Cephalosporins (1st Generation)

1. Excellent against MSSA, Strep. spp; no coverage against Enterococcus spp.
2. Limited
3. Only oral anaerobes
4. Hypersensitivity
5. Used for skin and soft tissue infections, surgical prophylaxis. Not reocmmended for URI and LRI due to gram negatives.

Cephalosporins (1st Generation)

1. Excellent against MSSA, Strep. spp; no coverage against Enterococcus spp.
2. Limited
3. Only oral anaerobes
4. Hypersensitivity
5. Used for skin and soft tissue infections, surgical prophylaxis. Not reocmmended for URI and LRI due to gram negatives.

Cephalosporins (1st Generation)

1. Excellent against MSSA, Strep. spp; no coverage against Enterococcus spp.
2. Limited
3. Only oral anaerobes
4. Hypersensitivity
5. Used for skin and soft tissue infections, surgical prophylaxis. Not reocmmended for URI and LRI due to gram negatives.

Cephalosporins (2nd Generation, 2A)

1. Good MSSA, Strep; no coverage against Enterococcus
2. Limited but effective against H. influenzae, M. catarrhalis
3. Oral anaerobes
4. Hypersensitivity
5. Used for URI due to gram negative coverage but resistance develops

Cephalosporins (2nd Generation, 2A)

1. Good MSSA, Strep; no coverage against Enterococcus
2. Limited but effective against H. influenzae, M. catarrhalis
3. Oral anaerobes
4. Hypersensitivity
5. Used for URI due to gram negative coverage but resistance develops

Cephalosporins (2nd Generation, 2A)

1. Good MSSA, Strep; no coverage against Enterococcus
2. Limited but effective against H. influenzae, M. catarrhalis
3. Oral anaerobes
4. Hypersensitivity
5. Used for URI due to gram negative coverage but resistance develops

Cephalosporins (2nd Generation, 2B)

1. Poor MSSA; moderate Strep; no coverage against Enterococcus
2. Limited but effective against H. influenzae and M. catarrhalis
3. Oral anaerobes and moderate B. fragilis
4. Hypersensitivity
5. Used for intra-abdominal and pelvic infections

Cephalosporins (3rd Generation)

1. Moderate MSSA; excellent Strep; no coverage against Enterococcus
2. Broad but not against Pseudomonas
3. Oral anaerobes
4. Hypersensitivity
5. N/A

Cephalosporins (3rd Generation)

1. Moderate MSSA; excellent Strep; no coverage against Enterococcus
2. Broad but not against Pseudomonas
3. Oral anaerobes
4. Hypersensitivity
5. N/A

Cephalosporins (3rd Generation)

1. Moderate MSSA; excellent Strep; no coverage against Enterococcus
2. Broad but not against Pseudomonas
3. Oral anaerobes
4. Hypersensitivity
5. N/A

Cephalosporins (3rd Generation)

1. Moderate MSSA; excellent Strep; no coverage against Enterococcus
2. Broad but not against Pseudomonas
3. Oral anaerobes
4. Hypersensitivity
5. Gold-standard for community-acquired meningitis, N. gonorrhea, and neuro Lyme
6. Biliary elimination

Cephalosporins (3rd Generation)

1. Moderate MSSA; excellent Strep; no coverage against Enterococcus
2. Broad but not against Pseudomonas
3. Oral anaerobes
4. Hypersensitivity
5. Gold-standard for community-acquired meningitis, N. gonorrhea, and neuro Lyme

Cephalosporins (3rd Generation)

1. Moderate MSSA; excellent Strep; no coverage against Enterococcus
2. Broad but not against Pseudomonas
3. Oral anaerobes
4. Hypersensitivity
5. N/A

Cephalosporins (3rd Generation)

1. Poor MSSA; poor Strep; no coverage against Enterococcus
2. Broad including Pseudomonas
3. Oral anaerobes
4. Hypersensitivity
5. N/A

Cephalosporins (3rd Generation)

1. MRSA; excellent Strep; no coverage against Enterococcus
2. Broad but not against Pseudomonas
3. Oral anaerobes
4. Hypersensitivity
5. Equivalent to Ceftriaxone + MRSA activity

