ANAEROBIC
•
•
Peptococcus
Peptostreptococcus
• Staphylococcus aureus
◦ MSSA
‣
‣
‣
1st GEN CEPHS
2nd Gen
N.O.D
‣
Augmentin/Unasyn
Zosyn/Trimentin
Ceftriaxone (3rd)
Cefepime (4th)
◦ MRSA
‣
‣
‣
‣
‣
‣
‣
‣
‣
‣
‣
‣
‣
‣
‣
VANCO
Ceftaroline
Delafloxacin
Clindamycin
TCNs
Tigecycline
Linezolid/Tedizolid
Synercid
Daptomycin
Telavancin/Dalba
Bactrim
Macrobid
Fosfomycin
◦ VRSA
‣
‣
‣
Synercid
Telavancin/Dalba
Catalase + Clusters
Coagulase + Coagulase -
ANAEROBIC AEROBIC
•
•
•
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
Alpha Hemolysis
AEROBIC
Coag (-) Staph sp (CoNS)
◦ N.O.D
1st Gen Cephs
Ceftaroline
Clindamycin
TCNs
Linez/Tedizolid
Synercid
Vanco
Daptomycin
Telavancin/Dalba
Bactrim
Staphylococcus epidermidis
Staphylococcus saprophyticus
◦ Macrobid
Streptococcus sp.
Catalase - Pairs/Chains
•
•
•
•
•
•
AMINOPCN - Carbapenem - Daptomycin
Nat PCN - FQ - Macrobid
N.O.D - Clindamycin
C.P.T. - Tigecycline
1st - 5th Gen. - Vanco
Zerbaxa. - Linez/Tediz (Res)
•
•
Strep viridans
Strep pneumoniae
◦ Natural PCN
◦
◦
◦
AminoPCN
C.P.T
1st Gen
◦
◦
◦
◦
◦
◦
◦
◦
◦
3rd Gen
Dela/Levo/Moxi
Clindamycin
Macrolide
TCNs
Tigecycline
Vanco
Bactrim
PCN-R
‣
‣
‣
‣
‣
2nd Gen
Cefepime
Ceftaroline
Zerbaxa
Carbapenem
•
•
Beta Hemolysis
Strep pyogenes ( A)
◦ NAT PCN
Strep agalactiae (B)
◦ NAT PCN
◦ AG (synergy)
•
•
•
•
•
•
Lactobacillus
Propionibacterium (acne)
◦ NAT PCN
◦
◦
◦
AminoPCN
C.P.T
Linez/Tediz
◦
◦
◦
Synercid
Vanco
Daptomycin
◦ Telavancin/Dalba
Actinomyces
Clostridium sp.
•
•
◦
◦
◦
◦
◦
◦
NAT PCN
Clindamycin (+ PCN)
•
Tigecycline (in vitro c.dif)
Synercid
Vanco
Daptomycin
◦
◦
◦
Telavancin/Dalba
Flagyl
Not Difficile
‣
‣
Carbapenem
TCNs
Linez/Tediz ‣
Clostridium difficile
◦ VANCO (PO)
◦
◦
Flagyl
◦ Fidaxomicin
Clostridium perfringens
Zerbaxa
•
•
Gamma/Nonhemolytic
•
•
•
Enterococcus sp. (D)
◦ AMINOPCN (amp)
◦
◦
◦
◦
C.P.T
Zosyn
Primaxin (& Dori????)
