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Drug Class

Penicillins

Drug

Common Uses

Penicillin G

Step (ear/throat/sinus
pneumonia), Staph
(non-R)

Penicillin V

minor infections

MOA

Methicillin
Nafcillin

Staph or Gram (+)


Cocci (when resistance
is expected)

Oxacillin
Ampicillin

gram +

Amoxicillin

"

Piperacillin

Used with
Streptomycin for
Endocarditis

Ticarcillin

Antipseudomonal

Piperacillin/Tazorbactam

Not Res. To Blactamase

Ampicillin/Sulbactam

Cephalosporins
1st Gen

Cefazolin

Surgical Prophylaxis

Cephalexin

2nd Gen

Cefuroxime
Cefoxitin

3rd Gen

Res. Gonorrhea,
meningitis
Res. Gonorrhea,
meningitis

Long half life, CNS


penetration
Shorter half life,
CNS penetration

Cefepime

Strep/Pseudomonas

CNS penetration

Imipenem/Cilastatin

DOC: Enterobacter

Pens

Aztreonam

Pseudomonas

Pens

Vancomycin

MRSA and C. dif

inhibits
transglycosylase

Ceftriaxone
Cefiximine

4th Gen
Carbapenems

Meropenem
Ertapenem

Monobactams
Glycopeptides
Bacitracin

Bacitracin

topical skin infections

Fosfomycin

simple UTI

Cycloserine

TB

Drug Class

Drug

Common Uses

MOA

Quinolones/Fluoro
quinolones

Ciprofloxacin

Pseudomonas

inhibit DNA
gyrase

Ofloxacin

Prophylaxis for
neutropenic pts,
pseudomonas

inhibit DNA
gyrase

Other
blocks
peptidoglycan
synthesis

E. coli and P.
mirababilis for
uncomplicated UTIs

long half life,


similar to Cipro
inhibit
dihydropteroate
synthase

Sulfisoxazole/
Sulfamethoxazole

UTIs

"

Sulfasalazine

"

"

Levofloxacin

Sulfonamides

Sulfacetamide
Trimethoprim/Sulfamethoxa
Pneumocystis jiroveci
zole (TMP/SMX)

Drug Class

Drug

Common Uses

synergistic combo
against folic acid
synthesis

MOA
reversibly binds
30S, block protein
synthesis

Tetracyclines
Doxycycline

Minocycline

Aminoglycosides
Streptomycin
Gentamicin
Tobramycin

Most common,
Chlamydia, anthrax,
long half life
cholera, RMSF, Lyme
Disease
Acne (increased skin
penetration)
used in combination
with pens/cephs for irreversible bind
serious strep/staph to 30S (some 50S)
infections
Endocarditis, TB
More potent against
enterococcus
more potent against
Pseudomonas

Macrolides
Erythromycin

Alt. to Pens/Cephs for


pharyngitis, sinusitis,
C-A pneumonia

binds 50S

Azithromycin

"

"

Clarithromycin

Legionella, C.
trachomatis, H. pylori

"

Clindamycin

bacterial endocarditis

Binds 50S,
antagonism for
Ery binding

Linezolid

VRE

binds 50S

Chloramphenicol

Disease
Enterobacter Infection
Resistant Gonorrhea

Drug of Choice
Carbapenems (Imipenemcilastatin)
ceftriaxone(IM) /cefixime
(PO)

C. dif and
pseudomembranous colitis

Metronidazole

Pneumocystis jiroveci

Trimethoprim/Sulfamethoxa
zole

Prostatitis (C. trachomatis),


Males <35

ofloxacin

binds 50S

Prostatitis (E. Coli,


Pseudomonas) Older Males

Cipro, Ofloxacin, or
TMP/SMX

Resistant Gonorrhea, and


allergic to Pens/Cephs

Spectinomycin

cidal/-static

Efective Against

Dosage Form

B-lactamase?

IV/IM

Sensitive

PO

Gram (+)

common gram (-) E. coli,


H. Influenzae,
Salmonell/Shigella,
anaerobes

PO

Sensitive

"

"

"

Broad Spectrum

Parenteral

Sensitive

poor PO availability

Sensitive

cidal

Gram (+)

IM/IV/some PO

Resistant

IM/IV/some PO

Resistant

IM/IV/some PO

Resistant

IM/IV/some PO

Resistant

cidal

Gram (-)

IM

Resistant

cidal

Gram (-)

PO

Resistant

cidal

Gram (-)

cidal

Broad Spectrum (+/-)


and anaerobes

cidal

Gram (-) rods

Resistant

cidal

Gram (+)

Resistant

Gram (+)

Resistant

Parenteral

Resistant

PO (single dose)

cidal/-static

Efective Against

Dosage Form

cidal

broad Gram (-), select


Gram (+)

PO/IV

cidal

PO/IV

cidal

PO

static

not used alone due to


resistance

XR?

no XR to Pens

static

systemic use

static

local use (bowel


lumen) in ulcerative
colitis

static

ophalmic

static

Gram (-) not


pseudomonas

cidal/-static

Efective Against

static

"Broad Spectrum"

Dosage Form

static

"

often compounded
with Cephalosporin
for anaerobic
infections

static

"

PO

cidal

Broad Spectrum, Aerobic


Gram (-), Pseudomonas

cidal

"

cidal

"

cidal

"

Deep IM

XR?

static

Selective for both (+/-)

enteric coated PO

static

" plus increase gram (-)


activity

better PO

static

same spectrum as Ery,


but greater potency

better PO

static

most gram (+) and


anaerobes, not C. Dif

PO

cidal
static

PO/ IV
broad spectrum

PO

Penicillin Allergy XR?

Can use with Pregnancy?

XR

NO XR

NO XR

Adverse Efects

Can use with Pregnancy?

photosensitivity, crystalluria in
alkaline urine, tendonitis

NO

photosensitivity, crystalluria in
alkaline urine, tendonitis

NO

photosensitivity, crystalluria in
alkaline urine, tendonitis

NO

crystalluria in acidic urine

NO

hemolytic anemia, newborn


kernicterus/basal ganglia dysfunction

NO

hemolytic anemia, newborn


kernicterus/basal ganglia dysfunction

NO

NO
NO

Adverse Efects/Contra

Can use with Pregnancy?

NOT for children

NO

NOT for children

NO

inhibit CYP450

inhibit P450
can lead to pseudomembranous
colitis from C. diff!!!

Gray baby syndrome, Inhibits


CYP450