Spectrum of antimicrobial drugs kushal

Spectrum of Antimicrobial drugs

Kushal PoudelInstitute of Medicine

Maharajgunj Medical CampusNepal

Chemotherapeutic spectra1. Gram +ve cocci

2. Gram +ve bacilli

3. Gram –ve cocci

4. Gram –ve bacilli

5. Anaerobic organisms

6. Spirochetes

7. Mycoplasmas

8. Rickettsia and Chlamydia

9. Other organisms (Acti-nomycetes, Protozoa)

Penicillin G & Penicillin VGram + Cocci •Streptococci (except viridans, group D or

enterococci)•Pneumococci

Gram + Bacilli •Bacillus anthracis•Corynebacterium diphtheriae

Gram – Cocci •N. meningitidis

Gram – Rods

Anaerobic organisms •Clostridium spp.

Spirochetes •Treponema pallidum

Mycoplasma

Chlamydia and RickettsiaeOther organisms

Penicillinase resistant penicillins (Methicillin, Cloxacillin, Dicloxacillin)

Gram + Cocci Staphylococci (except MRSA)

Gram + Bacilli

Gram – Cocci

Gram – Rods

Anaerobic organisms

Spirochetes

Mycoplasma


Extended Spectrum Penicillins (Ampicillin, Amoxicillin)

Gram + Cocci (When combined with sulbactam/clavulanic acid)•Most penicillinase producing Staphs (except MRSA)

Gram + Bacilli •Listeria

Gram – Cocci

Gram – Rods •E. coli•H. influenzae•Proteus mirabilis•Salmonella

Anaerobic organisms

Spirochetes

Mycoplasma


Antipseudomonal penicillins (Carbenicillin, Piperacillin, Ticarcillin)

Gram + Cocci

Gram + Bacilli

Gram – Cocci

Gram – Rods •Enterobacter spp•E. coli•Proteus mirabilis & indole +ve Proteus•H. influenzae•Pseudomonas aeruginosa

Anaerobic organisms

Spirochetes

Mycoplasma


1G Cephalosporins (P-Cefazolin, O-Cephalexin)

Gram + Cocci •Staphylococci (except MRSA)•Strep pneumoniae, pyogenes & viridans•Anaerobic Streptococci

Gram + Bacilli

Gram – Cocci •Moraxella catarrhalis

Gram – Rods •E. coli•Klebsiella•H. influenzae

Anaerobic organisms

Spirochetes

Mycoplasma


2G Cephalosporins (P-Cefuroxime, O-Cefaclor)

Gram + Cocci •Strep pneumoniae, pyogenes•Anaerobic Streptococci

Gram + Bacilli

Gram – Cocci •N. gonorrhoeae (including PPNG)

Gram – Rods •Enterobacter•E. coli•H. influenzae•Klebsiella pneumoniae•Proteus mirabilis

Anaerobic organisms

Spirochetes

Mycoplasma


3G Cephalosporins (P-Ceftriaxone, Cefoperazone, Ceftazidime; O-Cefixime, Cefpodoxime proxetil)

Gram + Cocci Reduced activity

Gram + Bacilli Reduced activity

Gram – Cocci •N. gonorrhoeae (including PPNG)

Gram – Rods •Enterobacter•E. coli•H. influenzae•Salmonella•Proteus (indole +ve)•Serratia•Pseudomonas (Cefoperazone &Ceftazidime only)

Anaerobic organisms

Spirochetes

Mycoplasma


Monobactams (Aztreonam)Gram + Cocci

Gram + Bacilli

Gram – Cocci

Gram – Rods •Enteric bacilli•H. influenzae•Pseudomonas

Anaerobic organisms

Spirochetes

Mycoplasma


Carbapenems (Imipenem, Meropenem, Faropenem, Doripenem)

Gram + Cocci •Staphs (except MRSA)•Streptococcus groups A,B,C•Enterococcus•Strep pneumoniae


Gram – Cocci •N. meningitidis & PPNG

Gram – Rods •Enterobacteriaceae•Ps. aeruginosa

Anaerobic organisms •Bacteroides fragilis•Clostridium difficile

Spirochetes

Mycoplasma

Chlamydia and RickettsiaeOther organisms •Actinomyces

•Nocardia

VancomycinGram + Cocci •Staphylococci including MRSA

•Streptococcus group A, B, C•Enterococcus•Strep pneumoniae


Gram – Cocci

Gram – Rods

Anaerobic organisms •Clostridium spp

Spirochetes

Mycoplasma

Chlamydia and RickettsiaeOther organisms •Actinomyces

Aminoglycosides (Gentamicin, Streptomycin, Kanamycin, Tobramycin, Amikacin, Neomycin)

Gram + Cocci •Enterococcus spp (Gentamicin + PnG)•Strep agalactiae (Gentamicin + PnG)

Gram + Bacilli

Gram – Cocci

Gram – Rods •Brucella spp (Gentamicin + Doxycycline)•Francisella tularensis (Gentamicin)•Klebsiella spp (Gentamicin + Antipseudomonal penicillin)•Pseudomonas aeruginosa (Tobramycin + Antipseudomonal penicillin)•Yersinia pestis (Streptomycin + Doxycycline)

