Cell Wall Inhibitors

Penicillin VK route, coverage, and indications

PO, Gram +, Strep throat, dental infections

Penicillin G route, coverage, and indications

IV, Gram +, DOC for CNS manifestations of syphillis, and major strep infections

Benzathine route, coverage, and indications

IM, Gram +, DOC for primary and secondary syphilis, can be used for strep

What is a containdication for penicillin VK

tastes bad

What are the antistaphylococcal PCNs

Dicloxacillin, Nafcillin, Oxacillin, Methicillin

Docloxacillin route, coverage, indication

PO, gram + and staph aureus, bacteriocidal against MSSA

Nafcillin route, coverage, indication

IV, Gram + and staph aureus, bacteriocidal against MSSA, in stock at most hospitals

what is a antistaphylococcal PCN that is no longer used due to resistance

Methicillin

Ampicillin route, coverage, indication

PO or IV, less gram positive coverage more gram negative coverage, DOC for listeria, most cidal drug for sensitive enterococcus

Amoxicillin route, coverage, indication

PO, some gram+ more gram negative coverage, strep throat, otitis media, CAP (if caused by strep penumo, sensitive/intermediate strep pneumo. Commonly prescribed achieves higher levels w/ fewer doses

Anti-gram negative PCNs

Piperacillin and zosyn

Piperacillin route, coverage, indication

IV, Gram-, gram + (not MRSA or resistant strep pneumo) and some anaerobe activity, covers Pseudomonas aeruginosa (PA) enterococcus. UTI, bone and joint infections, skin infections

What is the dosage for Piperacillin for pseudomonas aeruginosa

16g/day

piperacillin + tazobactam (Zosyn) route, coverage, indication

IV, Gram-, gram + (not MRSA or resistant strep pneumo) and some anaerobe activity, covers Pseudomonas aeruginosa (PA) enterococcus. UTI, bone and joint infections, skin infections

Does Zosyn (piperacillin/tazobactam) have MRSA coverage

NO

How does the coverage of cephalosporins change as generations increase

lose gram positive coverage and gain gram negative coverage

Cephalexin route, coverage, indications

PO, gram + and basic gram negative, Skin infections, MSSA, Staph, Strep throat, some E.coli. alternative for antistaphlylococcal PCN

Cefazolin route, coverage, indication

PO, gram + and basic gram negative, gram + and basic gram negative, Skin infections, MSSA, Staph, Strep throat, some E.coli., surgical prophylaxis

Cefuroxime route. coverage, indication

PO/IV, better Gram-negative coverage and some Gram-positive, COPD smokers w/ bronchitis from H. flu, M.cat, UTI. IV is used for surgical prophylaxis

Cefoxitin route, coverage, indication

IV, basic anaerobe and gram negative, intra abdominal/pelvic infections H.flu M. cat, used for surgical prophylaxis

Cefotetan route, coverage, indication

IV, basic anaerobe coverage and gram negative, intra abdominal/pelvic infections H.flu M. cat, OBGYN prophylaxis, gut surgeries, and aspiration pneumonias

Ceftazadime route, coverage, indication

IM/IV, gram negative, pseudomonas aeruginosa, high dose needed for PA

Ceftazadime contraindication

Potent inducer of beta-lactamase especially in enterobacter, don’t use alone

Ceftriaxone (Rocephin) route, coverage, indication

IM/IV, more gram positive and basic gram negative, DOC for N. Meningitides also covers strep pneumo, gonorrhea, lyme disease

Ceftriaxone (Rocephin) contraindication

Don’t give within 24 hours of calcium products or TPN, Avoid in neonates

how is ceftriaxone dosed for N. Meningitides

2g q12

Cefotaxime route, coverage, indications

IM/IV, gram positive and basic gram negative, strep pneumo, renal elimination used in NICU

Cefpodoxime route, coverage, indications

PO, gram positive and basic gram negative, strep pneumo H.flu M.cat

Cefdinir route, coverage, indications

PO, gram positive and basic gram negative, strep pneumo H.flu M.cat

Cefepime route, coverage, indication

IV, Gram negative and basic gram positive, pseudomonas aeruginosa, streptococci, strep pneumo, MSSA

