Created by Bennett Waxse, UTSW

Updated 5/26/2016

Gram Positive
MSSA MRSA

GABS

GPC

GPC

GPC

GPC

GPC

GPC

GPR

GNR

GNR

GNR

GNR

fac

fac

fac

fac

fac

aerotol

fac

fac

fac

fac

fac

+*

+*

GPC

More med school reference docs here

fac

penicillin G/V

b-lactam
anti-staph pen

Gram Negative

S. epi

For corrections, comment or contact me

GBBS S. pneu E. faec L. mono P. aerug

Serr.

Citrob. Enterob. P. mira

Anaerobes

E. coli

Kleb.

H. influ M. catar

Neiss.

B. frag

Prevo.

GNR

GNR

GNR

GNCB

GNDC

GNDC

GNR

GNR

GPR

GPC

GPR

fac

fac

fac

fac

aer

fac

ob

ob

C. diff Peptos. Actino.

ob

ob

fac

Other

Empiric Therapy

Syphilis

Syphilis, Necrotizing faciitis (S. pyogenes)

oxacillin, nafcillin

+*

ampicillin, amoxicillin

+*

+*

MSSA bacteremia/endocarditis, OM, CNS ifns AIN (urine eosinophils)

ENT favorite

Urticarial, mobiliform rash, angioedema, StevensJohnson

amp-sulb, amox/clav

+*

+*

+*

+*

ENT favorite

Urticarial, mobiliform rash, angioedema, StevensJohnson

ticarcillin/clavulanate,
piperacillin/tazobactam

tic, pip

+*

+*

meropenam

+*

imipenem

+*

+*

amino-penicllin

anti-pseudo pen

carbapenam

ertapenam

1st-gen ceph

cefazolin, cephalexin

+*

2nd-gen ceph

cefoxitin, cefuroxime

cefotaxime

ceftazidime

+*

3rd-gen ceph

ceftriaxone

+*

adv-gen ceph

ceftaroline

+*

4th-gen ceph

cefepime

vancomycin

+^

lincopeptide

+*

+*

+*

Resistance-prone (SPAICE)

Sepsis, meningitis, ab ifn, UTI, CAP

Rash (<10% cross-reactive), cytopenias (CBC),

mild cholestasis (alk phos)

Resistance-prone (SPAICE)

Meningitis, ab ifn, UTI, CAP, gonorrhea,

pyelo, AOM

Rash (<10% cross-reactive), cytopenias (CBC),

mild cholestasis (alk phos)

+*

+*

+*

VRE

+*

VRE

clindamycin

(CA)

TMP-SMX

+*

Rash (<10% cross-reactive), cytopenias (CBC),

mild cholestasis (alk phos)

+*

Sepsis, meningitis, ab ifn, UTI, CAP

+*

Resistance-prone (SPAICE)

erythromycin

+*
+

BMT patients (febrile

neutropenia - Pseudomonas)

+
+

azithromycin
clarithromycin
doxycycline

+
+

+
+

+
+

+
+

+
+

+
+

minocycline

+
+

aztreonam

+
-

+
-

+*
-

+*
-

+*
-

+*
-

+
-

+*

+
+*

Anaphylaxis, red man syndrome (IgE), AKI,

Linear IgA Bullous Dematosis

SSTI, R-sided endocarditis (aureus),

VRE, PNA (surfactant inactivation)

HTN, edema, Rhabdo (check CK, CI: statins)

Resistance (MRSA PNA, VRE, HAP, CAP)

HA, D, N, optic n. damage, peripheral

neuropathy, serotonin syndrome, BM
suppression (2+ weeks)

Anaerobes above diaphragm

CA-MRSA, necrotizing faciitis, cellulitis,

TSS, dental ifn

Pseudomembranous colitis, metallic taste

PCP, Nocardia, Toxo

MRSA SSTI, PCP, UTI, Nocardia, Toxo,

Listeria meningitis (pen allergy)

