with antacids and vitamins, βWarfarin effects (bleeding), βSulfonylureas and Insulin effects (Hypoglycemia)
- Give Medications ALONE (quinolone) β seperate from antacids and vitamins
-
-
- <8yo β tooth discoloration
- Suspension β RT and Shake
- Spectrum: UTI, Gram (-) β EXCEPT pseudomonas, proteus
- Uncomplicated UTI (Cystitis only)
- Dose: 100 mg PO BID 7d WITH FOOD
- Qd dosing is for prophylaxis
-
- IV single dose infused over 3 hours
-
-
- D5W (5 mL added to 125 mL D5W)
-
- Cloudy or crystals β TRASH
- Multi-dose vials are good for 48 hrs
- Spectrum: Gram (-), PCP, MRSA, UTI (uncomplicated)
- DOC in PCP (prophylaxis when CD4 <200)
- If SULFA Allergy give Dapsone or Atovaquone
-
- Oropharyngeal-Esophageal Thrush
- Nystatin βswish and swallowβ or Fluconazole
- Azole Fungal creams or Fluconazole (diflucan) 150 mg PO once
- Vision β 0.25% miconazole + Zn Oxide
- Fluconazole or Itraconazole
-
-
- Lamisil Cream 1% OTC qd/BID 1-4 weeks
-
- Gram (-) β thin cell wall, turn pink
-
- Atypicalls β do not have a cell wall and do not stain- use acid fast test
-
-
-
- Dental Prophylaxis β Amoxicillin 2 g PO 30-60 min before
- PCN Allergy β Cephalexin 2 g or Azithromycin 500 mg or Clarithromycin 500 mg or Doxycycline 100 mg
- Cellulitis β Strep and MSSA
-
- Abscess β enclosed sack full of pus that needs to be drained β MRSA
- Tx: Topical β Bactrim, Doxycycline, Clindamycin
- Diverticulosis β Formation of small bulging pouches in the colon wall
-
- Diverticulitis β infection of these small bulging pouches
- Tx: cover E. Coli and B. Fragilis
- Ciproflocacin or Levofloxacin + Metronidazole
-
- Amoxicillin + Clavulanate (Augmentin)
-
-
Cefaclor (Ceclor), Cephalexin (Keflex)
-
- Probenecid β used to prolong PCN Levels
-
- Penicillin V (Pen-Vee K, Veetids)
-
- Ampicillin + Sulbactam (Unysin)
-
-
- Cefepime (Maxipime) IM/IV
- Gram (+), Gram (-), Pseudomonas
-
- Only cephalosporin that covers MRSA Skin infection
-
- Ceftolozane + Tazobactam (Zerbaxa) IV
-
- ADR: Seizures, super-infections (fungal pathogens)
- AVOID with SEIZURES β can decrease Valproic Acid levels (seizure med)
-
- Aztreonam (Azactam) IV/IM
- Use if nephrotoxicity to aminoglycosides
- Spectrum: MRSA, All Gram (+)
-
- ADR: Ototoxicity, Nephrotoxicity, Red Man Syndrome
- Red Man Syndrome β histamine release due to rapid infusion. Treat with Diphenhydramine. Do not discontinue due to Red Man Syndrome.