Cefteraline route, coverage, indication

IV, gram negative and gram positive, MRSA/MSSA, strep pneumo, kleb pneumo, E.coli, CAP, and some enterococcus

Imipenem route, coverage, indication

IM/IV, Gram + gram - anaerobes atypicals, MSSA, Streptococci, anaerobes, enteric GNRs, Pseudomonas, nasty GNR. BROAD SPECTRUM

Imipenem possible side effect

seizures

Meropenem route, coverage, indication

IM/IV, Gram + gram - anaerobes atypicals, MSSA, Streptococci, anaerobes, enteric GNRs, Pseudomonas, nasty GNR. BROAD SPECTRUM

Doripenem route, coverage, indication

IM/IV, Gram + gram - anaerobes atypicals, MSSA, Streptococci, anaerobes, enteric GNRs, Pseudomonas, nasty GNR. BROAD SPECTRUM

Ertapenem route, coverage, indication

IM/IV, Gram + gram - anaerobes atypicals, MSSA, Streptococci, anaerobes, enteric GNRs, does NOT cover pseudomonas, nasty GNR. BROAD SPECTRUM

Aztreonam route, coverage, indication

IM/IV, Gram negative coverage, GN infections including pseudonomas, really good in patients with a history a B lactam allergy

What medicine has gram negative coverage and no cross reactivity with B-lactams and can be used in pts with PCN or ceph allergy

Azetronam

Amoxicillin/ Clavulanic Acid route, coverage, indication

PO; gram -, gram +, basic anaerobes, sensitive enterococcus; DOC for OM, acute sinusitis (H/flu & M.cat), animal/human bites, aspiration pneumonia.

Common contraindication of Amoxi/clav

GI upset/ Diarrhea

Piperacillin/Tazobactam (Zosyn) route, coverage, indications

IV; Gram -, Gram + (fair), some anaerobes; can treat pseudomonas (at high dose) and enterococcus

Ampicillin/ Sulbactam route and coverage

IV, basic gram -, weak gram +, and basic anaerobes

Ceftazidime/ Avibactam (Avycaz) route, coverage, indication

IM/IV; gram -; carbapenem-resistant enterobacteria (CRE)

Which medication restores activity back to B-lactamase producers

Ceftazidime/ Avibactam (Avycaz)

Ceftolozane/ Tazobactam (Zerbaxa) route, coverage, indication

IM/IV, gram - and anaerobes; pseudomonas aeruginosa and Bacteroides fragilis

Niche drug used against carbapenem resistant enterobacterales

Meropenem/ Vaborbactam (Vabomere)

Drug used for KPC (Klebsiella pneumoniae carbapenemase and CRE (carbapenem resistant enterobacterales) and some resistant Pseudomonas aeruginosa strains

Imipenem/ Relebactam (Recarbrio)

What PO medication is the DOC for C. diff colitis

Vancomycin

If infused too quickly vancomycin can cause

Red man syndrome

Vancomycin route, coverage, indications

PO/IV; Gram +, C.diff, MRSA, highly resistant strep pneumo, meningitis

What is the adult dose for vanc and how does it change for meingitis patients

30mg/kg/day Q12, double for meningitis

Oritavancin (Orbactic) route, coverage, indication

IM/IV, Gram +, MRSA

What is some criteria regarding other medications if deciign to use Oritavancin (Orbactic)

no heparin within 48hrs of dose

Oritavancin (Orbactic) has a long half life, so one single 1200mg dose lasts how long

7-10 days

Dalbavancin (Durata) route, dose, coverage

IM/IV, gram +, MRSA

Dalbavancin (Durata) dosing week 1 vs week 2

1000 wk 1, 500 wk 2

Daptomycin route, coverage, indication

IV; Gram +, MRSA and Vancomycin-resistant Enterococci (VRE)

Why can daptomycin not be used for pneumonia pts

It is destroyed by lung surfactant

Fosfomycin route, coverage, indications

PO (powder); Gram - and some gram +; uncomplicated custitis in women w/ adequate renal function, UTI

What is a medication that can be used to treat UTIs in pregnant women

Fosfomycin