Strep/Staph, Legionella,
Chlamydia, Gonorrhea, M.
pneumoniae, Bartonella

Colorectal decontamination

QTc prolongation, heartburn/GI upset/D

(prokinetic)

Chlamydia, Gonorrhea, M.
pneumoniae, MAC, Bartonella

AOM, atypical PNA, PID, GU ifns, MAC

QTc prolongation, heartburn/GI upset/D

(prokinetic)

Rickettsia, Chlamydia, Lyme,

non-TB myco, Q fever, 2
Syphilis

Lyme disease, Malaria PPx (clq resistance),

acne

+
+

+*

+
+*

+
+*

+
+*

+
+*

+
+*

+
+*

Positive Coombs (without hemolysis)

Sepsis, HCAP, lower RTI, skin, bone,

C. diff (PO, if Flagyl-unresponsive)

+
+*

+
-

Hyperkalemia, Stevens-Johnson, pancytopenia,

crystaluria, AKI, G6PD hemolysis, pancreatitis

Photosensitivity, pill esophagitis, grey teeth,

no urine penetration

Meningitis, Q fever, Rickettsia, Penicillin back-up, Malaria PPx (clq resistance), Photosensitivity, pill esophagitis, grey teeth,
Chlamydia, RMSF, Syphilis
acne
blue discoloration
Legionella, M. pneumoniae

HCAP, GU, prostatitis,

pyelo, osteo (Hgb SS)

Legionella, M. pneumoniae

HCAP (w/ Zosyn), GU, prostatitis,

pyelo (moxi), osteo (Hgb SS)

fluroquinolone
moxifloxacin, levo

Positive Coombs (without hemolysis)

ab ifn, CAP, SSTI, pyelo

tetracycline

ciprofloxacin

CAP, SSTI

MDR TB, Nocardia

Rash (<10% cross-reactive), cytopenias (CBC),

mild cholestasis (alk phos)

linezolid

Pelvic ifns, CAP, ab ifn, complicated UTI

Rash (<10% cross-reactive), cytopenias (CBC),

mild cholestasis (alk phos)

daptomycin

N, D

Lower URI, UTI, ab ifn, sepsis, endocarditis, VP seizure threshold

shunt, HCAP (prevent resistance, anaerobes)

URI, OM, GU

Nocardia PNA alternative

N, D, C

Borrelia

Meningitis, sepsis, brain abscess, VP shunt,

ab ifn, HCAP (prevent resistance, anaerobes)

SSTI, perioperatively

HCAP (w/ levaquin), aspiration CAP,

unknown sepsis

macrolide

monobactam

Adverse Effects (precautions)

Rash, seizure threshold

Upper and lower RTI, sepsis, SSTI, gyn,

GN w/ pen allergy

Tendonitis/rupture, QTc prolongation (less),

neuropathy, G6PD hemolysis
Tendonitis/rupture, QTc prolongation,
neuropathy, G6PD hemolysis
Rash, TEN, N, V, D, neutropenia, transaminitis,
little cross-reactivity with pens

amikacin

+*

+*

Mycobacteria, MDR TB,

Nocardia

MDR, 2 agent for G- bacilli and some G+

Nephrotoxicity, ototoxicity

gentamicin

+*

Mycobacteria, MDR TB,

Nocardia

Bone ifns, RTI, SSTI, abdominal ifns, UTIs,

endocarditis

Nephrotoxicity, ototoxicity

rifampin

Biofilms

Active TB, never use alone

nitrofurantoin

Increased activity in urine

UTIs ( ESRD)

metronidazole

Anaerobes below diaphragm

(+ CNS), protozoa

BV, trich, PID, Giardia, C. diff (severe)

aminoglycoside

+
-

+
-

+
-

Orange urine, OCPs don't work

N, V, pulmonary fibrosis, hepatitis, G6PD hemolysis
Disulfiram-like rxn, metallic taste, neuropathy,
N, V, QTc prolongation