Cephalosporins (4th Generation)

1. Good MSSA and Strep; no Enterococcus
2. Broad including Pseudomonas
3. Oral anaerobes
4. Hypersensitivity
5. N/A

Monobactam

1. None
2. Good, including Pseudomonas
3. None
4. Hypersensitivity
5. Safe to use in patients with severe allergic reactions to other beta-lactams

Carbapenems

1. Good MSSA and Step; decent E. faecalis
2. Excellent including Pseudomonas and other multi-drug resistant strains
3. Anaerobes including B. fragilis
4. Hypersensitivity, seizures
5. Cilastatin inhibits hydrolysis of Imipenem

Carbapenems

1. Good MSSA and Step; decent E. faecalis
2. Excellent including Pseudomonas and other multi-drug resistant strains
3. Anaerobes including B. fragilis
4. Hypersensitivity
5. N/A

Carbapenems

1. Good MSSA and Step; decent E. faecalis
2. Excellent including Pseudomonas and other multi-drug resistant strains
3. Anaerobes including B. fragilis
4. Hypersensitivity
5. N/A

Carbapenems

1. Limited, no Enterococcus
2. Excellent but not Pseudomonas
3. Anaerobes including B. fragilis
4. Hypersensitivity
5. Long half-life

Glycopeptides

1. Very good including Strep., MRSA/MRSE, and Enterococcus; not VRE
2. None
3. Poor against G- anaerobes; effective against C. difficile
4. Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse Erythema
5. Used exclusively for G+ infections and C. difficile diarrhea (PO). Resistance amongst staph/strep rare

Glycopeptides

1. Very good including Strep., MRSA/MRSE, and Enterococcus; not VRE
2. None
3. Poor against G- anaerobes; effective against C. difficile
4. Nephrotoxicity, Ototoxicity, Thrombophlebitis, diffuse Erythema
5. Clinical niche unclear

Penicillin V

Penicillin G

Natural Penicillins, Penicillins

1. Most Strep. spp; Enterococcus spp. especially E. faecalis
2. Minimal
3. Treponema pallidum, oral anaerobes
4. Hypersensitivity
5. Lost utility against Staph. and some S. pneumoniae. Needs aminoglycosides for cidal against Entero

Aminopenicillins, Penicillins

1. Most Strep., Enterococcus spp. (especially E. faecalis), Listeria monocytogenes
2. Minimal but some activity against E. coli, Proteus mirabilis, H. influenzae (resistance common)
3. Treponema pallidum, oral anaerobes, Lyme
4. Hypersensitivity
5. N/A

Ampicillin/Sulbactam

Amoxicillin/Clavulanate

Aminopenicillins+beta-lactamase inhibitor, Penicillins

1. Most Strep., Enterococcus spp. (especially E. faecalis), MSSA
2. Minimal but effective against E. coli, Klebsiella, H. influenzae
3. Treponema pallidum, Lyme, B. fragilis
4. Hypersensitivity, diarrhea

Penecillinase Resistant Penicillin, Penicillins

1. Excellent MSSA (drug of choice), most Strep, no Enterococcus spp.
2. None
3. None
4. Hypersensitivity, hepatotoxicity, interstitial nephritis
5. Hepatic elimination

Penecillinase Resistant Penicillin, Penicillins

1. Excellent MSSA (drug of choice), most Strep, no Enterococcus spp.
2. None
3. None
4. Hypersensitivity, hepatotoxicity, interstitial nephritis
5. Hepatic elimination

Penecillinase Resistant Penicillin, Penicillins

1. Excellent MSSA (drug of choice), most Strep, no Enterococcus spp.
2. None
3. None
4. Hypersensitivity, hepatotoxicity, interstitial nephritis
5. Hepatic elimination

Extended Spectrum Penicillin+beta-lactamase inhibitor, Penicillins

1. Excellent MSSA, most Strep., no Enterococcus spp.
2. Broad activity including Pseudomonas
3. Treponema pallidum, oral anaerobes, B. fragilis
4. Hypersensitivity, diarrhea

