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CLASS EXAMPLE SIDEEFFECTS USES/INFO EFFECTIVE RESISTANCE DOSE

AGAINST

Penicillin G,V Penicillin G Hypersensitivity, penicillin g drug of choice S.pneumoniae, varies Streptococcal infections
(permapen) anaphylaxis rare but in subacute bacterial s.pyogenes,ac (group A) and staphylococcal
fatal.(incidence higher endocarditis, opthalmia tinomyces infections 600,000-1000,000
with procaine pn) neonatorum, Neisseria units IM qDay
Jarisch-Herxheimer syphilis,leptospirosis,dipht meningitides,s Renal impairment:
reaction (seen in heria,tetanus,gas gangrene pirochets CrCl 10-50mL/min decrease
syphilitic patients dose by 25%
injected with penicillin
fever, shivering,
myalgia, vascular
collapse.
Hemolytic anemia, drug
induced interstitial
nephritis

Penicillinase Amoxicillin Hypersensitivity Ampicillin; HHEELPSS variable Ampicillin 0.5-2g 6hourly

sensitive (augmentin,c reaction, rash, UTI, bronchitis, otitis (H.influenza,h. (oral/IM/IV)
alamox),amp pseudomembranous media,sinusitis,meningitis, pylori,ecoli,Ent Amoxicillin 0.25g-1g TID
penicillin’s
icilllin,amino colitis gonorrhea,cholecystitis,H. erococci,Listeri (oral,IM/slow IV)
penicillins pylori,septicemia a,proteus,Salm
Amoxicillin onella,Shigella)
abscesses,carbuncles,perit
onitis,pharyngitis,pneumo
nia,pylenephritis,skin
infections

Anti Piperacillin,ti Hypersensitivity Bacterial infections, bone Pseudomonas 3.375g IV every 6 hourly
pseudomonal carcillin reaction, prolongation and joint infections, specie, gram - usual duration of treatment
(Tanzo: of bleeding time complicated appendicitis, rods 7-10 days
penicillins
piperacillin+t GI infections ,gonorrhea, Renal adjustment: CrCl
azobactum) septicemia, UTI, surgical >40ml/min no adjustment
prophylaxis recommended

Trimethoprim TMP-SMX Hyperkalemia(high Maybe used in combination Shigella moderate 1 bactrim DS or 2 bactrim
(folic acid (Bactrim, dose),megaloblastic with sulphonamide (co- Salmonella tablets PO q12-24hr,
inhibitor) bactrim DS, anemia, leucopenia, trimoxazole) Pneumocystis 8-20mg TMP/KG/day IV q6-12
septra, co granulocytopenia, co- Particularly in pneumonia. jirovecii hourly.
trimoxazole) administration with Used alone in RTI and UTI Used for 10-14 days in
leucovorin (folinic acid) UTI ,bronchial asthma
TMP Treats Marrow Renal impairment
Poorly Crcl>30ml:dose adjustment not
necessary
Crcl15-30ML/min:decrease dose
by 50%
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Cephalosporin 1st Cefazolin Hypersensitivity Cholecystitis, bone and joint 1st gen PEck varies Cefazolin 250-500mg IV/IM
(modified B Cephalexin Nephrotoxicity infections due to staph, Proteus, cxEcoli, every 8 hourly max 12g/day
lactam) 2nd cefaclor Skin reaction (disulfiram respiratory tract kleibsella Cefaclor 250-500mg 8 hourly
Cefuroxime(zi like) infections ,skin and skin 2nd gen Hens Cefoxitin 1-2g IV 12 hourly Iv
nacef) Ceftriaxone causes structures , infections, genital PEck followed by infusion
Cefoxitin(emid agranulocytosis, infections, Used prior to H influenza, Ceftriaxone/Rocephin
oxin) pseudomembranous surgery enterobacter 50-65mg/kg/day
3rd colitis aerogens, 1g IM/ IV BD usually
ceftriaxone(ox nesseria, In case of enteric and meningitis
idil,rocephin,ti serratia 2g IM/IV BD
tan) 3rd serious gram Duration of treatment 4-14 days
Ceftazidime(fo –
rtum) 4th gram- gram+
4th pseudomonas
cefepime(cefi 5th gram+ and
pime,cefpam) gram -
5th caftaroline
Carbapenems Imipenem GI distress,rash, CNS Limited use to life Gram + Imipenem/cilastin 5oomg IVq6h
Meropenem(p toxicity (seizures) at high threatening infections due to Gram – 1g IV every 8 hourly over 7 days
enro) plasma levels significant side effects. anaerobes if good clinical response and
Imipenem inactivated by organism other than
renal tubules always pseudomonas
administered with cilstatin. Meropenem standard dose
Meropenem safer than 500mg IV q6h
imipenem CrCl 25-49:500mg q8h
CrCl 10-24: 500mg q12h
CrCl <10:500mg q24h
Tetracyclines Tetracycline GI distress discoloration of Doxycycline is fecally Burrelia widespread Doxycycline 100mg PO/IV q12h
(t-RNA inhibitors) doxycycline teeth, teratogenic avoided eliminated so can be used in burgdorferri
in pregnancy and in renal failure as an alternative Chlaymadia,chol
children(except to B lactams era
doxycycline) Used a s prophylactic m.pneumoniae

