Antimicrobial Coverage

Question 1

Antimicrobials with Gram Positive Coverage

Answer 1

• PCNs (all families)
• Cephalosporins (all generations)
• Vanc
• Dapto
• Zyvox
• Cleocin
• Quinupristin Dalfopristin (Synercid)
• Tetracyclines
• Chloramphenicol
• Telavancin
• TMP/SMZ
• FQs (except cipro)
• Macrolides
• Carbapenems
• Tigecycline

Question 2

Agents with MRSA Coverage

Answer 2

• Vanc
• Dapto (not lung)
• Zyvox
• Ceftaroline fosamil
• Telavancin
• Tigecycline
• Dalbavancin (skin)
• Oritavancin (skin)
• TMP/SMZ (CA-MRSA)
• Doxycycline (CA-MRSA)
• Cleocin (CA-MRSA)
• Synercid

Question 3

Enterococcal Coverage

Answer 3

• Vanc
• Carbapenem (not VRE)
• Dapto (VRE; cidal)
• Zyvox (VRE; static)
• Synercid (VRE; cidal; toxic)
• Chloramphenicol (VRE; toxic)
• Telavancin (activity but limited clinical data)
• Tigecycline (activity but limited clinical data)
• Nitrofurantoin (UTIs only)

Question 4

Gram Negative Coverage

Answer 4

• PCNs (Ureido > Amino)
• 2nd, 3rd, 4th generations
• Carbapenems
• Aztreonam
• Aminoglycosides
• FQs
• TMP/SMZ
• Tigecycline
• Polymyxin B, Colistin

Question 5

Pseudomonas Coverage

Answer 5

• Zosyn
• Cefepime, Ceftazidime/avibactam, Ceftolozane/tazobactam
• Carbapenems (not ertapenem)
• Cipro, Levaquin (not moxi)
• Aminoglycosides
• Aztreonam
• Polymyxin B, Colistin

Question 6

Anaerobic Coverage

Answer 6

• Flagyl
• Beta-lactam/Beta-lactamase inhibitors (pip/tazo, amp/sul)
• Cefoxitin, Cefotetan
• Carbapenems
• Cleocin
• Moxi
• Tigecycline
• Chloramphenicol

Question 7

Atypicals

Answer 7

• FQs (cipro has weaker atypical coverage than the rest)
• Macrolides (Zithromax, Clarithromycin, Erythromycin)
• Tetratcyclines (doxycycline, tetracycline, tigecycline)