- MOA: Inhibits protein synthesis, Ribosomal Subunit 30S
- Concentration dependent killing β peaks are more important
- ADR: Nephrotoxicity, Ototoxicity, Neuromuscular Block
- Avoid in patients (kids) that have tubes in their ears due to Ototoxicity
- ADR: Neuropathy, Myopathy
- Stop Statin while using Daptomycin β restart Statin upon discharge due to myopathy
- ADR: HA, dizzy, Seizures, agitation, delirium, Nephrotoxicity (crystalluria), phototoxicity, βQTc, peripheral neuropathy, hyper/hypoglycemia
- BOX: Tendon Rupture (especially if on a corticosteroid)
- Drug-Drug: Avoid with antacids and vitamins, βWarfarin effects (bleeding), βSulfonylureas and Insulin effects (Hypoglycemia)
- Give Medications ALONE (quinolone) β seperate from antacids and vitamins
-
-
- <8yo β tooth discoloration
- Suspension β RT and Shake
- Spectrum: UTI, Gram (-) β EXCEPT pseudomonas, proteus
- Uncomplicated UTI (Cystitis only)
- Dose: 100 mg PO BID 7d WITH FOOD
- Qd dosing is for prophylaxis
-
- IV single dose infused over 3 hours
-
-
- D5W (5 mL added to 125 mL D5W)
-
- Cloudy or crystals β TRASH
- Multi-dose vials are good for 48 hrs
- Spectrum: Gram (-), PCP, MRSA, UTI (uncomplicated)
- DOC in PCP (prophylaxis when CD4 <200)
- If SULFA Allergy give Dapsone or Atovaquone
-
- Oropharyngeal-Esophageal Thrush
- Nystatin βswish and swallowβ or Fluconazole
- Azole Fungal creams or Fluconazole (diflucan) 150 mg PO once
- Vision β 0.25% miconazole + Zn Oxide
- Fluconazole or Itraconazole
-
-
- Lamisil Cream 1% OTC qd/BID 1-4 weeks
-
-
-
-
-
-
-
-
-
-
-
-
- Pseudomonas β gram (-) and lactose (-)
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
- Outpatient PO, Inpatient IV
-
-
-
-
-
-
-
- Causes: Staph. Aureus, Strep. Viridians, Enterococcus, Candida, Pseudomonas
- Vegetations are shown by echocardiogram, 3 sets of blood cultures
-
-
- Erysipelas β red border is very sharp
-
-
-
-
-
-
-
-
- Strep Agalactiae (Group B Strep β GBS)
-
-
- Pneumococcus β Strep Pneumo
-
-
-
Erythromycin, Azithromycin
-
-
- 2nd trimester and most of 3rd
-
-
-
- Birth defects in 1st trimester
-
-
-
-
- Avoid in 1st trimester due to birth defects
-
- Avoid Avoid in 1st trimester due to cardiac birth defect. Avoid during delivery
-
-
-
-
-
-
-
-
- MOA: Inhibit cell wall synthesis, renally eliminated
- ADR: Bronchospasm, Seizure, Diarrhea, HIVES, Renal
-
-
- Bicillin C-R and Bicillin L-A CAN NOT BE SWITCHED
- Spectrum: Strep, Treponema Pallidum (Syphilis), dental prophylaxis/infection
-
- Spectrum: Strep, Enterococci, Listeria
-
-
- Used in combo to broaden coverage.
- 1st Line for Strep throat
-
- 1st Line for Otitis Media
- DOC for infective endocarditis
-
-
- 1st Line for Otitis Media
-
-
- DOC for Syphilis and Pregnant
-
-
-
-
- Close structurally to PCN, B-lactam antibiotic
- ADR: Seizures, GI upset, Diarrhea
-
-
-
-
- Otitis media, CAP, sinus infections
-
-
-
-
-
-
-
-
-
-
- CAP, Meningitis, Pyelonephritis
-
-
-
-
-
-
-
-
-
-
- Hospital use only β All IV
- Extended Spectrum B-lactamase (ESBL)
- Good in Intra-abdominal infections, DOC for infectious pancreatitis
- Meropenem + Vaborbactam (Vabomere)
-
- MOA: Inhibits cell wall synthesis
- Spectrum: Aerobic Gram (-) only including Pseudomonas
-
-
- MOA: inhibits synthesis of cell wall phospholipids
- Good to use in PCN Allergy
-
-
- Trough β drawn 30 min before 4th dose
- Peak β drawn 30 in after 4th dose ends β peaks are more important for these drugs
-
- MOA: Binds to cell membrane and causes rapid depolarization. Inhibition of Protein, DNR, RNA, without cell lysis.