AG (synergy)
◦
◦
◦
◦
Vanco
Telavancin/Dalbavancin
Macrobid
VRE
‣ Tigecycline
‣
‣
Tediz/Linezolid
(bacteremia)
Daptomycin (BSI)
Fosfomycin ‣
Enterococcus faecium
◦ VRE.faecium
‣ Synercid
Enterococcus faecalis
•
•
•
Corynebacterium diptheriae
◦ Erythromycin
◦
◦
Penicillin
Corynebacterium jeikium
Linez/Tedizolid
◦
◦
◦
◦
Listeria
◦
◦
◦
◦
Synercid
Vanco
Daptomycin
Telavancin/Dal
Ampicillin + Gent
Zosyn/Trimentin
Linez/Tedizolid
Synercid
◦
◦
◦
Vanco
Daptomycin
Telavancin/Dalba
Listeria monocytogenes
◦
◦
◦
◦
◦
Bacillus
FQ
Macrolides
TCNs
Tigecycline
AG (+ Amp)
◦
◦
◦
Linez/Tedizolid
Synercid
Vanco
◦
◦
Daptomycin
Telavancin/Dal
Bacillus anthracis
◦
Nocardia
Cipro
◦ BACTRIM (+
◦ imi)
Primaxin
Lactobacillus
• Oral Anaerobes (Peptococcus / Peptostreptococcus /
Prevotella )
◦ Nat PCN
◦
◦
◦
AminoPCN
C.P.T
Cephamycins
◦
◦
◦
◦
◦
◦
Zerbaxa
Carbapenem
Moxifloxacin
Clindamycin
Macrolide
Tigecycline
◦
◦
◦
◦
◦
Linezolid/Tedizolid
Synercid
Vanco (G+ only)
Daptomycin
Telavancin/Dalbavancin
Gram (+)
• GUT ANAEROBES
◦ Flagyl

•
•
•
•
•
•
•
PCNs
Natural PCN
◦
◦
◦
Pen G
Pen VK
Benzathine PCN
Anti-Staphylococcal PCN = NOD (G+ only)
◦ Nafcillin
◦
◦
Oxacillin
◦ Dicloxacillin
AminoPCN
Ampicillin
◦ Amoxicillin
Anti-Pseudomonal PCNs = CPT
◦ Carbenicillin
◦
◦
Piperacillin
Ticarcillin
BLI
◦
◦
◦
Avibactam
Clavulanic acid
Sulbactam
◦ Tazobactam
AminoPCN + BLI
◦ Augmentin (amox/clav)
◦ Unasyn (amp/sulb)
Anti-Pseudomonal PCNs + BLI
◦ Trimentin (Ticacrcillin/clav)
◦
◦
Zosyn (Pip/tazo)
IF CPT, THEN THESE WORK TOO
•
•
•
•
•
Cephalosporins
1st Gen (G+ , G- PEcK)
◦
◦
◦
Ancef (cefazolin)
Keflex (cephalexin)
Duricef (cefadroxil)
2nd gen (G-: HENPEcK
◦ Ceftin (Cefuroxime)
◦
◦
Cefzil (Cefprozil)
Cephamycins
‣ Cefoxitin
‣ Cefotetan
3rd gen
◦
◦
◦
◦
◦
◦
CefPOdoxime
Cefdinir
Cefixime (Suprax)
Cefotaxime
Ceftriaxone (Rocephin)
Ceftazidime (Fortaz)
‣ Ceftazidime/
Avibactam(Avycaz)
Ceftolozane/Tazobactam (Zerbaxa) ◦
4th Gen
◦
5th Gen
◦
Cefepime (Maxipime)
Ceftaroline (Teflaro)
CARPABENEMS (D.I.M.E)
◦ PRIMAXIN (IMIPENEM-CILASTIN)
◦
◦
◦
MERREM (MEROPENEM)
INVANZ (ERTAPENEM)
DORIBAX (DORIPENEM)
Monobactam
◦ Azactam (Aztreonam)
•
•
•
•
•
•
•
Lincosamide
◦ Clindamycin (Cleocin)
Macrolides
◦ Azithromycin (Zithromax)
◦
◦
Clarithromycin (Biaxin)
◦ Erythromycin
Tetracyclines
TCN
◦
◦
Doxycycline (Vibramycin)
Minocycline
Tigecycline (Tygacill)
Aminoglycosides (Synergy/add-on to G+, not monotx)
◦ Amikacin
◦
◦
Gentamicin
◦ Tobramycin
Oxazolidinones
Linezolid (Zyvox)
◦ Tedizolid (Sivextro)
Streptogramins (G+ & Anaerobes ONLY)
◦ Quinupristin/dalfopristin (Synercid)
