Study Guide - Bacterial Coverage

Question 1

Focused Gram Positive Coverage

Answer 1

1st generation cephalosporins
Antistaphylococcal penicillins
clindamycin
vancomycin

Question 2

Focused Gram Negative Coverage

Answer 2

3rd generation cephalosporins
aminoglycosides
aztreonam
quinolones

Question 3

Excellent Anaerobic Coverage

Answer 3

2nd generation cephalosporins
B-lactamase inhibitor combos
carbapenems
clindamycin
metronidazole
tigecycline

Question 4

Broad Spectrum Therapy

Answer 4

B-lactamase inhibitor combos
carbapenems
tigecycline
cefipime (no anaerobic coverage)

Question 5

Atypical Pathogens

Answer 5

macrolides
quinolones
tetracyclines

Question 6

Pseudomonal Coverage

Answer 6

aminoglycosides
antipseudomonal penicillins
aztreonam
cefipime –4th generation cephalosporins
ceftazidime (Fortaz) –3rd generation cephalosporins
ciprofloxacin

Question 7

MRSA - inpatient therapy

Answer 7

*vancomycin

linezolid (Zyvox)

Question 8

MRSA - community acquired

Answer 8

Bactrim
clindamycin
minocycline or doxycycline
linezolid (Zyvox)
rifampin

Question 9

Treat Clostridium difficile Diarrhea

Answer 9

metronidazole (mild to moderate)
oral vancomycin (severe or resistant)

Question 10

Genital Herpes

Answer 10

acyclovir, valacyclovir, or famciclovir

Question 11

Systemic Fungal Infections

Answer 11

amphoteracin B & others

fluconazole & other “azoles”

Question 12

Urinary Tract Infections

Answer 12

Bactrim
quinolones
nitrofurantoin

Question 13

Prostate Infections

Answer 13

Bactrim

quinolones

Question 14

Chlamydia trachomatis

Answer 14

doxycycline x 7 days

azithromycin x 1 dose

Question 15

Pelvic Inflammatory Disease

Answer 15

cefotetan or cefoxitin + doxycycline
clindamycin + gentamicin + doxycycline
ceftriaxone + doxycycline ± metronidazole

Question 16

Bacterial Vaginosis

Answer 16

metronidazole

clindamycin

Question 17

Gonorrhea

Answer 17

**ceftriaxone (Rocephin) IM x 1
azithromycin if severe cephalosporin allergy
PLUS chlamydial coverage

Question 18

Acne

Answer 18

tetracyclines
topical clindamycin
topical macrolides

Question 19

Group A Strep Throat (strep pyogenes)

Answer 19

benzathine PCN G IM x 1 or oral PCN x 10 days
amoxicillin
macrolides if allergic to PCN

Question 20

Acute Sinusitis

Answer 20

**amoxicillin x 10 – 14 days
*Bactrim
2nd gen cephalosporins (cefuroxime, cefaclor)
3rd gen cephalosporins (cefpodoxime, cefixime)
doxycycline
macrolides
moxifloxacin
levofloxacin

Question 21

Otitis Media

Answer 21

**amoxicillin x 10 days
erythromycin / sulfisoxazole
macrolides
2nd gen cephalosporins (cefuroxime, cefaclor)
3rd gen cephalosporins (cefpodoxime, cefixime)

Question 22

Community Acquired Pneumonia (outpatient)

Answer 22

doxycycline
macrolides
quinolones (levofloxacin, moxifloxacin)

Question 23

Community Acquired Pneumonia (inpatient)

Answer 23

add ceftriaxone or cefotaxime to CAP therapy

Question 24

Aspiration Pneumonia

Answer 24

add clindamycin to CAP therapy
add metronidazole to CAP therapy
amoxicillin / clavulanate
     if very ill…
carbapenems
piperacillin/tazobactam
ticarcillin/clavulanate

Question 25

Hospital Acquired Pneumonia

Answer 25

ceftriaxone levofloxacin moxifloxacin

Question 26

Hospital Acquired Pneumonia | multi-drug resistant

Answer 26

``` piperacillin/tazobactam cefepime carbapenem + gentamicin + vancomycin if suspect MRSA ```

Question 27

Bacterial Meningitis (newborn - 1 month)

Answer 27

ampicillin + gentamicin ampicillin + cefotaxime ampicillin + ceftriaxone

Question 28

Bacterial Meningitis (1 month - 60 years old)

Answer 28

cefotaxime ± vancomycin | ceftriaxone ± vancomycin

Question 29

Bacterial Meningitis (>60 years old)

Answer 29

ampicillin + cefotaxime ± vancomycin | ampicillin + ceftriaxone ± vancomycin

Question 30

Surgical Prophylaxis

Answer 30

most procedures: cefazolin | abdominal procedures: cefotetan or cefoxitin

Question 31

Infective Endocarditis (cultures pending)

Answer 31

vancomycin + ceftriaxone ± gentamicin

Question 32

Intra-Abdominal Infections

Answer 32

``` cefotetan ampicillin/sulbactam clindamycin (…won’t cover gm negatives) carbapenems ticarcillin/clavulanate metronidazole above ± gentamicin or quinolone ```