Antibiotic classes
Betalactams: PCN, cephalosporins, carbapenem, aztreonam
Cephalosporins:
First Generation: GPC (except enterococci, MRSA, and coagulase-negative staphylococci), E. coli, Klebsiella pneumoniae, and Proteus mirabilis.
Cefadroxil (Duricef, Ultracef)
Cephalothin (Keflin)
Cephapirin (Cefadyl)
Cephalexin (Keflex)
Cephradine (Velocef, Anspor)
Cefazolin (Ancef, Kefzol)
Second Generation: Less active against GPC than first-generation cephalosporins; more active against some gram-negative organisms such as H. influenzae, Enterobacter spp. and some Proteus spp.
Cefamandole (Mandol)
Cefoxitin (Mefoxin)
Cefotetan
Cefprozil
Cefuroxime (Zinacef)
Ceforanide (Precef)
Cefonicid (Monocid)
Cefaclor (Ceclor)
Loracarbef (Lorabid)
Third Generation: Expanded activity against Gram-negative rods. Cefotaxime and Ceftriaxone have slightly less activity against GPC than first-generation cephalosporins. Ceftazidime and cefoperazone have even less activity against GPC, but are excellent antipseudomonal agents.
Cefotaxime (Claforan)
Moxalactam (Moxam)
Cefixime (Suprax)
Cefoperazone (Cefobid)
Ceftizoxime (Ceftizox)
Ceftazidime (Fortaz)
Tazidine
Ceftriaxone (Rocephin)
Cefipodoxime
Claforan
Cefdinir (Omnicef)
Fourth Generation:
Cefepime (Maxipime): active against gram positives (including MRSA) and gram negatives (including Pseudomonas); not effective against enterococcus.
Listeria, MRSA, and enterococcus are resistant to all forms of cephalosporins.
PID: cefotetan, cefoxitin + doxycyline. Cefotetan can increase the risk of bleeding by depleting prothrombin. Also has disulfiram like reaction with EtOH.
PCNs
First generation:
Benzathine PCN
PCN G Benzathine and PCN G procaine (Bicillin C-R)
PCN G
PCN V
Procaine PCN
Second-generation: Penicillin resistant penicillins (PRPs). Not effective against MRSA or enterococcus. MRSA = resistant to oxacillin.
Dicloxacillin
Naficillin
Oxacillin
Third generation:
Amoxicillin
Hemophilus inf, E. coli, Listeria, Proteus, Salmonella
Augmentin
Ampicillin
Unasyn
Fourth generation:
Piperacillin, ticarcillin, azlocillin, mezlocillin: Covers GNB (E. coli, proteus), from enterobacteriacea group and pseudomonas. Not very effective against anaerobes. Always used with beta-lactamase inhibitor (clavulanate or tazobactam).
Best initial Tx fro cholecystitis, ascending cholangitis, pyelonephritis, bacteremia, HAP, VAP, neutropenic fever
Piperacillin/tazobactam (Zosyn)
Timentin
Quinolones (ciprofloxacin, gemifloxaxin, levofloxacin, moxifloxacin). Best CAP, GNB-pseudomonas.
Cipro for cystitis and pyelo.
Moxi does not enter the urine in high conc
Diverticulitis and GI inf: cipro, gemi - but also needs metronidazole for anaerobic coverage. Moxifloxacin covers anaerobes; can be use as a single agent to treat diverticulitis.
SE: bone growth, tendon rupture
First generation
Naldixic acid (NegGram)
Second generation
Ciprofloxacin
Enoxacin
Lomefloxacin
Norfloxacin
Ofloxacin
Third generation
Levofloxacin (Levaquin)
Fourth generation
Gemifloxacin
Moxifloxacin (Avelox)
Aminoglycosides synergistic with beta-lactam ABx for stap. enterococci. No effect on anaerobes (needs O2 to work). Nephrotoxicity/ototoxicity
Amikacin
Gentamicin
Streptomycin
Tobramycin
Carbapenems
Ertapenem (Invanz)
Imipenem/cilastatin (Primaxin)
Meropenem
Macrolides
Azithromycin
Clarithromycin
Dirithromycin
Erythromycin
Tetracyclines
Doxycycline
Minocycline
Tetracycline
Glycopeptide
Vancomycin
Ketolide
Telithromycin (Ketek)
Monobactam
Aztreonam is a synthetic monocyclic beta-lactam antibiotic (a monobactam). Aztreonam has strong activity against susceptible gram-negative bacteria, including Pseudomonas aeruginosa. It has no useful activity against gram-positive bacteria or anaerobes. It is known to be effective against a wide range of bacteria including Citrobacter, Enterobacter, E. coli, Haemophilus, Klebsiella,Proteus, and Serratia species
Nitrofurantoin has one indication: cystitis in pregnancy
MRSA: vanco, linezolid (reversible BM toxicity), dapto (↑CPK); tigecycline
Minor MRSA skin inf: TMP-SMX, clindamycin, doxycycline
Anaerobes:
Oral PCN VK, ampicillin, amoxicillin, clindamycin - coverage above diaphragm.
GI/Abd: metronidazole
GNB: (citrobacter, enterococcus, E.coli, Klebsiella, pseudomonas, proteus).