Antibiotic Study Guide & Cheat Sheet

When You See… Consider Using…

GRAM POSITIVES
See This… Think NOT for…
MSSA Oral: cephalexin; IV: Oxacillin, nafcillin, cefazolin
Daptomycin Pneumonia
Oral: Bactrim, doxycycline, clindamycin, linezolid,
Bacteremia or
MRSA tedizolid; IV: vancomycin, daptomycin, telavancin, Tigecycline
Pseudomonas
dalbavancin, oritavancin, ceftaroline, tigecycline
Ampicillin, then vancomycin, then linezolid (VRE), Linezolid MRSA bacteremia
Enterococci Anaerobes,
daptomycin (VRE), or tigecycline (VRE) Cefepime Enterococci
Strep. pyogenes or
Penicillin, clindamycin Acinetobacter,
Strep. agalactiae
Ertapenem Pseudomonas,
Strep. pneumoniae or Ceftriaxone, levofloxacin, amoxicillin-clavulanic Enterococci - “APE”
Viridans group Strep acid (beware penicillin & macrolide resistance)
Aztreonam Gram positives
GRAM NEGATIVES Aminoglycoside
Oral: ciprofloxacin, levofloxacin; IV: pip/taz, Non-UTI indication
monotherapy
ceftazidime, ceftazidime-avibactam, cefepime,
Pseudomonas Rifampin Monotherapy
ceftolozane-tazobactam, imipenem-cilastatin,
aeruginosa meropenem, meropenem-vaborbactam, Micafungin UTI or meningitis
aztreonam, aminoglycosides, polymyxins Fluconazole Candida krusei
Oral: cephalexin, amoxicillin-clavulanic acid, With this… Beware…
Bactrim, nitrofurantoin, fosfomycin, ciprofloxacin,
E. coli Beta-lactams GI upset, seizures
levofloxacin; IV: ceftriaxone, ampicillin-sulbactam,
Hyper-K+, allergy,
cefepime, piperacillin-tazobactam, ertapenem Bactrim
myelosuppression
Stenotrophomonas Bactrim, levofloxacin
QT prolong, CNS
Carbapenems, ceftolozane-tazobactam,
effects, tendon
ESBL+ ceftazidime-avibactam, polymyxins,
Fluoroquinolones rupture, peripheral
aminoglycosides, fosfomycin neuropathy, binding
Carbapenem resistant ESBL+ drug list minus carbapenems cations
MISCELLANEOUS Ototoxicity,
Oral: Metronidazole, clindamycin, amoxicillin- Aminoglycosides
nephrotoxicity
clavulanic acid, moxifloxacin; IV: ampicillin- Macrolides QT prolong
Anaerobes
sulbactam, piperacillin-tazobactam, cefoxitin, Tetracyclines Phototox., esophagitis
cefotetan, ertapenem, tigecycline
Tigecycline Nausea/ vomiting
Oral vancomycin or fidaxomicin
Clostridium difficile Daptomycin CK elevation
! Metronidazole no longer preferred
Atypicals Macrolides, fluoroquinolones, tetracyclines Thrombocytopenia,
Linezolid peripheral neuropathy,
Candida albicans Fluconazole
optic neuritis
Candida krusei Micafungin, anidulafungin, or caspofungin
Vancomycin Nephrotoxicity
Aspergillus Voriconazole
Rifampin Hepatotoxicity, DDIs
CMV PO: valganciclovir; IV: ganciclovir
Azoles Hepatotoxicity, DDIs
HSV PO: acyclovir, valacyclovir; IV: acyclovir Hypo-K, Hypo-Mg,
Cryptosporidium Nitazoxanide Amphotericin B
infusion rxn, nephrotox

[Last updated October 2018] For More Cheat Sheets Visit: www.LearnAntibiotics.com