Bugs and Drugs Cheat Sheet April 2021 PDF

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Antimicrobial Bugs and drugs cheat sheet study guide...

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Bugs & Drugs Study Cheat Sheet When You See…

Consider Using… GRAM POSITIVES Oral: cephalexin, cefadroxil, amox/clav; IV: cefazolin, oxacillin, nafcillin

MSSA

Oral: SMX/TMP, doxycycline, clindamycin, linezolid, tedizolid, omadacycline, delafloxacin; IV: vancomycin, daptomycin, telavancin, dalbavancin, oritavancin, ceftaroline, tigecycline, eravacycline; all oral options also come as IV Ampicillin, then vancomycin; if VRE: linezolid, daptomycin, oritavancin, tigecycline, omadacycline, eravacycline, nitrofurantoin (UTI only), Fosfomycin (UTI only)

MRSA

Enterococci Strep. pyogenes or Strep. agalactiae

Penicillin, amoxicillin, clindamycin Ceftriaxone, levofloxacin, amoxicillin, amoxicillinclavulanic acid ( beware penicillin & macrolide resistance) Ampicillin

Strep. pneumoniae or Viridans group Streptococci Listeria monocytogenes

GRAM NEGATIVES Oral: ciprofloxacin, levofloxacin, delafloxacin; IV: pip/taz, ceftazidime, ceftazidime-avibactam, cefepime, ceftolozane-tazobactam, cefiderocol, imipenem-cilastatin +/- relebactam, meropenem, aztreonam, aminoglycosides, polymyxins Oral: cephalexin, amoxicillin-clavulanic acid, SMX/TMP, nitrofurantoin (cystitis only), fosfomycin, ciprofloxacin, levofloxacin, delafloxacin IV: ceftriaxone, ampicillin-sulbactam ( resistance), cefepime, piperacillin-tazobactam, carbapenems! Carbapenems, ceftolozane-tazobactam, ceftazidimeavibactam, meropenem-vaborbactam, imipenemcilastatin-relebactam, cefiderocol, polymyxins, aminoglycosides, fosfomycin, nitrofurantoin (cystitis only), tigecycline, omadacycline, eravacycline ESBL-producer drug list minus carbapenem alone Aztreonam + (MERO/VAB or CAZ/AVI) SMX/TMP, levofloxacin, minocycline Fluoroquinolone, SMX/TMP, ceftriaxone FUNGI Fluconazole Echinocandin, but can use fluconazole if susceptible Micafungin, anidulafungin, or caspofungin Micafungin, anidulafungin, or caspofungin Voriconazole VIRUSES Valganciclovir, letermovir, ganciclovir, foscarnet PO: acyclovir, famciclovir, valacyclovir; IV: acyclovir Valacyclovir (PO), famciclovir (PO), acyclovir (IV/PO) PO: oseltamivir, baloxavir marboxil; IV: peramivir Remdesivir; monoclonal antibodies

Pseudomonas aeruginosa

E. coli, Klebsiella

ESBL-producer / Drug-Resistant GNR Carbapenem resistant GNR NDM producer Stenotrophomonas Salmonella typhi Candida albicans Candida glabrata Candida krusei Candida auris Aspergillus Cytomegalovirus (CMV) Herpes Simplex Virus (HSV) Varicella Zoster Virus (VZV) Influenza SARS-CoV-2 (COVID-19)

MISCELLANEOUS Anaerobes Clostridioides difficile (formerly Clostridium difficile) Atypical organisms Cryptosporidium parvum Cystoisospora sp. (Isospora) Leishmania sp. Borrelia burgdorferi (Lyme dz) Treponema pallidum (Syphilis) Mycobacterium tuberculosis Mycobacterium avium (MAC) Pneumocystis Pneumonia (PCP) Toxoplasma gondii

Oral: metronidazole, clindamycin, amoxicillinclavulanic acid, moxifloxacin IV: ampicillin-sulbactam, piperacillin-tazobactam, cefoxitin, cefotetan, ertapenem, tigecycline Oral vancomycin or fidaxomicin ! Metronidazole no longer preferred Macrolides, fluoroquinolones, tetracyclines, lefamulin

Nitazoxanide SMX/TMP Amphotericin B Doxycycline Penicillin Rifampin + isoniazid + pyrazinamide + pyridoxine + ethambutol – “RIPPE” Clarithromycin+ ethambutol (tx), azithromycin (px) SMX/TMP (tx or px) Pyrimethamine +sulfadiazine +leucovorin (tx); SMX/TMP (px)

ABBREVIATIONS: Amox/clav = amoxicillin/clavulanic acid, CAZ/AVI = ceftazidime/avibactam, ESBL = extended-spectrum beta-lactamase, GNR = Gram negative rod, IV = intravenous, MERO/VAB = meropenem/vaborbactam, MRSA = methicillin-resistant S. aureus, MSSA =methicillin-susceptible S. aureus, NDM = New Delhi metallo-beta-lactamase, PIP/TAZ = piperacillin/tazobactam, PO = oral, SMX/TMP = sulfamethoxazole/trimethoprim, VRE = vancomycin resistant Enterococci

Last updated April 2021

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