• MOA: Disrupt synthesis of cell wall and promotes active destruction. Acts of PBP's on cytoplasmic membrane.
• TX: Mostly on gram positive (exc. resistant staph). Gram Neg Cocci, anaerobic bacteria, spirochetes. All forms may be used IM
• SE: Allergic rxn, severe 2-30 min. cross rxn w/ cepholosporins 1%. Interfere with BC, fungal infection, GI upset.
• Penicillin G, Nafcillin, Oxacillin, Ampicillin, Amoxicillin, Ticacillin, Pipericillin.

• Penicillin G: Important prophylactic, destroyed in stomach, use IM. Narrow spectrum.
• Nafcillin/Oxacillin: Narrow spectrum, resistant to inactivation by B-lactamases.
• Ampicillin/Amoxicillin: Broad spectrum, PO

• MOA: B-Lactam, bacteriacidal, Broad spectrum, disrupts cell wall synthesis and activates autolysins.
• TX: With generations increasing activity against gram negative, anaerobes, increasing ability to reach CSF and increasing resistance to B-Lactamases. Most widely used in hospitals. Parenteral (exc. Cefazolin).
• SE: Allergic rxn, very safe, low toxicity. C. Diff
• 1-Cefazolin, 2-Cefotetan, 3-Ceftriaxone, 4-Cefapime

• MOA: B-Lactam, weaken cell wall (lysis), bacteriacidal, broad spectrum (TX with narrow first), parenteral
• TX: gram pos. and gram neg. Cocci, gram neg. bacilli, group A betahemolytic strep., E. coli, salmonella.
• SE: GI effects, N/V/D, fungal infections, cross rxn to other B-Lactams, suprainfections in 4%. Rare seizures.
• Imipenem: most broad spectrum available, mixed with additive that prevents renal enzymes from destroying it.

• 1-Cefazolin: (PO) active against gram pos., staph and nonenteral strep., prophylactic for surgery.
• 2-Cefotetan: gram pos. gram neg., otitis, sinusitis, respiratory tract infections. bleeding tendency, no ETOH
• 3-Cefriaxone: broad spectrum, gram pos., gram neg., can reach CSF, P. aeruginosa, gonorrhea. do not mix with calcium
• 4-Cefepime: very broad specrtum, CSF penetration good.

• MOA: No B-Lactam ring, disrupts cell walls by binding to molecules that serve as precursors for cell wall by a synthesis. 
• TX: save for last resort. Good for C. Diff, MRSA. Only for gram pos., esp. S. aureus and S. epidermidis, also strep. PCN resistant pneumococci and C. Diff causing pseudomembranous colitis. Low level in CSF.
• SE: Lots of adverse reactions.

• Ototoxicty-hearing loss. s&s-tenitus, headache. usually reversable. Stop.
• Thrombocytopenia-destroy platelets. No clotting. s&s-petechiae, bruising, bloody gums. Stop.
• Redman syndrome-Not allergic rxn, s&s-BP drops, tachycardia, redness. Need to slow admin.
• Thrombophlebitus-Irritating to the veins s&s-redness, heat, swelling, pain, streaking. Use slow IV infusion (minimum 1 hour) diluted in normal saline. Must always change IV 72-96 hours.

• MOA: B-Lactam ring not fused with a second ring, inhibits cell wall synthesis. Cannot bind to PBP in anaerobes or gram pos., narrow spectrum, highly resistant to B-Lactamases.
• TX: E. coli, salmonella, P. aeruginosa. Parenteral. Can be used for CSF.
• SE: No cross rxn. Pain and thrombophlebitus

• MOA: Suppresses growth by inhibiting protein synthesis, inhibits binding of tRNA to 30s subunit. Bacteriostatic. Broad spectrum. Cannot cross mammalian cell membranes.
• TX: Chlamydia, Mycoplasma, H. pylori, anthrax, rocky mountain spotted fever, cholera, lyme disease, acne tx, peridontal disease, PO, IM, IV
• SE: Stains deciduous teeth. GI upset, C. Diff, candida, hepatotoxic, nephrotoxic, stunts growth
• Do not mix with milk products, MOM, antacids.

• MOA: inhibits protein synthesis, broad spectrum, commonly used, large molecules. Bacteriostatic, binds to 50s
• TX: Gram + bacteria, Pertussis, diptheria, chlamydia, pneumonia, strep. pneumonia, group A strep. pyrogenes
• SE: GI effects, pain N/V/D, QT prolongation in high []
• Interacts with Theophyline, Carbamazepine, Warfarin.
• Z-pack less GI upset.

• Clindamycin: promotes C. Diff, used against gram pos. and gram neg., staph. and strep.
• Linezolid: Effective against VRE and MRSA, bacteriostatic, N/D, headache, myelo suppression. 
• Telethromycin: effective against CAP-strep. pneumonia, AE severe liver injury.
• Chloramphenicol: broad spectrum, AE fatal, aplastic anemia
• Tigecycline: new class, broad spectrum, effective against MRSA and VRE

• MOA: disrupts bacterial protein synthesis, bacteriacidal, narrow spectrum.
• TX: gram neg. bacilli- E. coli, K. pneumonia, P. aeruginosa. Parenteral.
• SE: Ototoxic. Irreversable. settles on cochlea, causes nerve damage. Level doesn't trough enough to leave cochlea. Stop. Nephrotoxic. Neuromuscular blockade (flaccid paralysis). Do not mix with PCN. Take peak and trough.
• Gentamycin, amikacin, tobramycin

• MOA: suppress growth by inhibing synthesis of folic acid. high resistance. Bacteriostatic
• TX: UTI, gram pos. cocci, MRSA, chlamydia, pneumocystitis jiroveci (severe immune compromise/HIV)
• SE: crystalluria (drink lots of water), hypersensitivity, blood dyscrasia (decrease in blood cells), Kernicturus (bilirubin in brain, not for newborns), stevens-johnson syndrome (lesions mostly around the mouth, 25% fatal).
• Bactrim, used first to treat MRSA

Inhibits bacterial synthesis of DNA/RNA or disrupt DNA function.

• Ciprofloxacin-broad spectrum, PO/IV. SE-achilles tendon rupture (changes matrix of cartilage), sensitive to UV light, candida. Use for E. coli, salmonella, anthrax, P. aeruginosa