Common Antibacterial Activity - Gram Positive Bacteria

Gram-Positive Cocci Clusters - Associated bacteria

Staphylococcus aureus (Coagulase +) & Staphylococcus epidermis (Coagulase -)

Staphylococcus aureus (Coagulase +) / Staphylococcus epidermis (Coagulase -) Associated Conditions

Methicillin/Oxacillin Sensitive (MSSA); Methicillin/Oxacillin Resistant (MRSA)

Treatment Options againsts Methicillin/Oxacillin Sensitive Organisms

Antistaphylococcal penicillin, 1st Generation Cephalosporin, Beta-Lactam/Beta-Lactamase Inhibitor Combo

First-Line Treatment Options against Methicillin/Oxacillin Resistant Organisms

Clindamycin, trimethoprim/sulfamethoxazole, Doxycycline, glycopeptides

Second line Treatment Options against Methicillin/Oxacillin Resistant Organisms

Daptomycin, Linezolide, Ceftaroline, Delafloxacin

Gram Positive Cocci Pairs/Chains Alpha-Hemolytic Associated Microorganisms

Streptococcus pneumoniae & Viridans Streptococci

What should one consider before treating against Streptococus pneumoniae?

selection of agent based on MIC levels

Treatment Options against Streptococcus pneumoniae

All Penicillins, 1st Gen Cephalosporin (cefotaxime, ceftriaxone), 3rd Gen Cephalosporin, 4th Gen Cephalosporin, Macrolides (azithromycin, clarithromycin), FQ (delafloxacin, levofloxacin, moxifloxacin), Doxycycline, Vancomycin

Treatment Options against Viridans Streptococci

Penicillin G, 3rd Gen Cephalosporins (cefotaxime, ceftriaxone), Macrolides (azithromycin, clarithromycin), Clindamycin

Gram Positive Cocci Pairs/Chains Beta-Hemolytic Associated Microorganisms

Streptococcus pyogenes (Group A) / Streptococcus agalactiae (Group B)

Treatment Options against Streptococcus pyogenes / Streptococcus agalactiae

All Penicillin; 1st Generation Cephalosporin;

Macrolides (azithromycin, clarithromycin);

Clindamycin

Gram Positive Cocci Pairs/Chains Non-Hemolytic Associated Microorganisms

Enterococcus faecalis associated with UTIs

Treatment Options against Enterococcus faecalis associated with UTIs

Ampicillin; Amoxicillin;

Fosfomycin; nitrofurantoin (cystitis only)

Gram Positive Bacilli Associated Mircoorganisms

Clostridioides (formerly Clostridium) difficile (CDI), Listeria monocytogenes

Treatment Options against Clostridioides (formerly Clostridium) difficile (CDI)

Fidaxomicin; oral or rectal vancomycin; metronidazole

Treatment Options against Listeria monocytogenes

Penicillin G; ampicillin;

FQ (levofloxacin, moxifloxacin)

What drugs have a role in reducing toxin production, depending on specific bacteria and toxin?

Clindamycin, Linezolid, Macrolides, TCNs

What drugs may be added to serious gram-positive cocci infections for synergic effects?

gentamicin, rifampin