Anaerobic organisms

Spirochetes

Mycoplasma

Chlamydia and Rickettsiae

Other organisms

Tetracyclines (Tetracycline, Oxytetracycline, Demeclocycline, Doxycycline, Minocycline)

Gram + Cocci •Strep pyogenes•Enterococci

Gram + Bacilli •Bacillus anthracis

Gram – Cocci •Few N. gonorrhoeae & N. meningitidis

Gram – Rods •Brucella spp (Tetracycline + Gentamicin)•Vibrio cholerae•Yersinia pestis•Calymmatobacterium granulomatis

Anaerobic organisms •Clostridium perfringens & tetani

Spirochetes •Borrelia burgdoferi•Leptospira

Mycoplasma •Mycoplasma pneumoniae


•Chlamydia spp•Rickettsia rickettsii

Other organisms •Actinomyces

ChloramphenicolGram + Cocci

Gram + Bacilli

Gram – Cocci •N. meningitidis

Gram – Rods •H. influenzae•B. pertussis•Klebsiella•Salmonella

Anaerobic organisms •Bacteroides fragilis•Clostridia

Spirochetes

Mycoplasma •Mycoplasma pneumoniae


•Rickettsiae

Other organisms

Macrolides (Erythromycin, Clarithromycin, Azithromycin)

Gram + Cocci •Staph aureus (Azithromycin only)•Strep pyogenes & pneumoniae

Gram + Bacilli •Corynebacterium diphtheriae

Gram – Cocci •Moraxella catarrhalis (Azithromycin)•Neisseria gonorrhoeae

Gram – Rods •Bordetella pertussis•Campylobacter jejuni•H. influenzae•Legionella pneumophila

Anaerobic organisms

Spirochetes •Treponema pallidum

Mycoplasma •Mycoplasma pneumoniae•Ureaplasma urealyticum


•Chlamydia pneumoniae•Chlamydia trachomatis

Other organisms

ClindamycinGram + Cocci •Staphylococci (except MRSA)

•StreptococciGram + Bacilli •C. diphtheriae

Gram – Cocci

Gram – Rods

Anaerobic organisms •Bacteroides fragilis•Most of the anaerobes

Spirochetes

Mycoplasma


LinezolidGram + Cocci •Enterococcus (VRE)

•Staphylococci (VRSA)•Strep pneumoniae & viridans (Penicillin resistant)

Gram + Bacilli •Corynebacterium spp•Listeria

Gram – Cocci

Gram – Rods

Anaerobic organisms •Cl. perfringens

Spirochetes

Mycoplasma


Sulfonamides (Sulfadiazine, Sulfamethoxazole, Sulfadoxine, Silver sulfadiazine, Sulfasalazine)

Gram + Cocci

Gram + Bacilli

Gram – Cocci

Gram – Rods •H. influenzae & ducreyi•Calymmatobacterium granulomatis•Vibrio cholerae

Anaerobic organisms

Spirochetes

Mycoplasma


•Chlamydia

Other organisms •Actinomyces•Nocardia

CotrimoxazoleGram + Cocci •Staph aureus


Gram – Cocci •Gonococci•Meningococci

Gram – Rods •E. coli•Proteus mirabilis•Salmonella typhi•Shigella spp•H. influenzae•Legionella pneumophila

Anaerobic organisms

Spirochetes

Mycoplasma

Chlamydia and RickettsiaeOther organisms •Pneumocystis jiroveci

Nalidixic acidGram + Cocci

Gram + Bacilli

Gram – Cocci

Gram – Rods •E. coli•Proteus•Klebsiella•Enterobacter•Shigella

Anaerobic organisms

Spirochetes

Mycoplasma


1G Fluoroquinolones (Ciprofloxacin, Norfloxacin, Ofloxacin)

Gram + Cocci

Gram + Bacilli •Bacillus anthracis•Mycobacterium tuberculosis

Gram – Cocci •Neisseria gonorrhoeae & meningitidis•Branhamella catarrhalis

Gram – Rods •Enterobacter spp•E. coli•Klebsiella pneumoniae•Proteus mirabilis•Vibrio cholerae•Shigella spp•Salmonella typhi•Nontyphoid Salmonella•H. influenzae•Legionella pneumophila•Pseudomonas aeruginosa

Anaerobic organisms

Spirochetes

Mycoplasma


Other organisms

2G Fluoroquinolones (Levofloxacin, Moxifloxacin)

Gram + Cocci •Strep pneumoniae

Gram + Bacilli •M. tuberculosis

Gram – Cocci

Gram – Rods •E. coli•Klebsiella pneumoniae•Proteus

Anaerobic organisms Some

Spirochetes

Mycoplasma •Mycoplasma pneumoniae (Levofloxacin)


•Chlamydia trachomatis (Levofloxacin)

Other organisms

MetronidazoleGram + Cocci

Gram + Bacilli

Gram – Cocci

Gram – Rods

Anaerobic organisms •Bacteroides fragilis•Fusobacterium•Clostridium perfringens & difficile•Helicobacter pylori•Campylobacter•Peptococci

Spirochetes •Anaerobic spirochetes

Mycoplasma

Chlamydia and RickettsiaeOther organisms •Anaerobic protozoa

‒ Trichomonas‒ Amoeba‒ Giardia lambia

References

• Lippincott’s Illustrated Review Pharmacology

• Essentials of Medical Pharmacology, KD Tripathi

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