antibiotic coverage

Question 1

Fosfomycin (PO)

Answer 1

Covers:

• VSE
• VRE
• MSSA
• MRSA
• GNRs (except Acinetobacter)

Diarrhea, Headache, Rare Liver Damage

Only reaches [therapeutic] in bladder, Long half-life = 1x dose

UTIs

Question 2

Rifampin

Answer 2

Inhibits RNA Polymerase, preventing RNA production (24 hr AUC/MIC)

Covers:

• MSSA/MRSA (S+ w. Biofilm)
• Hemophilus
• Neisseria Meningitis

Myalgia, Arthralgia, Hyperbilirubinemia, Liver adjust, Can develop resistance w. prolonged monotherapy use

DDI - Subtherapeutic levels, Fluids may turn Orange, Reduces contraceptive effectiveness

Question 3

Quinupristin/Dalfopristin (IV)

Answer 3

Streptogramins - inhibit 50s (24 hr AUC/MIC)

Covers:

• VSE
• VRE
• MSSA
• MRSA
• GP Anaerobes

Myalgia, Arthralgia, Hyperbilirubinemia; Liver adjust

For highly resistant infections, esp. VRE

Question 4

Daptomycin

Answer 4

Covers:

• Strept
• VSE
• VRE
• MSSA
• MRSA

Cannot use w. pneumonia/lung infxn - binds to surfactant

Myalgia, Rhabdo, Inc. CPK, Neuropathy; Renal Adjustment

Question 5

Tedizolid/Linezolid

Answer 5

Covers:

• Strept
• VSE
• VRE - DOC
• MSSA
• MRSA - DOC
• GP Anaerobes

Thrombocytopenia, Serotonin Syndrome; Liver adjust

Question 6

Nitrofurantoin

Answer 6

Covers:

• VSE
• GNRs

Don’t use if CrCl <50 ml/hr; Dependent on Renal Function

Hepatotoxicity, Pulmonary Toxicity, Neuropathy; Renal Adjust

Tx UTIs, Cystitis

Question 7

Azithromycin

Answer 7

Macrolide (24 AUC/MIC)

Covers:

• Streptococcus
• Hemophilus
• Atypicals
• Helicobacter pylori

GI, QTc Prolongation, Liver adjust

URIs

Question 8

Clarithromycin

Answer 8

Macrolide (24 hr AUC/MIC)

Covers:

• Streptococcus
• Hemophillus
• Atypicals
• Helicobacter pylori

GI, QTc Prolongation, DDI - accumulation, Liver adjust

URIs

Question 9

Erythromycin

Answer 9

Macrolide (24 hr AUC/MIC)

Covers:

• Streptococcus
• Hemophillus
• Atypicals
• Helicobacter pylori

GI, QTc Prolongation, DDI - accumulation; Liver adjust

URIs

Question 10

Metronidazole

Answer 10

Inhibits DNA synthesis by causing strand breakage (24 hr AUC/MIC)

Covers:

-Anaerobes (+/-)

Peripheral Neuropathy, GI Intolerance, Metallic Taste; Liver adjustment

Disulfram interaction with Alcohol

Question 11

Bactrim

Answer 11

Sulfamethoxazole/Trimethoprim (24 hr. AUC/MIC)

Covers:

• Streptococcus
• MSSA/MRSA
• GNR
• HNM

Hyperkalemia, Inc. SCr, AKI, Photosensitivity, SJS, TEN; Renal adjustment

Monitor SCr, BUN, K: esp. with interacting medications

UTIs/MRSA

Question 12

Amikacin

Answer 12

Aminoglycoside (24 AUC/MIC or Cmax/MIC)

Covers:

• Streptococcus (S+)
• VSE/VRE (S+)
• MSSA/MRSA (S+)
• GNRs
• Pseudomonas

Variable dosing based on Renal Function, AKI, Ototoxicity

Monotherapy for MDR GNRs & Pseudomonas

Combo: GPC Endocarditis

Question 13

Gentamicin

Answer 13

Aminoglycoside (24 AUC/MIC or Cmax/MIC)

Covers:

• Streptococcus (S+)
• VSE/VRE (S+)
• MSSA/MRSA (S+)
• GNRs
• Pseudomonas

Variable dosing based on Renal Function, AKI, Ototoxicity

Monotherapy for MDR GNRs & Pseudomonas

Combo: GPC Endocarditis

Question 14

Tobramycin

Answer 14

Aminoglycoside (24 AUC/MIC or Cmax/MIC)

Covers:

• Streptococcus (S+)
• VSE/VRE (S+)
• MSSA/MRSA (S+)
• GNRs
• Pseudomonas

Variable dosing based on Renal Function, AKI, Ototoxicity

Monotherapy for MDR GNRs & Pseudomonas

Combo: GPC Endocarditis

Question 15

Plazomicin

Answer 15

Aminoglycoside (24 AUC/MIC or Cmax/MIC)

Covers:

• Streptococcus (S+)
• VSE/VRE (S+)
• MSSA/MRSA (S+)
• GNRs
• Pseudomonas

Variable dosing based on Renal Function, AKI, Ototoxicity

Monotherapy for MDR GNRs & Pseudomonas

Combo: GPC Endocarditis