Drug of Choice Antibiotics GOOD
Streptococcus pneumoniae, penicillin resistant
(depends) cephalosporins (2nd/3rd) and fluoroquinolones (3/4th) or Vancomycin, Linezolid, streptogramins
GI infections
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Urogenital infections
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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