-
- MOA: Inhibits Bacterial DNA gyrase
- Indications: CAP, UTI, STD
- Spectrum: Gram (-), Atypicals (mycoplasma, legionella, chlamydia)
- CI: Pregnancy, Children <18 yo, patients with myasthenia gravis
-
- MOA: Binds to ribosomal subunit 50S
-
-
-
-
- MOA: Inhibits protein synthesis, Binds to 30S
- Spectrum: Gram (+) and (-) Aerobes, Mycoplasma, Chlamydia, Syphilis (in PCN ALLERGY)
- Caution: photosensitivity, βINR with warfarin, βPO contraceptives effects
-
- MOA: Inhibits protein synthesis, binds to 50S
- Gram (+) and all Anaerobes
- Avoid Erythromycin, and decrease dose in renal
-
-
- MOA: Disruption of bacterial DNA Synthesis
- Spectrum: C. Diff, B. Fragilis, Giardia
-
- ADR: Disulfiram reaction, dark urine, metallic taste, Seizures, furry tongue, neuropathy
- IV β RF, if crystals re-disolve at RT, NS, Protect from light
-
-
- ADR: Brown urine, hepatotoxicity, pulmonary toxicity, peripheral neuropathy
-
- Simple uncomplicated UTI in women
- 3 g single dose packet in Β½ Cup (4 oz) water
-
-
-
-
- MOA: inhibits protein synthesis
- Covers VRE, MRSA, and other Gram (+)
- ADR: Myalgia, Arthralgia, Venous irritation
- Covers E. Faecium ONLY β saved usually for VRE UTI of this sort only due to ADRs
-
-
-
- IBS-D (Irritable bowel syndrome with diarrhea)
- Prevention of hepatic encephalopathy
-
-
-
-
- MOA: inhibits cell wall synthesis
-
Trimethoprim + Sulfamethoxazole (Bactrim, Septra DS): β SULFA ALLERGY
- MOA: Inhibits bacterial dihydrofolate reductase, sulfonamide for synergism, inhibition of folic acid pathway
-
-
-
-
-
-
-
-
- Esophageal, oral, vaginal thrush, skin infections (Diaper Rash)
-
- Bird droppings (bats and pigeons), Decaying wood
-
-
- DOC: Voriconazole (VFend)
-
-
-
- MOA: Binds to ergosterol (cell membrane)
- ADR: Chills, HoTN, Nephrotoxicity, Shaking, βK, βMg
- Premedicate β Acetaminophen, Diphenhydramine, Hydrocortisone, Meperidine
-
- MOA: CYP3A4 Inhibitor, Cell membrane
-
-
-
-
-
-
-
- Varicella (Zoster) β Chickenpox and Shingles
-
-
-
-
-
-
-
-
-
- Tx: Acyclovir (Zorivax), Valacyclovir (Valtrex), Famicyclovir
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
- Pseudomonas β gram (-) and lactose (-)
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
- Outpatient PO, Inpatient IV
-
-
-
-
-
-
-
- Causes: Staph. Aureus, Strep. Viridians, Enterococcus, Candida, Pseudomonas
- Vegetations are shown by echocardiogram, 3 sets of blood cultures
-
-
- Erysipelas β red border is very sharp
-
-
-
-
-
-
-
-
- Strep Agalactiae (Group B Strep β GBS)
-
-
- Pneumococcus β Strep Pneumo
-
-
-
Erythromycin, Azithromycin
-
-
- 2nd trimester and most of 3rd
-
-
-
- Birth defects in 1st trimester
-
-
-
-
- Avoid in 1st trimester due to birth defects
-
- Avoid Avoid in 1st trimester due to cardiac birth defect. Avoid during delivery
-
-
-
-
-
-
-
-
- MOA: Inhibit cell wall synthesis, renally eliminated
- ADR: Bronchospasm, Seizure, Diarrhea, HIVES, Renal
-
-
- Bicillin C-R and Bicillin L-A CAN NOT BE SWITCHED
- Spectrum: Strep, Treponema Pallidum (Syphilis), dental prophylaxis/infection
-
- Spectrum: Strep, Enterococci, Listeria
-
-
- Used in combo to broaden coverage.