•
•
PEcK (proteus mirab, e coli, klebsiella)
◦ 1st gen cephs
HENPEcK (Haemophilus influenza, Enterobacter, Neisseria)
◦ 2nd gen cephs
•
•
•
Glycopeptide
◦ Vancomycin
Lipopeptide
◦ Daptomycin (Cubicin)
Lipoglycopeptide
◦
◦
◦
Telavancin (Vibativ)
Oritavancin (Orbactive)
Dalbavancin (Dalvance)
•
•
•
•
•
•
•
•
FQ
◦
◦
◦
Ciprofloxacin (Cipro)
Delafloxacin (Baxdela)
Levofloxacin (Levaquin)
◦ Moxifloxacin (Avelox)
Folate Antagonists
◦ Bactrim ; Septra (SMX/TMP)
Nitroimidazoles (anaerobes & atypicals only)
◦ Metronidazole (Flagyl)
Fidaxomicin (Dificid)
Nitrofurans (G+ & G-)
◦ Nitrofurantoin (Macrobid)
Fosfomycin (Monurol) : (G+ & G-)
Polymyxins (G-)
◦ Colistin (Polymyxin E)
◦ Polymyxin B
Rifamycins
◦ Rifampin-- Biofilms (prosthetics, valves)
◦
◦
Rifabutin
Rifaximin

Gram (-)
ANAEROBIC
•
•
•
•
•
•
•
Eikenella
◦ AMINOPCN/BLI
Bacteroides
◦ FLAGYL
◦
◦
◦
AminoPCN/BLI
Zosyn/Trimentin
Cephamycins
◦
◦
◦
Zerbaxa
Carbapenem
Tigecycline
Prevotella
◦ AminoPCN/BLI
◦ Zosyn/Trimentin
Fusobacterium
◦ AminoPCN/BLI
◦
◦
◦
Zosyn/Trimentin
Zerbaxa
Flagyl
Pasteurella multicoda
◦ AMINOPCN
Pasteurella
◦ Nat PCN
Yersinia pestis (plague)
◦ AG
Variable Gram:
• Gardnerella vaginalis
◦ FLAGYL
◦ Clindamycin
•
•
Enterobacter sp
◦ Macrobid
Providencia
◦ Bactrim
•
•
•
Vibrio
◦ Doxycycline
Aeromonas
Enterobacteriaceae
‣ C.P.T
‣
‣
‣
‣
‣
‣
‣
AminoPCN/BLI
3rd Gen
Cefepime
Ceftaroline
Zerbaxa
Carbapenem
Aztreonam
◦
◦
◦
‣
‣
‣
FQ
TCNs
Tigecycline ( not
Morganella/
Providencia/Proteus/
Pseudomonas)
‣
‣
AG
Bactrim
Salmonella
‣
Serratia
Macrolide
Shigella
◦
◦
◦
◦
◦
◦
‣ Macrolide
Klebsiella
‣ 1st Gen
‣
‣
‣
2nd gen
Macrobid
Fosfomycin
‣ KPC+
•
Escherichia coli
‣
‣
‣
Colistin
AminoPCN
1st Gen
2nd gen
‣
‣
‣
‣
Macrolide
Macrobid
Fosfomycin
ESBL+
• Colistin
Enterobacter
‣
2nd gen
‣ Macrobid
Proteus sp
‣ Fosfomycin
Proteus mirabilis
‣
‣
‣
AminoPCN
1st Gen
2nd gen
Citrobacter
‣ Macrobid
Standard agar
FERMENTERS
AEROBIC
NONFERMENTERS
•
•
•
•
•
Acinetobacter
◦ Sulbactam
◦
◦
Colistin
AG
Acinetobacter baumannii
◦
◦
Minocycline
Tigecycline
Burkholderia
◦ Meropenem
Psueodomonas aeruginosa
◦ C.P.T
◦
◦
◦
◦
◦
◦
Zosyn/Trimentin
Ceftazidime
Cefepime
Zerbaxa
Carbapenem (not Erta)
Aztreonam
◦
◦
◦
Levo/Cipro/Dela
Fosfomycin
Colistin
◦ AG
Stenotrophomonas maltophilia
◦ BACTRIM
◦
◦
Trimentin
Ceftazidime
•
•
•
•
Fastidious
•
•
Bartonella
Campylobacter jejuni
◦ Macrolide
Helicobacter pylori
◦ Clarithromycin
◦ TCNs
Haemophilus influenzae
◦ AMINOPCN/BLI
◦
◦
◦
C.P.T
2nd Gen
Aztreonam
◦
◦
◦
◦
◦
FQ
Macrolide
TCNs
Bactrim
BL-
‣ AMINOPCN
◦ BL+
‣
•
•
AMINOPCN/BLI
Neisseria sp.
