Drugs and Bugs

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  1. What bugs does penicillin cover?
    • Strep, Enterococcus 
    • Oral and Skin Anaerobes (Peptostreptococcus, P. menaninogenica, actinomyces)
  2. What bugs do ampicillin and amoxicillin cover?
    • Strep, Enterococcus (DOC)
    • Easy gram negative (though resistance)
    • Anaerobes (Peptostreptococcus, P. menaninogenica, actinomyces)
  3. What bugs does amox/clav cover?
    • Strep, Staph, Enterococcus
    • Easy gram negative
    • Anaerobes (Peptostreptococcus, P. menaninogenica, actinomyces)
  4. What bugs does cloxacillin cover?
    • Strep, Staph (DOC)
    • partial coverage of Anaerobes (Peptostreptococcus, P. menaninogenica, actinomyces)
  5. What bugs does piperacillin/tazobactam cover?
    Everything except MRSA
  6. What bugs do first generation cephalosporins cover?
    • Strep, Staph
    • Easy gram negatives
    • Anaerobes (Peptostreptococcus, P. menaninogenica, actinomyces)
  7. What bugs do second generation cephalosporins cover?
    • Strep, partial coverage of Staph
    • Easy gram negatives
    • Anaerobes (Peptostreptococcus, P. menaninogenica, actinomyces), cefoxitin and ceftizoxime also cover Bacteroides
  8. What bugs do 3rd and 4th generation cephalosporins cover?
    • Strep, partial coverage of Staph
    • Easy Gram negatives, SPACE bugs, ceftazidime and cefepime cover Pseudomonas
    • partial coverage of non-bacteroides anaerobic bacteria (no coverage for ceftazidime)
  9. What bugs do carbapenems cover?
    • Strep, Staph
    • Partial coverage of enterococcus
    • Easy Gram negative, DOC for SPACE Bugs, pseudomonas (except for ertapenem)
    • All anaerobes
  10. What bugs does erythromycin cover?
    • Strep, Staph, MRSA-CA (test first)
    • Non-bacteroides anaerobes
  11. What bugs do clarithromycin and azithromycin cover?
    • Strep, Staph, MRSA-CA
    • Easy Gram negatives (not E. coli)
    • Non-bacteroides anaerobes
  12. What bugs do the respiratory FQs cover (moxi/levo)?
    • Strep, partial coverage of MRSA-CA
    • Easy gram negatives and SPACE bugs (not Pseudomonas)
    • partial coverage of non-bacteroides anaerobes
  13. What bugs does ciprofloxacin cover?
    Easy gram negatives, SPACE bugs, and Pseudomonas
  14. What bugs do aminoglycosides cover?
    • Easy gram negatives, SPACE bugs, and Pseudomonas
    • Can be used for synergy in Staph, MRSA-CA, MRSA-HA, and Enterococcus
  15. What bugs do SMX/TMP cover?
    • Strep (except for Group A), Staph, MRSA-CA (test first)
    • Partial coverage of easy gram negatives due to resistance, SPACE bugs (not Pseudomonas)
  16. What bugs do tetracyclines cover?
    • Strep, partial coverage of Staph, MRSA-CA (test first)
    • partial coverage of easy gram negatives
    • non-bacteroides anaerobes
  17. What bugs does vancomycin cover?
    • Strep, Staph, MRSA-CA, MRSA-HA (DOC), Enterococcus
    • Non-bacteroides anaerobes
  18. What bugs does linezolid cover?
    • Strep, Staph, MRSA-CA, MRSA-HA, Enterococcus
    • Non-bacteroides Anaerobes
  19. What bugs does clindamycin cover?
    • Strep, Staph, MRSA-CA (test first)
    • All Anaerobes
  20. What bugs does metronidazole cover?
    All anaerobes
  21. What Abx do not cover Strep?
    ciprofloxacin, aminoglycosides, and metronidazole
  22. What antibiotics cover staph?
    • Full coverage: amox/clav, cloxacillin, piperacillin/tazo, 1st gen cephalosporins, carbapenems, erythromycin, clarithro/azithro, SMX/TMP, vancomycin, linezolid, clindamycin
    • Partial Coverage: 2nd and 3rd gen cephalosporins, tetracyclines
    • Synergy: aminoglycosides
  23. What Abx cover MRSA-CA?
    • Empiric: clarithro/azithromycin, vancomycin, linezolid
    • test first for susceptibility: erythromycin, SMX/TMP, tetracyclines, clindamycin
    • partial coverage: respiratory FQs
    • synergy: aminoglycosides
  24. What Abx cover MRSA-HA?
    • vancomycin and linezolid
    • AMGs used for synergy
  25. What Abx cover Enterococcus?
    • full coverage: penicillin, amp/amox (DOC), amox/clav, piperacillin/tazo, vancomycin, linezolid
    • Partial coverage: carbapenems
    • Synergy: aminoglycosides
  26. What Abx cover easy gram negative bugs?
    • Full: amp/amox (but increased resistance), amox/clav, all cephalosporins, carbapenems, clarithro/azithromycin (but not E. coli), respiratory FQs, ciprofloxacin, aminoglycosides
    • Partial: SMX/TMP, tetracyclines
  27. What Abx cover SPACE bugs?
    piperacillin/tazo, 3-4th gen cephalosporins, carbapenems, respiratory FQs, ciprofloxacin, aminoglycosides, SMX/TMP
  28. What Abx cover Pseudomonas?
    piperacillin/tazo, ceftazidime and cefepime (3rd/4th gen), carbapenems (not ertapenem), ciprofloxacin, aminoglycosides
  29. What Abx do not cover the non-bacteroides anaerobes (Peptostreptococcus, P melaninogenica, Actinomyces)?
    • no coverage: ciprofloxacin, aminoglycosides, SMX/TMP, ceftazidime
    • partial coverage: cloxacillin, 3rd-4th gen cephalosporins, respiratory FQs
    • penicillin only covers oral and skin bugs
  30. What Abx cover Bacteroides?
    piperacillin/tazobactam, cefoxitin and ceftizoxime, carbapenems, clindamycin, metronidazole
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Drugs and Bugs
drugs and bugs table
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