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ABX by Mind Map: ABX

1. CELL WALL INHIBITORS

1.1. PENICILLINS

1.1.1. AMPICILLIN

1.1.1.1. GRAM + COCCI + LISTERIA

1.1.1.1.1. STREP

1.1.1.2. GRAM - COCCI AND RODS

1.1.1.3. 25-500mg PO q6h

1.1.1.3.1. MAX 14g

1.1.1.4. .5-2g IV/IM q6h

1.1.1.5. CI: mono, hypersensitity, asthma, HIV, seizure, renal impairment

1.1.1.5.1. CrCl <10 q10h, CrCl < 30 q8-12, CrCl 30-50 q6

1.1.1.6. AE: Anaphylaxis, erythema multiforme, SJS, Cdiff, seizures, agranulocytosis, N/V/D, urticaria, rash, glossitis, stomatitis, black hairy tongue, candidiasis

1.1.2. PENICILLIN G

1.1.2.1. GRAM + COVERAGE (non resistant)

1.1.2.1.1. SA, SP, Enterococci, Strep A/G, viridans

1.1.2.1.2. BEST for Syphilis, GAS cellulitis,

1.1.2.2. 1-24 million U IM/IV q4h

1.1.2.2.1. MAX: 24million U/day

1.1.2.3. CI: hypersensitivity, asthma, seizure, renal impairment, sodium restrictions,

1.1.2.4. AE: hypersensitivtiy, exfoliative dermatitis, Cdiff, hemolytic anemia, neutropenia, N/V/D, hives, itching, fever, resh

1.1.3. PIPERACILLIN/TAZOBACTAM (Zosyn)

1.1.3.1. BROAD SPECTRUM + ANEROBES

1.1.3.1.1. gut bugs, oral infx, aspiration pneumonia

1.1.3.2. 3.375g IV q6h

1.1.3.2.1. pneumonia = 4.5g IV q6h

1.1.3.2.2. renal adjustment

1.1.3.3. CI: hypersensitivity, asthma, cystic fibrosis, seizure, renal impairment, sodium restrictuion, hypokalemia

1.1.3.4. AE: hypersensitivity, eosinophilia, erythema multiforme, SJS, epidermal necrolysis, Cdiff, pancytopenia, seizures, hypokalmeia, bleeding, N/V/D/C, HA, rash, insomnia, itching, fever, LFT elevation

1.1.4. **AMOXACILLIN

1.1.4.1. STAPH COVERAGE

1.1.4.2. 500-875mg PO q12

1.1.4.3. STREP PHARYNGITIS: 1g PO q24h x 10 days

1.1.4.4. OTITIS MEDIA: 1g PO q8h x 5-10days

1.1.4.5. CI: hypersensitivity, mono, ashtma, ALL, HIV, seizure, CrCl <30, PKU

1.1.4.6. AE: erythema multiforme, hypersensitivty, toxic epidermal necrolysis, Cdiff, hemolytic anemia, thrombocytopenia, hepatitis, seizures, jaundice, N/V/D, rash, hives, black hair tongue, ALT/AST elevation, candidasis

1.1.5. **AMOX/CAVULANATE ACID (Augmentin)

1.1.5.1. BROAD SPECTRUM + ANEROBES

1.1.5.1.1. gut bugs, oral infx, aspiration pneumonia

1.1.5.1.2. strep, e.coli and anaeroic coverage

1.1.5.1.3. diverticulitis

1.1.5.2. 500mg/125mg - 875mg/125mg PO q12h

1.1.5.2.1. renal dosing

1.1.5.3. CI: hypersensitivity, CrCl <30, mono, ashtma, ALL, HIV, seizure, renal/hepatic impairment, PKU

1.1.5.4. AE: hypersensitivity, erythema multiforme, SJS, Cdiff, leukopenia, hepatitis, seizures, N/V/D, rash, urticaria, itching, black hairy tongue, candidiasis, LFT elevation

