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Drugs of Choice

Terms in this set (33)

Enterococcus faecalis (serious infection)
1st: Ampicillin (or penicillin G) + (gentamicin or streptomycin)
Alt: Vancomycin + (gentamicin or streptomycin), daptomycin, linezolid, tedizolid, telavancin, tigecycline
Enterococcus faecium
Linezolid, quinupristin/dalfopristin, daptomycin, tigecycline
Staphylococcus aureus/Staphylococcus epidermidis (methicillin (oxacillin)-sensitive)
1st: Nafcillin or oxacillin
Alt: FGC, TMP/SMX, clindamycin, BL/BLI
Enterococcus faecalis (UTI)
1st: Ampicillin, amoxicillin
Alt: Fosfomycin or nitrofurantoin
Staphylococcus aureus/Staphylococcus epidermidis (hospital-acquired methicillin (oxacillin)-resistant)
1st: Vancomycin ± (gentamicin or rifampin)
Alt: Ceftaroline, daptomycin, linezolid, telavancin, tigecycline, TMP/SMX, quinupristin-dalfopristin
Staphylococcus aureus/Staphylococcus epidermidis (community-acquired methicillin (oxacillin)-resistant)
1st: Clindamycin, trimethoprim-sulfamethoxazole, doxycycline
Alt: Ceftaroline, dalbavancin, daptomycin, linezolid, oritivancin, tedizolid, telavancin, tigecycline, or vancomycin
Streptococcus (groups A, B, C, G, and Streptococcus bovis)
1st: Penicillin G or V or ampicillin
Alt: FGC, erythromycin, azithromycin, clarithromycin
Streptococcus pneumoniae (penicillin-sensitive)
1st: Penicillin G or V or ampicillin
Alt: FGC, doxycycline, azithromycin, clarithromycin, erythromycin
Streptococcus pneumoniae (penicillin-resistant)
1st: Vancomycin ± rifampin
Alt: ceftaroline, cefotaxime, ceftriaxone, levofloxacin, moxifloxacin, or gemifloxacin
Streptococcus, viridans group
1st: Penicillin G ± gentamicin
Alt: Cefotaxime, ceftriaxone, erythromycin, azithromycin, clarithromycin, or vancomycin ± gentamicin
Moraxella (Branhamella) catarrhalis
1st: Amoxicillin-clavulanate, ampicillin-sulbactam
Alt: TMP/SMX, erythromycin, azithromycin, clarithromycin, doxycycline, SGC, cefotaxime, or ceftriaxone
Neisseria gonorrhoeae (also give concomitant treatment for Chlamydia trachomatis)
Ceftriaxone or cefotaxime
Neisseria meningitides
1st: Penicillin G
Alt: Cefotaxime or ceftriaxone
Clostridium perfringens
1st: Penicillin G ± clindamycin
Alt: Metronidazole, clindamycin, doxycycline, cefazolin, carbapenem
Clostridioides (formerly Clostridium) difficile
1st: Oral vancomycin or fidaxomicin
Alt: Oral metronidazole
Acinetobacter spp.
1st: Doripenem, imipenem, or meropenem ± aminoglycoside (usually amikacin)
Alt: Ampicillin-sulbactam, polymyxins, or tigecycline
Bacteroides fragilis
1st: Metronidazole
Alt: BL/BLI, clindamycin, cefoxitin, cefotetan, ceftolozane-azobactam, ceftazidime-avibactam, or carbapenem
Enterobacter spp.
1st: Carbapenem or cefepime ± aminoglycoside
Alt: Ceftolozane-tazobactam, ceftazidime-avibactam, ciprofloxacin, levofloxacin, piperacillin-tazobactam, ticarcillin-clavulanate
Escherichia coli (meningitis)
Cefotaxime, ceftriaxone, meropenem
Escherichia coli (systemic infection)
1st: cefotaxime or ceftriaxone
Alt: BL/BLI, fluoroquinolone, carbapenem
Escherichia coli (UTI)
1st: Ampicillin, amoxicillin-clavulanate, doxycycline, or cephalexin
Alt: Aminoglycoside, FGC, nitrofurantoin, fluoroquinolone
Gardnerella vaginalis
1st: Metronidazole
Alt: Clindamycin
Haemophilus influenzae (meningitis)
1st: cefotaxime or ceftriaxone
Alt: meropenem
Haemophilus influenzae (non-meningitis)
1st: BL/BLI, or if β-lactamase-negative, ampicillin or amoxicillin
Alt: TMP/SMX, cefuroxime, azithromycin, clarithromycin, or fluoroquinolone
Klebsiella pneumoniae
1st: BL/BLI, cefotaxime, ceftriaxone, cefepime
Alt: Carbapenem (not ertapenem), ceftolozane-tazobactam, ceftazidime-avibactam, fluoroquinolone
Legionella spp.
1st: Azithromycin, erythromycin ± rifampin, or fluoroquinolone
Alt: Trimethoprim-sulfamethoxazole, clarithromycin, or doxycycline
Pseudomonas aeruginosa (UTI)
1st: Aminoglycoside
Alt: Ciprofloxacin,levofloxacin
Pseudomonas aeruginosa (systemic)
1st: Cefepime, ceftazidime, doripenem, imipenem, meropenem, piperacillin-tazobactam, or ticarcillin-clavulanate + aminoglycoside
Alt: Aztreonam, ceftolozane-tazobactam, ceftazidime-avibactam, ciprofloxacin, levofloxacin, polymyxin
Chlamydia pneumoniae
1st: Doxycycline
Alt: Azithromycin, clarithromycin, erythromycin, or fluoroquinolone
Chlamydia trachomatis
1st: Azithromycin or doxycycline
Alt: Levofloxacin, erythromycin
Mycoplasma pneumoniae
1st: Azithromycin, clarithromycin, erythromycin, fluoroquinolone
Alt: Doxycycline
Treponema pallidum (neurosyphilis)
1st: Penicillin G
Alt: Ceftriaxone
Treponema pallidum (primary or secondary)
1st: Benzathine, penicillin G
Alt: Ceftriaxone or doxycycline
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