Drugs for Bugs Flashcards
(23 cards)
Strep pneumoniae
G+
MACs, TCN, CLIN, LEVO or MOXI
Strep pyogenes
G+
MACs or CLIN
Viridians Strep
G+
CLIN
MSSA
G+
Diclox NOT Penicillin or amoxi/ampic
MRSA
G+
Vanco (or MACs, or TCNs) or Clinda
Nes gonn
G- (cocci)
Ceftriaxone PLUS a MAC or TCN
BECAUSE N gonn transpforms PBPs
E. Coli
G-
amoxi, amox/clav, PIP-TAZ (also cephs, carbas)
E. Coli (TEM-1) & Klebs (SHV-1)
G- (TEM-1 & SHV-1, and bla on SA are narrow spec beta-lactamases)
amox/clav OR PIP-TAZ
as these are paired with B-Lase inhibs
E. Coli (ESBL)
G-
ESBL means cephs (and pens) won’t work
Extended Spectrum Beta Lactamases (plasmid based)
So use carbapenems
Klebs with KPC
G-
KPC means carbapenems don’t work either (along with cephs and pens) …
…so use AGs
Pseudomonas
G-
PIP-TAZO, AGs, 3rd and 4th gen Cephs (NOT ceftriaxone), FQs (not Moxi), Carbas: Imip, Dori & Mero (but not Ertapenem)
C. Diff
Anaerobe
Vanco, Metro
Chlamydia, Mycoplasma
Atypicals
Doxy (a TCN), MACs (also TCNs, and FQs)
No Doxy for kids under 5 y/o?
Bacterioides
Anaerobe
Amox/Clav, Pip-Tazo, Carbas, Clin, Metro ALSO 2nd Gen CEPHs good vs anaerobes
DQCRIMES
Non renal excretion: (hepatoxic/DDI CRIMES)
D - Doxycycline (TCN)
Q - FluoroQuinolones (NOT Cipro, inhibits P450)
C - Clindamycin/chloramphenicol
R - Rifampin
I - Isoniazid
M - Metro (DDI with aldehyde metab - so used for AA)
E - Erythromycin and Clathromycin (DDI with P450 inhib)
S - Streptogramins (inhib p450) & Sulfonamides
IV ONLY
PIP-TAZ, CEF-TRI, VANCO, CARBAPENEMS, AGs
PO (oral)
TCNs & FQs
AGs accumulate …
ear, kidney, urine
TCNs accumulate …
teeth, bones, fetus
Ceftri accumulates …
CSF
MACs accumulate …
Lungs
Clindamycin accumulates …
bones
-Static vs -Cidal
Static: protein synthesis inhibitors except for AGs (they bind irreversibly) This includes MACs, TCNs, Clin
Cidal: AGs, FQs, Metro and NF (the DNA Inhibs), CW inhibs (better in rapidly dividing cells)