1.1.6. NAFCILLIN

1.1.6.1. STAPH COVERAGE

1.1.6.2. .5-2g IV q4-6h

1.1.6.3. CI: hypersensitvity, asthma, seizure, sodium restriction, lurasidone, paritaprevir, rilpivirine, tenofovir

1.1.6.4. EA: N/V/D, urticaria, pruritus, fever, rash, eosinophilia, candidiasis, ALT/AST elevation, hypokalemia, hypersensitivity Cdiff, renal tubular necrosis, myelosuppression, tissue necrosis

1.1.7. **PENICILLIN V

1.1.7.1. 125-500 mg PO q6-8h

1.1.7.1.1. STREP PHAR: 500mg PO QID x 10 days

1.1.7.2. 250 PCN VK = 400,000 U PCN

1.1.7.3. CI: hypsersensitivity, asthma, seizures, renal impairment

1.1.7.4. AE: hypersensitivity, exfoliative dermatitis, Cdiff, hemolytic anemia, nephropathy, N/V/D, fever, rash, hives, eosinophilia, black hairy tongue

1.2. CARBAPENEMS

1.2.1. MEROPENEM

1.2.1.1. nosocomial PNA - 1g IV q8h x 7-15 days

1.2.1.2. SKIN PSEUDOMONAL INFX = 1g IV q8h

1.2.1.3. CI: hypersensitivity, seizure, CNS infx, renal impairment,

1.2.1.4. AE: seizures, SJS, hypersensitivity, Cdiff, hemolytic anemia, N/V/D, HA, paresthesia, rash

1.2.2. IMIPENEM

1.2.2.1. last resort heavy broad spectrum bugs

1.2.2.2. 250-500mg IV q6-8h

1.2.2.3. CI: hypersensitivity, renal impairment, CNS dx, seizure,

1.2.2.4. AE: hypersensitivity, SJS, toxic epidermal necrolysis, neurotoxicity, seizures, Cdiff, myelosuppression, hepatotoxicity, AKI, LFT eelvation, eosinophilia, seizures, N/V/D, anuria, rash

1.3. CEPHALOSPORINS

1.3.1. CEPHALEXIN (Keflex)

1.3.1.1. first generation

1.3.1.2. GRAM + COCCI AND GRAM - RODS

1.3.1.2.1. MSSA, GAS, bowel surgery

1.3.1.2.2. cellulitis infx + PCN allergy

1.3.1.3. SKIN AND SOFT TISSUE

1.3.1.4. 1000 - 4000 mg/day PO divided q6-12h

1.3.1.4.1. STREP PHARYN: 500mg PO q12h x 10 days

1.3.1.5. CI: hypersensitivity, renal impairment, GI disorder,

1.3.1.6. AE: anaphylaxis, angioedema, erythema multiforme, SJS, Cdiff, anemia, hepatitis, seizures, N/V/D, HA, rahs, dizziness, AST/ALT elevation,

1.3.2. CEFAZOLIN

1.3.2.1. first generation

1.3.2.2. GRAM + COCCI AND GRAM - RODS

1.3.2.2.1. bowel surgery prophylaxis

1.3.2.3. 250-1.5g IM/IV q6-8h

1.3.2.3.1. MAX 12g/day

1.3.2.3.2. PNEUMOCOCCAL PNA: 500mg IM/IV q12h

1.3.2.4. CI: hypersensitivity, renal impairment, seizure,

1.3.2.5. AE: neutropenia, thrombocytopenia, anaphylaxis, SJS, nephrotox, seizures, cdiff, N/V/D, rash, abdominal pain, ALT/AST ele, hives, thrombophlebitis,

1.3.3. CEFUROXIME

1.3.3.1. second generation

1.3.3.2. not useful for much

1.3.3.3. STREP AND GRAM - RODS

1.3.3.4. .75-1.5g IM/IV q8h

1.3.3.4.1. meningitis - 1.5-3g IM/IV q8

1.3.3.4.2. gonococcal - 750-1.5g IM q8

1.3.3.5. CI: hypersensitivity, renal/hepatic impairment, seizure, malnutrition,

1.3.3.6. AE: angioedema, SJS, nephritis, agranulocytosis, neutropenia, anemia, seizures, C.diff,  ALT/AST elevation, renal impairment, diarrhea

