Antibiotic Study Guide & Cheat Sheet
When You See…
Consider Using…
GRAM POSITIVES
MSSA
MRSA
Enterococci
Strep. pyogenes or
Strep. agalactiae
Strep. pneumoniae or
Viridans group Strep
Oral: cephalexin; IV: Oxacillin, nafcillin, cefazolin
Oral: Bactrim, doxycycline, clindamycin, linezolid,
tedizolid; IV: vancomycin, daptomycin, telavancin,
dalbavancin, oritavancin, ceftaroline, tigecycline
Ampicillin, then vancomycin, then linezolid (VRE),
daptomycin (VRE), or tigecycline (VRE)
E. coli
Stenotrophomonas
ESBL+
Carbapenem resistant
Ceftriaxone, levofloxacin, amoxicillin-clavulanic
acid (beware penicillin & macrolide resistance)
Oral: ciprofloxacin, levofloxacin; IV: pip/taz,
ceftazidime, ceftazidime-avibactam, cefepime,
ceftolozane-tazobactam, imipenem-cilastatin,
meropenem, meropenem-vaborbactam,
aztreonam, aminoglycosides, polymyxins
Oral: cephalexin, amoxicillin-clavulanic acid,
Bactrim, nitrofurantoin, fosfomycin, ciprofloxacin,
levofloxacin; IV: ceftriaxone, ampicillin-sulbactam,
cefepime, piperacillin-tazobactam, ertapenem
Bactrim, levofloxacin
Carbapenems, ceftolozane-tazobactam,
ceftazidime-avibactam, polymyxins,
aminoglycosides, fosfomycin
ESBL+ drug list minus carbapenems
MISCELLANEOUS
Anaerobes
Clostridium difficile
Atypicals
Candida albicans
Candida krusei
Aspergillus
CMV
HSV
Cryptosporidium
Daptomycin
Tigecycline
Linezolid
Cefepime
Penicillin, clindamycin
GRAM NEGATIVES
Pseudomonas
aeruginosa
See This…
Oral: Metronidazole, clindamycin, amoxicillinclavulanic acid, moxifloxacin; IV: ampicillinsulbactam, piperacillin-tazobactam, cefoxitin,
cefotetan, ertapenem, tigecycline
Oral vancomycin or fidaxomicin
! Metronidazole no longer preferred
Macrolides, fluoroquinolones, tetracyclines
Fluconazole
Micafungin, anidulafungin, or caspofungin
Voriconazole
PO: valganciclovir; IV: ganciclovir
PO: acyclovir, valacyclovir; IV: acyclovir
Nitazoxanide
[Last updated October 2018]
Ertapenem
Aztreonam
Aminoglycoside
monotherapy
Rifampin
Micafungin
Fluconazole
With this…
Beta-lactams
Bactrim
Fluoroquinolones
Aminoglycosides
Macrolides
Tetracyclines
Tigecycline
Daptomycin
Linezolid
Vancomycin
Rifampin
Azoles
Amphotericin B
Think NOT for…
Pneumonia
Bacteremia or
Pseudomonas
MRSA bacteremia
Anaerobes,
Enterococci
Acinetobacter,
Pseudomonas,
Enterococci - “APE”
Gram positives
Non-UTI indication
Monotherapy
UTI or meningitis
Candida krusei
Beware…
GI upset, seizures
Hyper-K+, allergy,
myelosuppression
QT prolong, CNS
effects, tendon
rupture, peripheral
neuropathy, binding
cations
Ototoxicity,
nephrotoxicity
QT prolong
Phototox., esophagitis
Nausea/ vomiting
CK elevation
Thrombocytopenia,
peripheral neuropathy,
optic neuritis
Nephrotoxicity
Hepatotoxicity, DDIs
Hepatotoxicity, DDIs
Hypo-K, Hypo-Mg,
infusion rxn, nephrotox
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