- 1st Line for Strep throat
-
- 1st Line for Otitis Media
- DOC for infective endocarditis
-
-
- 1st Line for Otitis Media
-
-
- DOC for Syphilis and Pregnant
-
-
-
-
- Close structurally to PCN, B-lactam antibiotic
- ADR: Seizures, GI upset, Diarrhea
-
-
-
-
- Otitis media, CAP, sinus infections
-
-
-
-
-
-
-
-
-
-
- CAP, Meningitis, Pyelonephritis
-
-
-
-
-
-
-
-
-
-
- Hospital use only β All IV
- Extended Spectrum B-lactamase (ESBL)
- Good in Intra-abdominal infections, DOC for infectious pancreatitis
- Meropenem + Vaborbactam (Vabomere)
-
- MOA: Inhibits cell wall synthesis
- Spectrum: Aerobic Gram (-) only including Pseudomonas
-
-
- MOA: inhibits synthesis of cell wall phospholipids
- Good to use in PCN Allergy
-
-
- Trough β drawn 30 min before 4th dose
- Peak β drawn 30 in after 4th dose ends β peaks are more important for these drugs
-
- MOA: Binds to cell membrane and causes rapid depolarization. Inhibition of Protein, DNR, RNA, without cell lysis.
-
- MOA: Inhibits Bacterial DNA gyrase
- Indications: CAP, UTI, STD
- Spectrum: Gram (-), Atypicals (mycoplasma, legionella, chlamydia)
- CI: Pregnancy, Children <18 yo, patients with myasthenia gravis
-
- MOA: Binds to ribosomal subunit 50S
-
-
-
-
- MOA: Inhibits protein synthesis, Binds to 30S
- Spectrum: Gram (+) and (-) Aerobes, Mycoplasma, Chlamydia, Syphilis (in PCN ALLERGY)
- Caution: photosensitivity, βINR with warfarin, βPO contraceptives effects
-
- MOA: Inhibits protein synthesis, binds to 50S
- Gram (+) and all Anaerobes
- Avoid Erythromycin, and decrease dose in renal
-
-
- MOA: Disruption of bacterial DNA Synthesis
- Spectrum: C. Diff, B. Fragilis, Giardia
-
- ADR: Disulfiram reaction, dark urine, metallic taste, Seizures, furry tongue, neuropathy
- IV β RF, if crystals re-disolve at RT, NS, Protect from light
-
-
- ADR: Brown urine, hepatotoxicity, pulmonary toxicity, peripheral neuropathy
-
- Simple uncomplicated UTI in women
- 3 g single dose packet in Β½ Cup (4 oz) water
-
-
-
-
- MOA: inhibits protein synthesis
- Covers VRE, MRSA, and other Gram (+)
- ADR: Myalgia, Arthralgia, Venous irritation
- Covers E. Faecium ONLY β saved usually for VRE UTI of this sort only due to ADRs
-
-
-
- IBS-D (Irritable bowel syndrome with diarrhea)
- Prevention of hepatic encephalopathy
-
-
-
-
- MOA: inhibits cell wall synthesis
-
Trimethoprim + Sulfamethoxazole (Bactrim, Septra DS): β SULFA ALLERGY
- MOA: Inhibits bacterial dihydrofolate reductase, sulfonamide for synergism, inhibition of folic acid pathway
-
-
-
-
-
-
-
-
- Esophageal, oral, vaginal thrush, skin infections (Diaper Rash)
-
- Bird droppings (bats and pigeons), Decaying wood
-
-
- DOC: Voriconazole (VFend)
-
-
-
- MOA: Binds to ergosterol (cell membrane)
- ADR: Chills, HoTN, Nephrotoxicity, Shaking, βK, βMg
- Premedicate β Acetaminophen, Diphenhydramine, Hydrocortisone, Meperidine
-
- MOA: CYP3A4 Inhibitor, Cell membrane
-
-
-
-
-
-
-
- Varicella (Zoster) β Chickenpox and Shingles
-
-
-
-
-
-
-
-
-
- Tx: Acyclovir (Zorivax), Valacyclovir (Valtrex), Famicyclovir
-
-
-
-