1.3.4. CEFTRIAXONE (Rocephin)

1.3.4.1. third generation

1.3.4.2. GRAM + COCCI AND GRAM - COCCI

1.3.4.2.1. stones, urinary infx, strep pneumo, H. Flu

1.3.4.2.2. MENINGITIS**

1.3.4.2.3. does not cover atypicals (mycoplasm, chlamydia, legionella)

1.3.4.2.4. does not cover MRSA

1.3.4.3. 1-2g IM/IV q24h

1.3.4.4. GONOCCOCAL -  250-2g IM/IV q12-24h

1.3.4.5. CI: hypersensitivity, seizure, vit K, GI disorder, CaCl, CaGluconate

1.3.4.6. AE: anaphylaxis, bronchospasm, EM, necrolysis, agranulocytosis, jaundice, seizures, eosinophilia, thrombocytosis, ALT/AST elev, Diarrhea, leukopenia

1.3.5. CEFTAZIDIME (Fortaz, Tazcef)

1.3.5.1. fourth generation

1.3.5.2. GRAM + COCCI AND ALL GRAM -

1.3.5.2.1. + resistant gram -

1.3.5.2.2. hospital acquired pneumonia

1.3.5.3. 1g IV/IM q8-12h

1.3.5.3.1. MAX: 6g/day

1.3.5.4. CI: hypersensitivity, renal impairment, seizure,

1.3.5.5. AE: seizure, agranulocytosis, thrombocytopenia, hemolytic anemia, Cdiff, N/V/D, abdominal pain, itching, hives, HA, ALT/AST/BUN/Cr elevation

1.3.6. CEFEPIM MAXIPIME

1.3.6.1. fourth generation

1.3.6.2. GRAM + COCCI AND ALL GRAM -

1.3.6.2.1. + resistant gram -

1.3.6.3. PNA - 1-2g IV q8-12h x 10 days

1.3.6.3.1. 2g for pseudomonal

1.3.6.4. UTI - .5-2g IV/IM q12h

1.3.6.5. CI: hypersensitivity, renal impairment, GI disorder, Hflu infx,

1.3.6.6. AE: Anaphylaxis, seizures, aphasia, leukopenia, hemolytic anemia, aplastic anemia, toxic epidermal necrolysis, Cdiff, rash, diarrhea, ALT/AST elevation, nausea

1.4. VANCOMYCIN

1.4.1. MRSA COVERAGE

1.4.2. 15-20mg/kg IV q8-12h

1.4.2.1. CDIFF - 125-500mg PO q6h x 10-14days

1.4.3. CI: renal impairment, hearing impairment, elderly, cidofovir, streptozocin,

1.4.4. AE: anaphylaxis, hypotension, SJS, exfoliative dermatitis, necrolysis, nephritis, ototoxicity, nephrotoxicity, CDIFF, red-man syndrome, fever, N/V, rigors, urticaria, phlebitis, tinnitus, dizziness,

2. NUCLEIC ACID METABOLISM INHIBITORS

2.1. FLUOROQUINOLONES

2.1.1. BLACK BOX: tendon rupture, neuropathy, CNS effects, NO MG,

2.1.2. AE: prolonged QT, tendonopathy, C. Diff, hypersensitivity, phototoxicity, seizurs, ICP, suicidal ideation, torsades, MG, N/V/D, HA, dyspepsia, restlessness, lightheadedness, anxiety, myalgia

2.1.3. CI: MG, QT, torsades, arrhythmias, recent MI, CHF, pts >60, G6PD, tendon disorder, seizure disorder, renal/hepatic impairment, dehydration, DM, pimozide, tizanidine, cisapride, fibanserin, eliglustat