Aminoglycosid Gentamycin Nephrotoxicity, Severe gram – rod infections Gram – rod Widespread can 1.5-2.5mg/kg IV q8h
Streptomycin neuromuscular blockade, Neomycin for bowel surgery be overcome if monitoring of serum levels
es (inhibit cell neomycin absolute contraindication used with recommended
wall synthesis)
with myasthenia gravis, penicillin or CrCl 51-90:60-90% q8-12h
ototoxicity especially with vanc CrCl 10-50: 30-70% q12
loop diuretics, CrCl <10; 20-30% q24-48h
teratogenicity

Glycopeptide Vancomycin(vi Nephrotoxicity ,ototoxicity Gram positive bugs that are MRSA uncommon Vancomycin IV 15-20/mg q12h
(inhibit cell wall njec) , thrombophlebitis, diffuse serious and multi drug S epidermidis Consider 25mg/kg *1 loading
synthesis) teicoplanin flushing(red man resistant Sensitive dose in critically ill patients
syndrome) idiopathic enterococcus Dosing, therapeutic goals and
reaction can be prevented Clostridium monitoring should be
by pretreatment with difficile individualized for each patient
antihistamines to achieve troughs
10-20mcg/ml. AUC >400 ideal

Monobactam Aztreonam Usually non-toxic For penicillin allergic patients Gram – rods 1g IVq8h
(modified B Those with renal insufficiency No activity Moderate to severe infections,
lactam) who cannot tolerate against gram + pseudomonas 2gm IV q8hr
aminoglycosides rods or CrCl 10-30 same dose IV q12h
anaerobes CrCl <10:same dose IV q24h

Macrolides Azithromycin( M gastrointestinal motility Used against gram positive Atypical(mycopl moderate Azithromycin 250-500mg PO/IV
(inhibit azomax) issues infections asma,Chlaymyd q24h
translocation of Erythromycin Arrhythmias ai,legionalla Clarithromycin 0.5-1g PO q12
proteins) Clarithromyci C acute cholestasis Gram + If Crcl<30:50% PO q12h
n(claritek,Klari Rash streptococcus Erythromycin 250-500mg PO
cid) Eosinophilia pertussis q6-12h
Inhibit cytochrome P450 IV 15-20mg/kg/day divided q6-
Increases concentration of 8h
anticoagulants CrCl <10:50% PO/IV at same
interval
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Quinolones Ciprofloxacin( GI disorders, skin rashes, Useful against gram – rods of uncommon Levofloxacin
(inhibits DNA novidat) superinfection urinary and GI tracts 500mg PO/IV q24h (max
transcription) Levofloxacin(l Contraindicated during including pseudomonas 750mg)
eflox) pregnancy or CrCl 20-49:500mg*1dose,then
Moxifloxacin( breastfeeding and in 250mg
moxiget,avelo children <18 years due to CrCl <20,HD/PD:500mg
x) possible cartilage damage. *1dose,then 250mg q48h
ofloxacin May cause tendonitis or UTI,cystitis 250mg PO/IV q24h
tendon rupture in Moxifloxacin 400mg over 24hr
people>60 years old and Ciprofloxacin 500mg PO
patients taking prednisone BD,400mg IV
Don’t use in conjugation
with theophylline

Metronidazole Flagyl Disulfiram like reaction Treat anaerobic infection GET GAP on the Uncommon but 500mg PO/IV q8h
entamizole (severe below the diaphragm v/s metro with growing CrCl <10,HD or severe hepatic
(DNA synthesis flushing,tachycardia,hypot clindamycin anaerobic metronidazole dysfunction consider 50% at
ention with alcohol) infections above diaphragm Giardia same interval if >4 day duration
Inhibitor) headache,metallic taste Entamoeba
Trichomonas
Gardenella
vaginalis
Anaerobes
(bacteroides,c
difficile)
P H pylori

Nitrofurantoin Peripheral neuropathy,GI Effective against most gram+ uncommon 50-100mg PO q12h
(disrupts DNA) upset,long term use can cocci and against Ecoli (G-) IF CrCl <30 use not
cause lung fibrosis often used for LUTIs recommended

Chlorampheni Highly toxic, bone marrow Topical for conjunctivitis, Hemophilus moderate 12.5-25mg/kg IV q6h
toxicity, neuritis, rashes, meningitis, rickettsia influenza
col (disrupts Grey baby syndrome in Neisseria
DNA)
infants (lack UDP enzyme) meningitis
sterptococcus

Lycosamides clindamycin Pseudomembranous Anaerobic infections in Anaerobic moderate PO

(inhibit protein colitis(c difficile aspiration pneumonia, lung bacteroides 150-450mg PO q6-8h
synthesis) overgrowth) abscess, oral infections, Clostridium 600mg PO q8h(MRSA)
Neutropenia, invasive group A perfringens IV
thrombocytopenia streptococcal infection Group A Standard dose 600mg IV q8h
streptococcal Necrotizing fasciitis 900mg IV
q8h
linezolid Zolrest,Nezkil, Bone marrow suppression Vancomycin resistant Gram + species 600mg PO/IV q12h
ecasil especially enterococcal Including MRSA
thrombocytopenia, infections,complicated skin VRE
peripheral neuropathy, and skin structure infections,
serotonin syndrome nosocomial pneumonia

Polymixin Colistin, Nephrotoxicity ,neurotoxi Salvage therapy for multidrug Wide coverage uncommon Use loading dose of 300mg IV in
polymixin E,B city e.g slurred speech, resistant gram – P.aeruginosa, all patients start maintaining
weakness, Polymixin B component of H.influenza, dose 12h after loading dose
paresthesia ,respiratory triple antibiotic ointment k.pneumoniae CrCl, ml/min
failure Useful for superficial skin >90 180mg q12h
infections 80 to <90 170mg q12h
70to <80 150mg q12h
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