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Sorting Out Antibiotics: A systematic approach to antibiotic selection Kenneth Alexander, M.D., Ph.D. Associate Professor of Pediatrics and Microbiology Duke University Medical Center Durham, North Carolina kenneth.alexander@duke.edu Streptococci (Group A and Group B) Pseudomonas aeruginosa

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Sorting Out Antibiotics:A systematic approach to antibiotic selectionKenneth Alexander, M.D., Ph.D.Associate Professor of Pediatrics and MicrobiologyDuke University Medical CenterDurham, North Carolinakenneth.alexander@duke.edu

agents for infections due to gram positive bacteria

Streptococci

(Group A and Group B)

Pseudomonas aeruginosa

Staph. epidermidis

Staph. aureus

MRSA

RGNR

GNR

Penicillin G

Penicillin V

Vancomycin

Agents for Infections Due to Gram Positive Bacteria

Methicillin, Oxacillin, Nafcillin, Cloxacillin

Dicloxacillin, Cloxacillin

Dalfopristin/Quinopristin, Linezolid, Daptomycin

Linezolid

broad and extended spectrum penicillins
Broad and Extended Spectrum Penicillins

Streptococci

(Group A and Group B)

Pseudomonas aeruginosa

Staph. epidermidis

Staph. aureus

MRSA

RGNR

GNR

Ampicillin

Amoxicillin

Carbenicillin, Mezlocillin, Piperacillin, Ticarcillin

Ampicillin + Sulbactam = Unasyn®

Amoxicillin + Clavulanic Acid = Augmentin®

Ticarcillin + Clavulanic Acid = Timentin ®, Piperacillin + Tazobactam = Zosyn®

cephalosporins
Cephalosporins

Streptococci

(Group A and Group B)

Pseudomonas aeruginosa

Staph. epidermidis

Staph. aureus

MRSA

RGNR

GNR

Cefuroxime, Cefoxitin

Cefaclor, Loracarbef, Ceftibuten

Cefprozil, Cefuroxime axetil, Cefpodoxime, Cefdinir

Ceftriaxone, Cefotaxime

Cefixime

Ceftazidime

Cefazolin

1st Generation

Cephalexin, Cefadroxil

2nd Generation

3rd Generation

Cefepime

4th Generation

macrolides azalides and ketolides
Macrolides, Azalides and Ketolides

Streptococci

(Group A and Group B)

Pseudomonas aeruginosa

Staph. epidermidis

Staph. aureus

MRSA

RGNR

GNR

Erythromycin

Erythromycin

Azithromycin

Clarithromycin, Azithromycin, Telithromycin

broad spectrum antibiotics
Broad Spectrum Antibiotics

Streptococci

(Group A and Group B)

Pseudomonas aeruginosa

Staph. epidermidis

Staph. aureus

MRSA

RGNR

GNR

Ciprofloxacin, Levofloxacin, Moxifloxacin, Gatifloxacin

Ciprofloxacin, Levofloxacin, Moxifloxacin, Gatifloxicin

Gentamicin, Tobramycin, Netilmicin, Amikacin

Trimethoprim/Sulfamethoxazole

Trimethoprim/Sulfamethoxazole

Tetracycline, Doxycycline, Minocycline

Tetracycline, Doxycycline, Minocycline, Tigecycline

Imipenem, Meropenem, Ertapenem