2.1.4. **CIPROFLOXACIN

2.1.4.1. UTI**

2.1.4.1.1. 10000mg ER PO q24

2.1.4.2. bad for pneumonia - no gram + coverage

2.1.4.3. COVERS JUST GRAM -

2.1.4.3.1. and atypicals

2.1.4.3.2. SPACEK BUG COVERAGE

2.1.4.4. 250-750mg PO

2.1.4.4.1. 200-400mg IV q12

2.1.5. **LEVOFLOXACIN

2.1.5.1. "Respiratory quinolones"

2.1.5.2. COER GRAM - AND GRAM + COCCI

2.1.5.2.1. S. Pneumo & Staph

2.1.5.2.2. SPACEK BUG COVERAGE

2.1.5.2.3. and atypicals

2.1.5.3. PNA - 750mg PO/IV q24h

2.2. RIFAMYCINS

2.2.1. RIFAMPIN

2.2.1.1. TB: 10mg/kg PO/IV qd x 6mo

2.2.1.2. meningococcal prophylaxis: 600mg PO BID x 2 days

2.2.1.3. CI: IM/SC admin, porphyria, hepatic impairment, DM, -evir, -nib, voriconazole

2.2.1.4. AE: Hepatitis, thrombocytopenia, anemia, hemorrhage, DIC, nephritis, shock, psychosis,EM, SJS, CDIFF, anorexia, fatigue, diarrhea, ataxia, dyspnea, vision changes

2.2.2. RIFAXIMIN

2.2.2.1. travelers diarrhea: 200mg PO TID x 3 days

2.2.2.2. IBS: 550mg PO TID X 14days

2.2.2.3. CI: hypersensitivity, hepatic impairment,

2.2.2.4. AE: Cdiff, angioedema, anaphylaxis, N/V, edema, dizziness, ascites, HA, muscle spasm, dyspnea, arthrlgia, fever, rash

2.3. NITROIMIDAZOLE

2.3.1. **METRONIDAZOLE

2.3.1.1. BLACK BOX: CARCINOGENIC RISK

2.3.1.2. 500mg PO q6-8 x 7-14

2.3.1.3. amebiasis: 750mg PO q8h x 5-10 days

2.3.1.4. vaginosis: 500mg PO q12h x 7 days

2.3.1.5. trich 2g PO/IV x 1

2.3.1.6. GIARDIASIS: 250mg PO q8h x 5-7 days

2.3.1.7. CI: PREGNANCY, hypersensitivity, alcohol use, CNS disorder, hepatic impairment, busulfan, ritonavir,

2.3.1.8. AE: Seizures, aseptic meningitis, SJS, leukopenia, N/V/D, rash, HA, dizziness, dark brown urine, candidiasis, metallic taste

2.4. DIHYDROFOLATE REDUCTASE INHIBITORS

2.4.1. COTRIMOXAZOLE (Bactrim)

2.4.1.1. bactrim

2.4.2. **TRIMETHOPRIM

2.4.2.1. UTI: 100mg PO q12

2.4.2.2. travelers diarrhea: 200mg PO BID

2.4.2.3. CI: anemia, folate deficiency, renal/hepatic impairment, bone marrow depression, dofetilide

2.4.2.4. AE: thrombocytopenia, neutropenia, SJS, aseptic meningitis, EM, phototoxicity, jaundice, Cdiff, Rash, pruritus, N/V fever, glossitis, taste change hyperkalemia, hyponatremia photosensitivity

2.5. SULFONAMIDES

2.5.1. TRIMETHOPRIM/SULFAMETHOXAZOLE (Bactrim)

2.5.1.1. 160mg PO q12

2.5.1.1.1. UTI: 160mg  PO q12h

2.5.1.2. CI: hypersensitivity to sulfa, thrombocytopenia, <2mo, pregnancy, anemia, hepatic impairment, folate deficiency, elderly, hyperkalemia, renal impairment, porphyria, malnutrition, dofetilide, methanamine, PREGNANCY

