Antimicrobial Coverage Spectrum Chart (Done!)

You got this!!

Try to break it up into chunks: By each class or the mechanism as a whole.

Examples of separating by class/mechanism to learn it easier

1) Only ONE cephalosporin covers MRSA (ceftaroline)

2) NO cell wall inhibitor covers atypicals (atypicals don't have cell walls, therefore, cell wall inhibitors won't do anything)

3) Every tetracycline covers MRSA

4) Every aminoglycoside covers Pseudomonas

5) NOT ONE SINGLE cephalosporin covers enterococcus

6) Pipercillin/Tazo is the ONLY penicillin that covers pseudomonas

Penicillin G/V

PENICILLIN ONLY COVERS STREP!!

Nafcillin / Oxacillin / Dicloxacillin (anti-staph)

G(+): MSSA, CoNS*, and strep

Nafcillin / Oxacillin / Dicloxacillin memory trick

Think penicillin coverage (strep) + CoNS* and MSSA

Amoxicillin / Ampicillin

ONLY active against Streptococcus and Enterococcus

Amoxicillin / Ampicillin memory trick

Think penicillin coverage (strep) + enterococcus

Amoxicillin/clavulanate and Ampicillin/sulbactam memory trick

- G(+): ALL EXCEPT MRSA

- G(-): ALL EXCEPT pseudomonas

- anaerobes!

(zosyn coverage minus pseudomonas)

Piperacillin / Tazobactam (Zosyn) spectrum

Broad coverage including MSSA, Streptococcus, Enterococcus, Enterobacterales, Pseudomonas aeruginosa, and Anaerobes.

Piperacillin / Tazobactam (Zosyn) memory trick

- G(+): ALL except MRSA

- G(-) ALL OF EM (including pseudomonas)

- anaerobes!

Piperacillin / Tazobactam (Zosyn) memory trick pt.2

Only penicillin antibiotic with pseudomonas coverage

Cephalexin/Cefadroxil/Cefazolin (1st Gen Cephalosporins)

- G(+): MSSA, CoNS*, Strep

- G(-): Enterobacterales ONLY

- Cefaclor/Cefuroxime

- Cefdinir

- Cefpodoxine

- Ceftriaxone

- G(+): MSSA, CoNS*, Strep

- G(-): Enterobacterales, H.influ, and M. cat

- Cefaclor/Cefuroxime

- Cefdinir

- Cefpodoxine

- Ceftriaxone

memory trick

Same as 1st gen coverage PLUS H&M!!

Cephamycins

- G(+): MSSA, CoNS*, Strep

- G(-): Enterobacterales, H.influ, and M. cat

- ANAEROBES

Cephamycins memory trick

ONLY CEPHALOSPORIN WITH ANAEROBE COVERAGE!!!

(think cefaclor/cefuroxime, etc. coverage + anaerobes)

Ceftazidime

- G(+): NONE(variable strep)

- G(-): enterobacterales, H.influ. M. Cat

Ceftazidime memory trick

- Covers all G(-) EXCEPT pseudomonas!!!

- NO GRAM (+)!!

Cefepime

- G(+): MSSA, CoNS*, strep

- G(-): ALL OF EM

Cefepime memory trick

Same as ceftazidime PLUS gram (+) coverage

Ceftaroline coverage

G(+): all except enterococcus

G(-): all except pseudomonas

ONLY CEPHALOSPORIN ( & beta lactam on the chart***)THAT COVERS MRSA

Cefiderocol

ONLY COVERS 2!!

1. PSEUDOMONAS

2. Enterobacterales

Which cephalosporins cover MRSA?

ONLY CEFTAROLINE!!!!

Which cephalosporins cover Pseudomonas aeruginosa?

ONLY 3!!!

1) Ceftazidime

2) Cefepime

3) Cefiderocol.

Which cephalosorins cover anaerobes?

ONLY CEPHAMYCINS!!!!! (Cefoxitin and Cefotetan)

Cephalosporins class coverage: enterococcus (G+)

NO CEPHALOSPORIN COVERS ENTEROCOCCUS!!!

Cephalosporins class coverage: enterobacterales (G-)

ALL CEPHALOSPORINS COVER ENTEROBACTERALES

Cephalosporin class coverage: MSSA and CoNS*

All cepahlos cover MSSA and CoNS* EXCEPT:

1) Ceftazidime

2)Cefiderocol

Cephalosporin class coverage: Strep

All cepahlos cover strep EXCEPT:

1) Ceftazidime (variable)

2) Cefiderocol

Cephalosporin class coverage: H. Influenzae and M. catarrhalis

All cepahlos cover H.influ and M.cat EXCEPT:

1) 1st gen (cephalex/cefadrox/cefaz)

2) Cefiderocol

Ertapenem

G(+): MSSA, CoNS*, strep

G(-): All EXCEPT pseudomonas

- Anaerobes!!

