Drug of Choice Antibiotics GOOD

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Streptococcus pneumoniae, penicillin resistant

(depends) cephalosporins (2nd/3rd) and fluoroquinolones (3/4th) or Vancomycin, Linezolid, streptogramins

GI infections

...

Urogenital infections

...

H. influenzae, beta-lactamase producing

2nd/3rd gen cephalosporin, Amoxicillin-clavulanic acid or Co-trimoxazole

H. influenzae, non-beta-lactamase producing

Amoxicillin or 2nd/3rd gen cephalosporin, Co-trimoxazole

Acute otitis media

Amoxicillin or Amoxicillin-clavulanic acid Macrolide (penicillin allergy) Clindamycin Second or third generation cephalosporin

Bacterial sinusitis

Amoxicillin or Amoxicillin-clavulanic acid Macrolide (penicillin allergy) Co-trimoxazole Second or third generation cephalosporin

Bacterial endocarditis prophylaxis IV

Ampicillin

Enterococcus spp

Ampicillin +/- gentamicin, Vancomycin +/- gentamicin or Linezolid, daptomycin, streptogramins

S.Aureus or epidermis Methicillin-susceptible

Antistaphylococcal penicillin or Cephalosporin, clindamycin, fluoroquinolone, imipenem

Psuedomonas aeruginosa, Methicillin susceptible

Antistaphylococcal penicillin, Ciprofloxacin or Levofloxacin, Aztreonam, Aminoglycoside

Campylobacter jejuni

Azithromycin or Erythromycin, Ciprofloxacin

H. pylori treatment

Bismuth subsalicylate + metronidazole + tetracycline + PPI Clarithromycin + amox + PPI Clarithromycin + metronidazole + PPI Clarithromycin + amox + metronidazole + PPI

Enterobacter spp

Carbapenems, Cefepime or Aminoglycoside, TMP-SMX, fluoroquinolones

Bacterial endocarditis staph aureus penicillin allergy

Cefazolin (w/ or w/out gentimicin)

Gonorrhea

Ceftriaxone or Doxycycline, azithromycin

Klebsiella pneumoniae

Ceftriaxone, Cefotaxaime or Fluroquinolones

E.coli

Cephalosporins, fluoroquinolones or Many penicillins, TMP-SMX, aminoglycosides

Travelers diarrhea

Ciprofloxacin or Amoxicillin, Azithromycin, Doxycycline

Aspiration pneumonia

Clindamycin or Metrondiazole

Bacterial endocarditis prophylaxis allergic to oenicillin and IV

Clindamycin IV or Cefazolin IV

Bacterial endocarditis prophylaxis penicillin allergy

Clindamycin or Cephalexin or Azithromycin or Clintromycin

Causes of C. difficile infections

Clindymycin, ampicillin, amoxicillin, cephalosporins, fluoroquinolones (FREQUENTLY) Penicillin, erythromycin, trimethoprim (occasionally) Tetracycline, methonidazole, vancomycin, fidaxomicin, aminoglycosides

Uncomplicated UTI

Co-trimoxazole or Ciprofloxacin, Nitrofurantoin, Amoxicillin-clavulanic acid

Legionella

Fluoroquinolone, azithromycin or Doxycycline, co-trimoxazole

Acute bacterial prostatitis

Fluoroquinolones, Co-trimoxazole, Doxycycline

Bacterial endocarditis emperic therapy intolerant to vanco

Linezolid and daptomycin

Bacterial Meningitis, immunocompromised

Listeria- Ampicllin +gentamicin P.aeruginosa- Ceftazidime + gentamicin S.pneumoniae- Vancomycin + ceftriaxone

Bordetella petrussis

Macrolide or Cotrimoxazole

Community acquired pneumonia, outpatient, previously healthy

Macrolide or Doxycycline

Mycoplasma pneumoniae

Macrolide, doxycycline or 3rd/4th gen cephlosporin

Giardia

Metronidazole

Bacteroides

Metronidazole or Clindamycin, carbapenems, penicillins + beta-lactamase inhibot

Bacteroides fragilis

Metronidazole, Beta-lactam/Beta-lactamase inhibitor, Cindymycin, Carbapenems

Bacterial endocarditis staph aureus

Nafcillin or oxacillin

Bacterial pharyngitis

Pencillin V or Amoxicillin Penicillin G benzanthine Macrolide Clindamycin first or second gen cephalosporin

C. perfringens

Penicillin +/_ clindamycin or cephalosporins, doxycycline

Syphilis

Penicillin G or Doxycycline, erythromycin

Streptococcus pneumoniae, penicillin susceptible

Penicillin G, amoxicillin or Cephlosporin, Clindamycin, fluroquinolone, macrolide, co-trimoxazole

Bacterial endocarditis alpha hemolytic strep (viridans)

Penicillins (Penicillin G and ampicilin) with gentamicin

Uncomplicated UTI in pregnancy

Penicillins, Cephalosporins, Nitrofurantoin (not after 38 weeks), Sulfonamides (not close to term due to risk of kernicterus)

Community acquired pneumonia, inpatient, non-ICU

Respiratory fluroroquinolones or beta-lactam plus a macrolide

Community acquired pneumonia, outpatient, comorbidities or used antibiotics within 3mo

Respiratory fluroroquinolones or beta-lactam plus a macrolide

Bacterial endocarditis emperic therapy prosthetic heart valve

Rifampin

Bacterial Meningitis prophylaxis

Rifampin, Ciprofloxacin, Ceftriaxone

Bacterial Meningitis, posttramatic/ surgical (4 pathogens)

S.epidermidis- vancomycin S.aureus- oxacillin P.aeruginosa- Ceftazidime + gentamicin S.pneumoniae- penicillin G or ceftriaxone

Bacterial Meningitis, community aquired (3 pathogens)

S.pneumoniae- penicillin G or ceftriaxone N.meningitidis- penicillin G or ceftriaxone H.influenzae- Ceftriaxone

Tularemia

Streptomycin or Gentamicin, Chloramphenicol

Bacterial endocarditis staph aureus oxacillin resistant strains

Vancomycin (w/ or w/out gentimicin)

Bacterial Meningitis empiric treatment

Vancomycin + ceftriaxone

Bacterial endocarditis emperic therapy

Vancomycin and gentamicin

Bacterial endocarditis alpha hemolytic strep (viridans) w/ penicillin allergy

Vancomycin with gentamicin or IV ceftriaxone w/ gentamicin

C. dificile

Vancomycin, Fidaxomicin or Metronidazole

C. difficile

Vancomycin, fidaxomicin or Metronidazole

S.Aureus or epidermis Methicillin-resistant

Vancomycin, linezolid or Daptomycin, doxycycline, fluoroquinolone, streptogramins

Psuedomonas aeruginosa, Methicillin resistant

Vancoymycin, Linezolid or Cefaroline

MOraxella catarrhalis

amoxicillin-clavulanic acid, 2nd/3rd gen cephalosporins, co-trimoxazole or Macrolide

Chlamydia

azithromycin or doxycycline

Community acquired pneumonia, inpatient, ICU

beta-lactam plus azithro or a respiratory fluoroquinolone or (penicillin allergy) respiratory fluoroquinolone plus aztreonam

S. typhi

ceftriaxone, fluoroquinolone or Chloramphenicol, TMP-SMX, ampicillin

bacterial vaginosis

metronidazole or clindamycin

Trichomoniasis

metronidazole or tinidazole

Bacterial endocarditis prophylaxis

when: Prosthetic valves, previous infection, CHD, transplants Amoxicillin


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