2.5.1.3. AE: SJS, toxic epidermal necrosis, aplastic anemia, hepatotoxicity, myelosuppresion, seizures, SLE, hypoglycemia, N/V/D, dizziness, HA, lethargy, dyspepsia

2.5.2. **SULFAMETHOXAZOLE

2.5.2.1. in bactrim

2.6. OTHER

2.6.1. DAPTOMYCIN (Cubicin)

2.6.1.1. MRSA COVERAGE

2.6.1.2. SKIN: 4mg/kg IV q24h

2.6.1.3. STAPH BACTEREMIA: 6mg/kg IV q12h

2.6.1.4. CI: hypersensitivity, <1, elderly, renal impairment,

2.6.1.5. AE: Cdiff, pNA, anaphylaxis, thrombocytpenia, myopathy, rhabdo, insomnia, CK elevation, edema, abdominal pain, itchy, HTN, HA, diarrhea, rash, UTI, dizziness, dyspnea

2.6.2. FIDAXOMICIN

2.6.2.1. CDIFF: 200mg PO BID x 10 days

2.6.2.2. CI: hypersensitivity

2.6.2.3. AE: hypersensitivity, GI bleed, neutropenia, anemia, N/V, abdominal pain, neutropenia,

2.6.3. **NITROFURANTOIN (Macrobid)

2.6.3.1. UTI

2.6.3.1.1. IR: 50-100mg PO q6h x 7 days

2.6.3.2. CI: hypersensitity, hepatic impairment, pts <1, oliguria, anuria, PREGNANCY, labor and delivery, anemia, DM, G6PD, articaine, -ivacaine,

2.6.3.3. AE:hemolytic anemia, aplastic anemia, leukopenia, thrombocytopenia, pancreatitis, hepatitis, cyanosis, CDiff, EM, SLE, N/VD, anorexia, abdominal pain, asthenia, vertigo dizzines, HA, drowsiness, confusion, alopecia, fever, rash itching, myalgia, rigors

3. PROTEIN SYNTHESIS INHIBITORS

3.1. AMINOGLYCOSIDES

3.1.1. BLACK BOX: neuro/oto/nephro toxicity & neuromuscular blockade

3.1.2. CI: renal impairment, dehydration, impaired auditory, neuromuscular dx, lyte abnormaltiies, prolonged use, high dose, infants, elderly, cidofovir, streptozosin

3.1.3. AE: nephrotoxicity, fanconi syndrome, ototoxicity, neurotoxicity, NM blockade, seizures, BUN/Cr elevation, dizziness, vertigo, tinnitus, hearing loss

3.1.4. GENTAMICIN

3.1.4.1. 1-1.7mg/kg IV q24h

3.1.4.1.1. gonococcal: 240mg IM x 1

3.1.4.1.2. PID: 1.5mg/kg IM/IV q8h

3.1.5. AMIKACIN

3.1.5.1. 7.5mg/kg IM/IV q12h

3.1.5.2. active TB: 15mg/kg IM/IV q24h

3.1.6. NEOMYCIN

3.1.6.1. colorectal surgery prophylaxis: 1000 mg PO

3.1.6.2. hepatic encephalopathy: 1000-3000 mg PO q6h

3.1.7. STREPTOMYCIN

3.1.7.1. 1-2g/day IM divided q6-12h

3.1.7.2. active TB: 15mg/kg IM/I q24h

3.1.8. TOBRAMYCIN

3.1.8.1. 1.-1.7mg/kg IM/IV q8h

3.2. MACROLIDES

3.2.1. CI: elderly, hepatic/renal impairment, QT prolongation, MI, bradycardia, CHF torsades, lyte abnormalities, mGF, cisapride, dronedarone, pimozide, thioridazine

3.2.2. AE: angiedema, anaphylaxis, jaundice, hepatotox, pancreatitis, SJS, necrolysis, CDIFF, QT prolongation, MG, N/V/D, HA, abdominal pain, vaginitis, dyspepsia, rash, anorexia, impaired hearing