Ertapenem does NOT cover pseudomonas

I'll say it again. Ertapenem does NOT cover pseudomonas

Imipenem/cilastatin

G(+): MSSA, CoNS*, strep

G(-): ALL OF EM

- Anaerobes!

- Same as mero (except imi/cila has variable enterococcus)

Meropenem

G(+): MSSA, CoNS*, strep

G(-): ALL OF EM

- Anaerobes!

- Same as imi/cila, but no variable enterococcus coverage

Which carbapenems cover pseudomonas?

1) Meropenem

2) Imipenem/cilastatin

Carbapenem class coverage: anaerobes

ALL CARBAPENEMS COVER ANAEROBES!!!

Carbapenem class coverage: MRSA

NO CARBAPENEMS COVER MRSA!!!

Carbapenem class coverage: enterococcus

NO CARBAPENEMS COVER ENTEROCOCCUS!!!

(*imi/cili has variable)

Carbapenem class coverage: G(+) - MSSA, CoNS*, and strep

ALL carbapenems cover MSSA, CoNS*, and strep

Carbapenem class coverage: G(-) enterobacterales, H. influ, M. cat

ALL carbapenems cover enterobacterales, H. influ, M. cat

Aztreonam spectrum of activity

ONLY COVERS GRAM (-) INCLUDING PSEUDOMONAS

(Think: complete opposite of vanc,dalba, and dapto)

Vancomycin, dalbavancin, and daptomycin

DVD COVERS ALL THE G(+) INCLUDING MRSA

(Think: complete opposite of aztreonam)

Vancomycin tip

ONLY PO COVERS C.DIFF

Cell wall inhibitor (front page of chart) recap: MSSA

Everything EXCEPT:

1) Penicillin

2) Amox/amp

3) Ceftazidime

4) Cefiderocol

5) Aztreonam

Cell wall inhibitor (front page of chart) recap: MRSA

ONLY covered by:

1) Ceftaroline

2) Vancomycin

3) Dalbavancin

4) Daptomycin

*NO other cell wall inhibitor on the front of the chart covers MRSA*

Cell wall inhibitor (front page of chart) recap: CoNS*

Everything EXCEPT:

1) Penicillin

2) Amox/amp (variable)

3) Ceftazidime

4) Cefiderocol

5) Aztreonam

*Every other cell wall inhibitor on the front of the chart covers CoNS*

Cell wall inhibitor (front page of chart) recap: Strep

Everything EXCEPT:

1) Ceftazidime (variable)

2) Cefiderocol

3) Aztreonam

*Every other cell wall inhibitor on the front of the chart covers strep*

Cell wall inhibitor (front page of chart) recap: Enterococcus

ONLY covered by:

1) Amp/amox

2) amox/clav & amp/sul

3) Piper/tazo

4) Vancomycin

5) Dalbavancin

6) Daptomycin

*NO other cell wall inhibitor on the front of the chart covers Enterococcus*

Cell wall inhibitor (front page of chart) recap: Enterobacterales

Everything EXCEPT:

1) Penicillins without a beta-lactamase inhibitor

2) Vancomycin

3) Dalbavancin

4) Daptomycin

*Every other cell wall inhibitor on the front of the chart covers enterobacterales*

Cell wall inhibitor (front page of chart) recap: anaerobes

ONLY covered by:

1) amox/clav & amp/sul

2) Piper/tazo

3) Cephamycins

4) Ertapenem

5) Imipenem/cilastatin

6) Meropenem

*NO other cell wall inhibitor on the front of the chart covers anaerobes*

Cell wall inhibitor (front page of chart) recap: pseudomonas

ONLY covered by:

1) Piper/tazo

2) Ceftazidime

3) Cefepime

4) Cefiderocol

5) Imipenem/cilastatin

6) Meropenem

7) Aztreonam

*NO other cell wall inhibitor on the front of the chart covers pseudomonas*

Aminoglycosides

1) Gentamicin

2) Amikacin

3) Tobramycin

Gentamicin coverage

- G(+): SYNERGY for strep + enterococcus (only when administered with cell-wall inhibitor)

- G(-): Enterobacterales and Psedomonas

Amikacin and Tobramycin coverage

G(-): Enterobacterales and Psedomonas

Aminoglycoside class coverage tips

- Only truly cover G(-): enterobacterales and pseudomonas

- *gentamicin has some G(+) coverage when admin with cell-wall inhibitor*

Tetracyclines

1) Tetracycline

2) Doxycycline

3) Minocycline

Tetracycline class coverage

- G(+): MSSA, MRSA, CoNS

- G(-): H. influ and M. cat

- Atypicals!

