antibiotic coverage

  • every time abx prescribed, define the infection: Microbiologically Anatomically: structures involved Pathophysiologically: how infection got there

CAP

high dose amoxicililn: 1 gm TID or high dose doxycycline comorbidity: Augmentin: combine with another macrolide or doxy

Cephalosporin

  • Good CNS penetration with 3rd and 4th gen
  • Cefazolin: MSSA, strep spp. Skin/soft tissue, bone/joint infection, surgical ppx

2nd gen: cefoxitin, IV. Cefuroxime IV/PO

  • a bit more gut anerobic. More gm neg
  • respiratory tract, intraabdoinal infection, surgical ppx

durations

  • CAP: 5 days
  • HAP/VAP: 7 days
  • Cystitis: 3 days
  • pyelo: 7 days
  • Cellulitis: 5-7 days
  • intra abdominal infection with source control: 3-5 days

3rd gen: cefixime, cefpodoxime

  • ceftriaxone: CSF, meningitis, gonorrhea, CAP Ceftazidime: anti-pseudomonal

4th: cefepime

pseudomonas coverage

  • zosyn
  • meropenem
  • aminoglycosides
  • ceftazidime

vancomycin

  • does not cover: VRE, listeria (1st line ampicillin, 2nd line bactrim), lactobacillus, leukonostoc, pediococcus