antibiotic coverage

• related: pharmacology

• 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