Tetracycline class important coverage

- MRSA

- ATYPICALS

Tetracycline class coverage mnemonic

All Tetracyclines are atypical staff at H&M

(covers all staph, H. influenz, M. cat, and atypicals)

Macrolides

1) Clarithromycin

2) Erythromycin

3) Azithromycin

4) Fidaxomicin

Clarithromycin/Erythromycin coverage

ONLY ATYPICALS

(some other variable coverage)

Azithromycin coverage

- G(-): H.influenz, M. cat

- Atypicals

Fidaxomicin

ONLY COVERS C.DIFF!!

Clindamycin

- G(+): MSSA, MRSA, CoNS, Strep

- Anaerobes

Linezolid/Tedizolid coverage

COVERS ALL G+ (including MRSA)

Linezolid/Tedizolid coverage hint

Same coverage as vanc, dalba, and dapto

Ciprofloxacin coverage

- G(-): ALL OF EM (including pseudomonas)

- Atypicals

Ciprofloxacin coverage trick

Cipro has an A-

[covers atypicals and all gram(-) ]

Levofloxacin coverage

- G(+): CoNS* and strep

- G(-): ALL OF EM (including pseudomonas)

- Atypicals!

Which fluoroquinolone(s) have coverage pseudomonas?

1) Ciprofloxacin

2) Levofloxacin

Moxifloxacin coverage

- G(+): CoNS* and strep

- G(-): H. influ and M. cat

- Anaerobes!

- Atypicals!

Which fluoroquinolone(s) cover anaerobes?

ONLY MOXIFLOXACIN

Which fluoroquinolones are respiratory fluoroquinolones?

1) Levofloxacin

2) Moxifloxacin

Why is ciprofloxacin not considered a respiratory fluoroquinolone?

Cipro doesn't cover streptococcus (very common cause of respiratory infections)

Fluoroquinolone class coverage

All fluoroquinolones on the chart cover:

- H.influ

- M. cat

- Atypicals

TMP/SMX (Bactrim) coverage

- G(+): MSSA, MRSA, CoNS

- G(-): H. influ and M. cat

Nitrofurantoin coverage

G(+): ONLY RELIABLE FOR ENTEROCOCCUS*

(Variable for enterobacterales (E.coli, P. mirabilis, etc.) - important to know this for UTIs because we use it in those cases)

Nitrofurantoin emphasis

Know that it was pretty much created for UTIs. Will not work for kidney infection or pyelonephritis

Metronidazole coverage

- Anaerobes

- C.diff

Protein/DNA inhibitor coverge recap (back of chart): C.diff

ONLY covered by:

1) Fidaxomixin

2) Metronidazole

*NO other drug on the back of the chart covers C. diff

Protein/DNA inhibitor coverge recap (back of chart): Atypicals

ONLY covered by:

1) All tetracyclines

2) Clarithromycin/Erythromycin

3) Azithromycin

4) Fluoroquinolones

*NO other drug on the back of the chart covers atypicals

Protein/DNA inhibitor coverge recap (back of chart): Anaerobes

ONLY covered by:

1) Clindamycin

2) Moxifloxacin

3) Metronidazole

*NO other drug on the back of the chart covers atypicals

Protein/DNA inhibitor coverge recap (back of chart): Pseudomonas!!!

ONLY covered by:

1) All Aminoglycosides

2) Ciprofloxacin

3) Levofloxacin

*NO other drug on the back of the chart covers pseudomonas

Protein/DNA inhibitor coverge recap (back of chart): enterococcus

ONLY covered by:

1) Linezolide/Tedizolid

2) Nitrofurantoin

NO other drug on the back of the chart covers enterococcus

Protein/DNA inhibitor coverge recap (back of chart): streptococcus

ONLY covered by:

1) Clindamycin

2) Linezolide/Tedizolid

3) Levofloxacin

4) Moxifloxacin

NO other drug on the back of the chart covers streptococcus

Protein/DNA inhibitor coverge recap (back of chart): MRSA!!

ONLY covered by:

1) All tetracyclines

2) Clindamycin

3) Linezolid/Tedizolid

4) TMP/SMX (Bactrim)

NO other drug on the back of the chart covers MRSA

*Note: MSSA has the same coverage as well*