3.2.3. **AZITHROMYCIN

3.2.3.1. COVERS GRAM - RODS, GRAM + COCCI

3.2.3.1.1. NO SPACEK BUGS

3.2.3.1.2. Added to ceftriaxone to cover hospital acquired pneumonia

3.2.3.2. 500mg PO x1 then 250mg PO q24h x 4 days

3.2.4. ERTHYROMYCIN

3.2.4.1. MRSA

3.2.4.2. 1000mg/day PO divided q6-12h

3.2.4.3. CI: + eliglustat, fluconazole, lovastatin, quinidine, simvastatin, thioridazine

3.3. STREPTOGRAMINS

3.3.1. QUINUPRISTIN/DALFOPRISTIN

3.3.1.1. BLACK BOX: indication for VREF bacteremia

3.3.1.2. 7.5mg/kg IV q12h

3.3.1.3. CI: hypersensitivity, alfuozsin, cisapride, eletriptan, pimozide

3.3.1.4. AE: Cdiff, angioedema, anaphylaxis, arthralgia, N/V rash, LDH elevation, anemia

3.4. LINCOSAMIDES

3.4.1. **CLINDAMYCIN

3.4.1.1. MRSA COVERAGE

3.4.1.2. BLACK BOX: CDIFF

3.4.1.3. 150-450mg PO q6h

3.4.1.4. CI: hypersensitivity, UC, neonates, GI dx, elderly, atopic, renal/hepatic impairment

3.4.1.5. AE: CDIFF, hypersenstivity, SJS, necrolysis, granulocytopenia, rash, N/V/D, abdominal pain, jaundice, urticaria, hypotension, metallic taste

3.5. OXAZOLIDINONES

3.5.1. **LINEZOLID (Zyvox)

3.5.1.1. MRSA COVERAGE

3.5.1.2. 600mg PO/IV q12h

3.5.1.3. PNA, VRE, skin/suture infx

3.5.1.4. CI: hhypersensitivity, myelosuppression, uncontrolled HT, pKU, hepatic impairment, seizure, renal impairment, amitriptyline, amoxapine, bupropion, duloxetine, fluoxetine, imipramine, isocarboxazid,

3.5.1.5. AE: CDIFF, anemia, lactic acidosis, SJS, serotonin syndrome, vision loss, seizures, N/V/D, HA, rash, HTN

3.6. TETRACYCLINES

3.6.1. AE: CDIFF, photosensitivity, skin rxn, anemia, hepatitis, toxicities, HA, N/V/D, dyspepsia, URI, dysmenorrhea, candidiasis, HTN, tooth discoloration

3.6.2. CI: hypersensitivity, PREGNANCY, <8, hepatic impairment, SLE, candidiasis, acitretin,

3.6.3. MRSA

3.6.4. **DOXYCYCLINE

3.6.4.1. 100mg PO/IV qd

3.6.4.2. ACNE: 50-100mg PO QD-BID

3.6.4.3. ROSACEA: 40mg pO qAM

3.6.4.4. CHLAMYDIA: 100mg PO x7days

3.6.5. TIGECYCLINE

3.6.5.1. BLACK BOX: ALL CAUSE MORTALITY

3.6.5.2. 50mg IV q12h

3.6.5.2.1. PNA, skin, intra abdominal

3.6.6. **MINOCYCLINE

3.6.6.1. 100mg PO q12

3.6.6.2. ACNE: 1mg/kg ER PO x 12wk

3.6.7. TETRACYCLINE

3.6.7.1. 1-2g/day PO divided BID-QID

3.6.7.2. ACNE: 125-250mg PO QID

3.6.7.3. SYPHILIS: 500mg PO QID x 14days

3.7. OTHER

3.7.1. AZTREONAM

3.7.1.1. 1-2g IM/IV q8-12h

3.7.1.2. CI: hypersensitivity, renal/hepatic impairment,

3.7.1.3. AE: anaphylaxis, necrolysis, seizures, Cdiff, hepatitis, neutropenia, anemia, phlebitis, N/V/D, rash, AST/ALT/Cr elevation,