Extended Spectrum Penicillin+beta-lactamase inhibitor, Penicillins

1. Excellent MSSA, most Strep., no Enterococcus spp.
2. Broad activity including Pseudomonas
3. Treponema pallidum, oral anaerobes, B. fragilis
4. Hypersensitivity, diarrhea

Inhibitors of DNA/RNA Synthesis

1. Good S. aureus, S. epi including most MRSA, MRSE; poor Strep.; No Enterococcus
2. Most G- including Stenotrophomonas maltophilia; not Pseudomonas
3. Nocardia, Pneumocystis jiroveci (PCP), Toxoplasma gondii, not B. fragilis
4. Skin rash/Stevens-Johnson/toxic epidermal necrolysis, elevated serum creatinine, hyperkalemia, acute intersitial nephritis, agranulocytosis, neutropenia
5. UTI, GI, skin, pneumocystis (treatment and prophylaxis), toxoplasmosis, nocardiosis

Inhibitors of DNA/RNA Synthesis

1. Rapid Staph/Strep resistance when used alone, no Enterococcus spp.
2. Limited, N. meningitidis (prophylaxis only)
3. M. tuberculosis
4. Orange-red discoloration of tears, sweat, urine; GI; hepatotoxicity
5. TB, staphylococcal endocarditis, infections of prosthetic materials; many drug-drug interactions
6. Biliary elimination

Inhibitors of DNA/RNA Synthesis

1. Variable Staph., Strep., and Entero.
2. None
3. G+ anaerobes, especially C. difficle
4. Relatively non-toxic
5. Only for C. difficile infection

Quinolones

1. Moderate Strep., quick resistance to Staph., poor S. pneumonae, poor Enterococci
2. Excellent, including Pseudonomas
3. Poor anaeobes, good atypicals: Chlamydia spp., Mycoplasma, Legionella spp.
4. Headache, dizziness, insomnia, mood alterations, seizures; tendinitis with rupture
5. UTI, prostatitis, respiratory tract, GI, bone, joint infection, STDs. Resistance common

Quinolones

1. Moderate Strep., quick resistance to Staph., excellent S. pneumonae, poor Enterococci
2. Excellent, including Pseudonomas
3. Poor anaeobes, good atypicals: Chlamydia spp., Mycoplasma, Legionella spp.
4. Headache, dizziness, insomnia, mood alterations, seizures; tendinitis with rupture
5. UTI, prostatitis, respiratory tract, GI, bone, joint infection, STDs. Resistance common

Quinolones

1. Moderate Strep., quick resistance to Staph., excellent S. pneumonae, poor Enterococci
2. Moderate
3. good anaeobes, good atypicals: Chlamydia spp., Mycoplasma, Legionella spp.
4. Headache, dizziness, insomnia, mood alterations, seizures; tendinitis with rupture
5. UTI, prostatitis, respiratory tract, GI, bone, joint infection, STDs. Resistance common

Aminoglycosides

1. Moderate Strep. and Staph.; cidal against Enterococci with penicillins
2. Broad activity including Pseudomonas (gentamicin<tobramycin<amikacin)
3. None
4. Nephrotoxicity, reversible; Ototoxicity, irreversible
5. Used together with cell-wall agents for staph/strep/enterococcal endocarditis; "double coverage" for G- infection

Aminoglycosides

1. Moderate Strep. and Staph.; cidal against Enterococci with penicillins
2. Broad activity including Pseudomonas (gentamicin<tobramycin<amikacin)
3. None
4. Nephrotoxicity, reversible; Ototoxicity, irreversible
5. Used together with cell-wall agents for staph/strep/enterococcal endocarditis; "double coverage" for G- infection

Aminoglycosides

1. Moderate Strep. and Staph.; cidal against Enterococci with penicillins
2. Broad activity including Pseudomonas (gentamicin<tobramycin<amikacin)
3. None
4. Nephrotoxicity, reversible; Ototoxicity, irreversible
5. Used together with cell-wall agents for staph/strep/enterococcal endocarditis; "double coverage" for G- infection

