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