◦ 3rd Gen ( Ceftriaxone )
◦ Aztreonam
Neisseria meningitidis
◦ 2nd Gen (Cefuroxime)
◦
◦
◦
Nat PCN
AminoPCN
C.P.T
Moraxella sp
◦ 2nd Gen
◦ Aztreonam
Moraxella catarrhalis
◦ AMINOPCN/BLI
◦
◦
◦
◦
◦
Zosyn/Trimentin
FQ
Macrolide
TCNs
Bactrim
•
•
•
•
•
•
Avycaz
AG
Colistin
ESBL
Carbapenem
Tigecycline
Fosfomycin
•
•
•
•
•
Resistant G (-)
KPC
Avycaz
Tigecycline
AG
Fosfomycin
Colistin
•
Amp-C
Avycaz
• ESBL & KPC-producing
◦ E.coli
◦
◦
Klebsiella
Proteus
•
•
•
•
•
•
•
•
: Serratia / Providencia / Acinetobacter / Citrobacter / Enterobacter / Morganella
C.P.T
Zosyn/Trimentin
3rd Gen (inducible amp-c...avoid use...)
Cefepime
Carbapenem (Ertapenem - not Acinetobacter)
AG
Fosfomycin
SPCEM, no A
◦ Ceftaroline
◦
◦
Zerbaxa
Aztreonam

•
•
•
•
•
•
•
Trichomonas
◦ Flagyl
Giardia lambia
◦ Flagyl
Blastocytosis
◦ Flagyl
Entamoeba histolytica
◦ FLAGYL
PCP
◦ Clindamycin
TOXOPLASMOSIS
◦ Clindamycin
Plasmodium sp (Malaria)
◦
◦
Clindamycin (combo w/ others)
TCNs
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
Atypicals
◦ Tigecycline
PNEUMOCYSTIS JIROVECI
◦ BACTRIM
UREAPLASMA UREALYTICUM
◦ FQ
◦ Macrolide
MYCOPLASMA PNEUMONIAE (atypical)
◦ FQ
◦
◦
Azithromycin
◦ Doxycycline
MYCOBACTERIUM (non-TB)
Primaxin
◦
◦
◦
Macrolide
Amikacin
Streptomycin
MYCOBACTERIUM AVIUM COMPLEX (MAC)
◦ Azithromycin (+ Rifampin, + Ethambutol)
◦ Clarithromycin
MYCOBACTERIUM FORTUITUM
◦ Cefoxitin
MYCOBACTERIUM ABSCESSUS
◦ Cefoxitin
MYCOBACTERIUM CHELONAE
◦ Cefoxitin
MYCOBACTERIUM TUBERCULOSIS
◦
◦
Streptomycin
MDR-TB
‣ MOXIFLOXACIN
‣ Linezolid/Tedizolid
CHLAMYDIA (psittaci)
◦ Azithromycin
◦ Doxycycline
CHLAMYDIA PNEUMONIAE
◦ FQ
CHLAMYDIA TRACHOMATIS
◦ Clindamycin
◦
◦
Doxycycline
◦ Azithromycin
LEGIONELLA PNEUMOPHILA
FQ
◦
◦
Azithromycin
Bactrim
TREPONEMA PALLIDUM (SPYPHILIS)
◦ Natural Penicillins - Pen G
RICKETTSIA RICKETTSIA (RMSF)
◦ DOXYCYCLINE
SPIROCHETES
•
•
•
Helicobacter pylori
Treponema Pallidum (Syphilis)
◦
◦
PEN G
Doxycycline
Borrelia burgdorferi (Lyme)
◦ DOXYCYCLINE

• Red Man Syndrome
◦ Oritavancin
◦
◦
Dalbavancin
Vancomycin
•
•
•
•
IV
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
Ancef (Cefazolin)
Cefoxitin
Cefotetan
Ceftriaxone
Ceftazidime
Cefotaxime
Ceftazidime/avibactam
Cefepime
Ceftaroline
Ceftolozane/tazobactam
Carbapenems
Aztreonam
Tigecycline
Synercid
Daptomycin
Telavancin
PO
◦
◦
◦
◦
◦
Penicillin VK
Dicloxacillin
Amoxicillin
Keflex (cephalexin)
Cefadroxil
◦
◦
◦
◦
◦
◦
Cefprozil
CefPOdoxime
Cefdinir
Cefixime
Clarithromycin
Tetracycline
Nitrofurantoin
Fosfomycin
IV/PO
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
◦
Ampicillin
Cefuroxime
FQ
Clindamycin
Azithromycin
Erythromycin
Doxycycline
Minocycline
Linezolid
Tedizolid
Flagyl
Rifampin
Inhalation
◦ Aztreonam (cayston)
•
•
Dalbavancin dawdles (t1/2 = 346h)
Oritavancin (T1/2 = 245h)