Macrolides

1. Some Strep. pneumoniae; other Strep., MSSA (not first line)
2. Good H. influenza, N. gonorrhea, M. catarrhalis, Campylobacter, H. pylori
3. Good Chlamydia, Legionella, Mycoplasma; anaerobes but not B. fragilis, Mycobacterium avium complex (MAC)
4. GI
5. Used for atypical pathogens in community acquired pneumonia; otitis, sinusitis, pneumonia

Macrolides

1. Some Strep. pneumoniae; other Strep., MSSA (not first line)
2. Good H. influenza, N. gonorrhea, M. catarrhalis, Campylobacter, H. pylori
3. Good Chlamydia, Legionella, Mycoplasma; anaerobes but not B. fragilis, Mycobacterium avium complex (MAC)
4. Torsades d pointes (ventricular tachycardia)
5. Used for atypical pathogens in community acquired pneumonia; otitis, sinusitis, pneumonia

Tetracyclines

1. Activity against Strep. pneumoniae, Staph., Enterococcus, minimal Strep. pyogenes
2. Good H. influenzae, N. gonorrhea, M. catarrhalis, Campylobacter
3. Extensive anaerobes; Rickettsial infections; Lyme disease
4. GI ulceration, teeth discoloration in children, photosensitivity
5. Limited use; may be used for COPD

Tetracyclines

1. Activity against Strep. pneumoniae, Staph., Enterococcus, minimal Strep. pyogenes
2. Good H. influenzae, N. gonorrhea, M. catarrhalis, Campylobacter
3. Extensive anaerobes; Rickettsial infections; Lyme disease
4. GI ulceration, teeth discoloration in children, photosensitivity
5. Limited use; may be used for COPD

Tetracyclines

1. Activity against Strep. pneumoniae, Staph., Enterococcus, minimal Strep. pyogenes
2. Good H. influenzae, N. gonorrhea, M. catarrhalis, Campylobacter
3. Extensive anaerobes; Rickettsial infections; Lyme disease
4. GI ulceration, teeth discoloration in children, photosensitivity
5. Limited use; may be used for COPD

Glycylcycline

1. Extensive including MRSA, VRE
2. Extensive except for Pseudomonas
3. Extensive anaerobic including B. fragilis
4. GI ulceration, teeth discoloration in children, photosensitivity
5. Not used for bacteremia due to low serum level

Lincosamide

1. Activity against S. aureus., S. epi., Strep. but not first line, no Enterococci
2. None
3. Good anaerobic, Bacteroides resistance
4. Nausea/vomiting/diarrhea; C. difficile colitis
5. Oral infections, skin/soft tissue infection in patients allergic to penicillin; part of combination therapy for necrotizing fasciitis

Oxazolidinone

1. Vast activity, MRSA and most VRE
2. None
3. Unknown
4. Myelosuppression, thrombocytopenia, serotonin syndrome
5. Reserved for resistant gram+ infections

DNA Damaging Agents

1. Good most gram+ including VRE
2. Most E. coli, Klebsiella, Enterobacter (variabl); Proteus and Pseudomonas resistant
3. None
4. GI, pulmonary
5. Not used for systemic infections (low serum level); UTI but not pyelonephritis

DNA Damaging Agents

1. None
2. None
3. Extensive anaerobes including B. fragilis; Trichomonas, Giardia, Helicobacter pylori, C. difficile
4. GI, metallic taste, peripheral neuropathy
5. Drug of choice for initial mild-moderate C. difficile disease; extensively cover anaerobic infections

Lipopeptides

1. Extensive including MSSA, MRSA, MRSE, VRE, resistant Strep, most Enterococci
2. None
3. None
4. Muscle pain/weakness, rash
5. Not used for pneumonia; mostly for G+ bloodstream infections that are refractory or resistant to first line

Polymyxins

1. None
2. Extensive including Pseudomonas
3. None
4. Dose-related reversible nephrotoxicity, neurotoxicity, parethesias
5. Last resort for multi-drug resistant gram- infections; used in combo