Pharm- Infections & ABX TX

Strep Pyogenes (strep throat)

First line:

Penicillin (PO Pen VK)

Amoxicillin

maybe Cephalexin (Keflex)

Second line:

Azithromycin

Clindamycin

CA-P (strep pneumo)

FIrst line:

Amoxocillin

Ampicillin

Ceftriaxone IV

Second line:

Azithromycin & maybe clarithromycin

Doxycycline

Maybe other 3rd gen: cefotaxime or cefnidir

CA-P (H. flu/M.cat)

DOC: Augmentin (amoxicillin/clavulanate acid)

Ceftriaxone (inpatient first line)

Cefuroxime

Second line:

Azithromycin

Clarithromycin

Lefamulin

Hospital acquired pnemonia

First line:

Piperacillin/tazobactam (Zosyn)

Cefepime IV

Meropenem/Imipenem

Ceftazidime

Add on: Gentamicin/Tobramycin (synergistic) or Azithromycin for double G - coverage

If suspected MRSA add: Vanc or Linezolid

Otitis media

DOC: Augmentin

Amoxicillin

Ceftriaxone IV/IM

Alternative (PCN allergy):

Cefdinir/Cefuroxime/Cefpodoxime (if non-anaphylactic PCN allergy)

Azithromycin

Clindamycin

Sinusitis

DOC: Augmentin

Other options: Doxycycline, Cefuroxime, Cefdinir, Cefpodoxime

Acute Exacerbation of Chronic Bronchitis

Cefuroxime

Cefdinir or Cefpodoxime

Augmentin

Azithromycin or Doxy (add on/allergy)

MSSA

Cephalexin or Cefazolin

Antistaphylcoccal PCNs (Diclox, Naf, Oxa)

4th or 5th gen cephalosporin

Maybe clindamycin or doxycycline if allergy

Gonnorhea

Ceftriaxone (3rd gen cephalosporin)

Neisseria meningitidis

Ceftriaxone high dose (2g Q12 IV)

Syphilis

CNS manifestations: Pen G (IV)

Primary/secondary: Benzathine IM

Allergy: Doxycycline

Dental Infections

Pen VK (PO)

Depot for strep

Benzathine (IM)

Listeria

DOC: Ampicillin

Maybe Pen G (IV)

Enterococcus

Sensitive: Ampicillin (most cidal)

Piperacillin or Zosyn

Augmentin

Maybe Ceftaroline

UTI

Piperacillin or Zosyn (IV)

Cefuroxime

Fosfomycin (PO powder)

Plazomicin

Bone & joint infections

Piperacillin or Zosyn

Pseudomonas aeruginosa

Zosyn (piperacillin/tazobactam)

Ceftazadime (3rd gen)

Cefepime (4th gen)

Carbapenem (not erta or tebi)

Aztreonam (monobactam- PCN/cephalo allergy)

Ceftolozane/ Tazobactam (Zerbaxa)

Imipenem/ Relebactam (Recarbrio)- resistant PA

Aminoglycosides (Genta, Tobra, Amikacin)

Skin & Soft Tissue infections

Zosyn (piperacillin/tazobactam)

Cephalexin or Cefazolin (1st gen)

Clindamycin (allergy)

Acne

Erythromycin (PO)

Tetracycline (Doxy, Mino, Sere)

Clindamycin

Intra-abdominal & pelvic infections

Cefoxitin/Cefotetan (2nd gen)

Zosyn (piperacillin/tazobactam)

Maybe a carbapenem

Lyme Disease

Ceftriaxone (Rocephin)

Doxycycline

RMSF

DOC: Doxycycline