Antibiotics Spectrum of Activity

Vancomycin

all gram positive except VRE

Daptomycin

• all gram positive

• moderate VRE

Dalbavancin/Oritavancin

• all gram positive

• moderate VRE

Penicillin

• Strep pyogenes

• Strep pneumo

• E. faecalis

Dicloxacillin, nafcillin, oxacillin

• strep pyogenes

• strep pneumo

• MSSA

Amoxicillin, ampcillin

• strep pyogenes

• strep pneumo

• E. faecalis

• H. influenzae

Amoxicillin/Clavulanate, Ampicillin/Sulbactam

• strep pyo

• strep pneumo

• MSSA

• E faecalis

• H flu

• Proteus

• E coli

• Klebsiella

• B fragilis

(all gram pos except DRSP, MRSA, VRE)

(all gram neg except serratia, enterobacter, pseudomonas)

Piperacillin/tazobactam

• strep pyo

• strep pneumo

• MSSA

• E faecalis

• H flu

• Enterobacterales (proteus, E coli, klebsiella, serratia, enterobacter)

• Psuedomonas

(all gram pos except DRSP, MRSA, VRE)

(all gram neg)

Cephalexin/Cefazolin

• 1st gen

• strep pyogenes

• strep pneumo

• MSSA

• proteus

• E. coli

• Klebsiella

Cefuroxime

• 2nd gen

• strep pyogenes

• strep pneumo

• MSSA

• H influenzae

• proteus

• E coli

• Klebsiella

Cefoxitin

• Strep pyogenes

• Strep pneumo

• MSSA

• H influenzae

• proteus

• E coli

• Klebsiella

• B fragilis

Ceftriaxone, Cefotaxime

• 3rd gen

• Strep pyogenes

• Strep pneumo

• DRSP

• MSSA

• H influenzae

• Enterobacterales (proteus, e coli, klebsiella, Serratia, enterobacter)

(all gram pos except MRSA, enterococcus)

Ceftazidime

• 3rd gen

• strep pyogenes

• strep pneumo

• h influenzae

• enterobacterales (proteus, e coli, klebsiella, serratia, enterobacter)

• pseudomonas

Cefepime

• 4th gen

• strep pyogenes

• strep pneumo

• DRSP

• MSSA

• H influenzae

• enterobacterales (proteus, e coli, klebsiella, serratia, enterobacter)

• psuedomonas

Ceftaroline

• 5th gen

• Strep pyogenes

• Strep pneumo

• DRSP

• MSSA

• MRSA

• H influenzae

• enterobacterales (proteus, e coli, klebsiella, serratia, enterobacter)

Ceftobiprole

• 5th gen

• strep pyogenes

• strep pneumo

• DRSP

• MSSA

• MRSA

• E faecalis

• H influenzae

• Enterobacterales (proteus, e coli, klebsiella, serratia, enterobacter)

Ceftolozane/Tazobactam

• 5th gen

• H influenzae

• Enterobacterales (Proteus, E Coli, Klebsiella, Serratia, Enterobacter)

• Psuedomonas

Ertapenem

• all gram pos except MRSA, Enterococcus

• all gram neg except pseudomonas

Imipenem/Meropenem

• all gram pos except MRSA, Enterococcus

• all gram neg

Aztreonam

all gram neg except B fragilis

Azithromycin/clarithromycin

• strep pneumo

• H influenzae

• atypical

• ± strep pyogenes

Clindamycin

• strep pneumo

• DRSP

• MSSA

• non B fragilis gram neg anaerobes

• ± strep pyogenes, MRSA

Doxycycline, Minocycline

• strep pneumo

• DRSP

• MSSA

• MRSA

• H influenzae

• atypical

Tigecycline, eravacycline, omadacycline

• all gram pos with ± VRE

• all gram neg except proteus, serratia, pseudomonas, b fragilis

• atypicals

Linezolid, Tedizolid

all gram positive

Ciprofloxacin

• H influenzae

• Enterobacterales (Proteus, E Coli, Klebsiella, Serratia)

• Pseudomonas

Levofloxacin

• Strep pyogenes

• Strep pneumo

• DRSP

• MSSA

• all gram neg except serratia, B fragilis

• atypical

Moxifloxacin

• Strep pyogenes

• Strep pneumo

• DRSP

• MSSA

• gram neg except proteus, pseudomonas, stenotrophomonas

• atypicals

SMX-TMP

• all gram pos except enterococcus

• H flu

• Enterobacterales (proteus, e coli, klebsiella, serratia)

• Stenotrophomonas

Metronidazole

b fragilis

Gentamicin

• Enterococcus synergy w beta lactams

• enterobacterales (proteus, e coli, klebsiella, serratia, enterobacter)

Amikacin, Tobramycin

• enterobacterales (proteus, e coli, klebsiella, serratia, enterobacter)

• pseudomonas

Plazomicin

Enterobacterales (proteus,e coli, klebsiella, serratia, enterobacter)

Nitrofurantoin

• Enterococcus

• E coli

• Klebsiella

• ± enterobacter

Fosfomycin

• Enterococcus

• E coli

MRSA activity

• vanco

• dapto

• dalba/orita

• ceftaroline

• ceftobiprole

• doxy/mino

• tige/era/omacycline

• line/tedizolid

• SMX/TMP

VRE activity

• Line/Tedizolid

• Nitrofurantoin

• Fosofomycin

Pseudomonas activity

• Ceftazidime

• Cefepime

• Imi/Meropenem

• Aztreonam (high resistance)

• Cipro

• Levo

• SMX/TMP

• Amikacin/Tobramycin

Anaerobic activity

• Amox-clav/Amp-sulb

• Pip-tazo

• Cefoxitin

• Erta/Imi/Meropenem

• Clinda (non B fragilis)

• Tige/era/omacycline (non F fragilis)

• Moxifloxacin

• Metronidazole

Atypical activity

• Azithro/clarithro

• doxy/mino

• tige/era/omacycline

• Levo

• Moxi