Specific Organism Groups and Their Treatments

wsmithv's version from 2015-07-11 01:09


Question Answer
Gram-Positive Cocci (Staph and Strep) Best initial Therapyoxacillin (IV), Cloxacillin (oral), Dicloxacillin (oral), Nafcillin (IV); first-gen cepholasporins (cefaxzolin, cephalexin); then floroquinolones (particularly for life-threatening penicillin allergies, BUT NOT CIPRO); macrolides (azithromycin, clarifthromycin, erythromycin) are 3rd-line b/c less efficacy than oxa, etc or cephalosporins (erythromycin is also more toxic = vomitting and diarrhea b/c increased motility; makes it good for diabetic gastroparesis)
Oxacillin (Methicillin)-Resistant Staphylococcus Best TXVanc, Linezolid (reversible bone marrow toxicity b/c platelet inhibition), Daptomycin (elevated CPK; not effective for lung); Tigecycline and Ceftaroline (just like each other; both cover pseudomonas, but like vanc+ceftriaxone for MRSA)
Minor (i.e., not blood, brain, heart) MRSA infectios of skin tx'd withTMP/SMX, Clindamycin, doxycycline, linezolid
Oral Anaerobes (above the diaphragm)includes lungs. penicillin (G, VK, ampicillin, amoxicillin) and clindamycin [Ox, Clox, Diclox, and Naf don't have Anaerobic coverage)
Abdominal/Gastrointestinal Anaerobes (Bacteroides Fragilis)Metronidazole (safe in pregnancy), beta-lactam/lactamase combinations
Clindamycin and Metronidazolesafe for vaginal use
Other Drugs for AnaerobesPiperacillin, carbapenems, and second-gen cephalosporins
Gram Negative Bacilli WHAT ARE THEYNon-Curved: E. Coli, Klebsiella, Proteus, Morganella, Serratia, Enterobacter, Citrobacter, Salmonella, Shigella, Pseudomonas --> these cause infections of bowel (peritonitis, diverticulitis), urinary tract (including pyelonephritis) and liver (cholecystitis, cholangitis)

Curved: include Vibrio, Camyplobacter, H Pylori
Gram-Negative Bacilli TXquinolones, aminoglycosides, cabapenems, piperacillin, ticarcillin, aztreonam, 3rd and 4th gen cephalosporins
Gram-Negative Cocci includeNeisseria, H. Flu, H Ducrey, Legionella, Yersinia, Gardnerella, Treponema, Leptospira
Gram-Positive Cocci includeStaph and Strep
Gram-Positive Rods includeCorynebacteria, Bacillus Anthracis and Cereus, Listeria, Clostridium, and Myobacteria