PCN’s
PCN
Amp/Amox
Oxacillin/Diclox
1st gen Cephalosporins
Cefazolin/Cephelexin
2nd gen
Cephalosporins
Cefuroxime
3rd gen
Ceftriaxone
Cefotaxime
Cefpodoxime PO
Ceftazadime
4th gen
Cefepime
Carbapenems
Imipenem
Ertapenem
Meropenem
Combinations
Amox/Clavulanate
(Augmentin)
Amp/Sulbactam
(Unasyn)
Pip/Tazo (Zosyn)
Aztreonam
G+ G- A
+
+ ?
+
MRSA PsA Inhibit peptidoglycan cross linking in cell walls
Not staph
Sensitive staph
Less susceptible to B lactamases
Sensitive staph. Gram - ESBL are resistant
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
+
?
+
+
Highly resistant to B lactamases;Lowers seizure threshold
+
+
+
++ +
++ +
++ +
+
No PsA!
+
Combo with B lactamase inhibitor
+
+
+
+
+
+
+
+
+
+
+
+
Binds only Gram – penicillin binding proteins
Macrolides
Azithromycin
Clarithromycin
Erythromycin
Quinolones
Levofloxacin
Ciprofloxacin
Moxifloxacin
Gatifloxacin
Tetracyclines
Doxycycline
+
+
+?
+
+
+
+
+
Aminoglycosides
Gent
Tobra
Neomycin
Vancomycin
Clindamycin
Metronidazole
Linezolid
Daptomycin
Tigecycline
Nitrofurantoin
Rifampin
Trimethoprim/Sulfa
Inhibits bacterial tRNA and ribosome translocation
atypicals
+
+
+
++
++
++
++ +
+
+
+
+
Inhibit bacterial DNA gyrase and topoisomerase. Watch INR. CDif.
And atypicals
Binds ribosome, inhibits tRNA binding. Photosensitivity!
And most atypical (not Legionella)
+
Binds ribosome, inhibis protein synthesis. Nephrotoxic, ototoxic
+
+
+
+
Not absorbed
++
+
++
++
++ +
+ +
+
+ +
?
+
+
?
+
+
?
+
+
+
+
+
Inhibits cell wall synthesis. 15mg/kg bid (less if renal insuff); Redman
Binds ribosome, inhibits tRNA and ribosomes (like macrolides).
Taken up by anerobes, forms toxic metabolites. Peripheral neuropathy
Prevents initiation complex of ribosomes. Marrow toxicity
Binds to cell membranes, depolarizes, cell death. VRE.
Binds ribosome, prevents translocation.
Toxic metabolites. e. coli only
Inhibits bacterial RNA polymerase. Neiserria
Inhibits successive steps in folate synthesis. Increases Cr but not
nephrotoxic