CAP/HAP Drug Table

What are the typical CAP organisms

S. pneumonia, H. influenza, M. catarrhalis

What are the atypical CAP organisms

C. pneumoniae, M. pneumoniae, legionella species

What is the MOA of beta-lactams (penicillin, cephalosporins, carbapenems)

binds penicillin binding proteins and inhibits cell wall synthesis

Brand name of amoxicillin

Amoxil

Amoxicillin:

• route:

• organism:

• AE:

• drug class

PO

S. pneumoniae

rash/NVD

beta-lactam (penicillin)

Brand name of amoxicillin/clavulanate

Augmentin

Amoxicillin/clavulanate

• route:

• organisms:

• drug class

PO

S.pneumonia, H. influenza, M. catarrhalis

beta-lactam (penicillin)

Cefpodoxime, cefuroxime

• route

• organisms

• drug class

PO

S. pneumoniae, H. influenza, M. catarrhalis

beta-lactam (cephalosporin)

ampicillin/sulbactam brand name

Unasyn

Unasyn generic name

ampicillin/sulbactam

ampicillin/sulbactam

• route

• organisms

• drug class

IV

S. pneumoniae, H. influenza, M. catarrhalis, MSSA

beta-lactam (penicillin)

cetriaxone brand name

Rocephin

Rocephin generic name

ceftriaxone

Cefotaxime, ceftriaxone, ceftaroline

• route

• organisms

• drug class

IV

S. pneumoniae, H. influenza, M. catarrhalis, MSSA

beta lactam (cephalosporin)

Unlike other CAP cephalosporins, ceftaroline also has coverage for:

MRSA

Which CAP cephalosporin does not require renal adjustments

cetriaxone

Macrolides MOA

binds 50s subunit of ribosome

brand name of clarithromycin

Biaxin

Biaxin generic name

clarithromycin

azithromycin:

• route

• organisms

• drug class

IV, PO

all typical and atypical CAP

macrolides

clarithromycin

• route

• organisms

• CI

• drug class

PO

all typical and atypical CAP

CI w/ CYP3A4 substrates simvastatin and lovastatin

macrolide

MOA of fluoroquinolones

bind topoII to prevent strand separation

brand name of levofloxacin

Levaquin

brand name of moxifloxacin

Avelox

Avelox generic name

moxifloxacin

levofloxacin, moxifloxacin

• route

• AE:

• renal considerations:

• drug class

IV, PO

C diff, QTc, tendon rupture, peripheral neuropathy, blood glucose disturbances, CNS effects, aortic aneurism

do not use levo- if CrCl <50

fluoroquinolone

MOA of tetracyclines

bind 30s subunit of ribosome

doxycycline

• route

• AE

• drug class

IV, PO

photosensitivity, tooth discoloration, esophagitis

tetracycline

What organisms are most common for HAP

P. aeruginosa, enterobacteria, MRSA/MSSA

Which bugs are anti-pseudomonas

beta-lactams, monobactams, fluoroquinolones, aminoglycosides

brand name of cefepime

Maxipime

Maxipime generic name

cefepime

brand name of ceftazidime

Fortaz

Fortaz generic name

ceftazidime

brand name of piperacillin-tazobactam

Zosyn

cefepime, ceftazidime, piperacillin/tazobactam

• route

• drug class

IV

beta-lactam (penicillin + cephalosporin)

brand name of imipenem + cilastatin

Primaxin

imipenem+cilastatin, meropenem

• route

• drug class

IV

beta-lactam (carbapenem)

levofloxacin, ciprofloxacin (HAP)

• route

• HAP organisms

• CAP organisms

IV, PO

HAP: P. aeruginosa, enterobacteria, MSSA

CAP: all typical and atypical (cipro does not cover S. pneumoniae)

brand name of Azactam

aztreonam

Azactam generic name

aztreonam

aztreonam

• route

• pearl

• drug class

IV

used for severe beta-lactam allergies

monobactam

aminoglycosides MOA

bind 30s subunit

amikacin, gentamicin, tobramycin

• route

• adverse effects

• drug class

IV

nephrotoxicity, ototoxicity

aminoglycosides

What drug classes cover MRSA

glycopeptides, oxazolidinone

glycopeptide MOA

binds D-Ala-D-Ala

vancomycin

• route

• HAP:

• CAP:

• side effects:

• drug class

IV

MRSA, MSSA, enterobacteria

S. pneumoniae

nephrotoxicity, infusion reactions

brand name of linezolid

Zyvox

linezolid

• route

• HAP:

• CAP:

• drug class

IV, PO

MSSA, MRSA, enterobacteria

S. pneumoniae

oxazolidinone

vancomycin and linezolid do not have have ______ coverage

gram negative