Lile Bai 1

Area/Site Common Organism Useful abx Other notes

S/SI Human bite Staph/strep, anaerobes Amox/clav (mild)
Amp/sulb (sev) or
Clinda+SMZ/TMP (alt) OR
Clinda+FQ
Cat bite Pasteurella multocida, staph Amox/clav
Doxycycline
Dog bite Pasteurella, staph, anaerobes Amox/clav
Clinda+SMZ/TMP
Clinda+FQ
Cellulitis Staph/strep Amox/clav
Cephalexin (Keflex)
Dicloxacillin
Clindamycin
IV equiv (if severe)
DFI Staph/strep (sup) Amox/clav
Cephalexin
Dicloxacillin
Clinda
IV equiv (if severe)
Staph/strep, GNR, anaerobes Amp/sulb Use IV abx or tx early!
(deep/old) Clinda+SMZ/TMP Odor = anaerobesa
Clinda+FQ
Ertapenem
UTI Outpt – 3d E. Coli, other GNR, Staph SMZ/TMP Male 7-10 therapy and
Nitrofurantoin (Macrodantin) Nonpreg women of
Fosfomycin (Monurol) child bearing age
Ciprofloxacin, levofloxacin
Outpt 7-10d E. Coli, other GNR, Staph SMZ/TMP
Nitrofurantoin (Macrodantin)
Fosfomycin (Monurol)
Ciprofloxacin, levofloxacin
Inpt 3-7 d E. Coli, other GNR, Staph IV FQ (Cipro, Levo)
Amp + gent
Celftriaxone
Pyelonephritis E. Coli, other GNR, Staph IV FQ (Cipro, Levo)
7-10d Amp + gent
Celftriaxone
Lungs Outpt Viruses, pneumococcus, H.flu, Azithro or clarithro Smokers have higher
mycoplasma Amox/clav incidence of H. flu
Cefprozil
Levo or moxi
Admitted to Pneumococcocus, H.flu, Ceftriaxone+azithro/clarithro
hospital mycoplasma Levo or moxi
Ertapenem+azithro/clarithro
Aspiration Mouth flora Amp/sulb
Pip/tazo
Ceftriaxone+metronidazole
Nosocomial Pneumococcus, H.flu, Pip/tazo+Cipro If suspect pseudomonas,
pseudomonas Pip/tazo+tobra pick at least one anti-
Imipenem+Cipro pseudo dual tx until
Imipenem+tobra MIC results
Other double-coverage regimens

Bone Osteomyelitis Staph, strep IV oxacillin (initially) IV for anything long

(6 weeks of Ceftriaxone (for home) term (PICC)
therapy) Vanco or linezolid if MRSA
suspected or proven
Lile Bai 2
Meningitis Pneumococcus, Ceftriaxone or cefotaxime + 3 abx (cross BBB, TB,
meningococcus, H.flu rifampin and vancomycin vanco until results),
Dexamethasone (anti-inflam) steroid when bac dies
Otitis Media Cause virus. #1 bact = strep Amox
pneumo, then hemophilis Amox/clav
Cefprozil (Cefzil)
Azithro/clarithro
GI/intra- Abx-associated Clostridium difficle PO vancomycin IV for pts who cannot
abdominal colitis (AAC) PO fidaxomicin (difficid) swallow
PO/IV metronidazole (when PO
vanco not available)
Appendicitis e. coli, klebsiella pneumoniae, Amp/sulb Same tx all 4
Abscess proteus, other GNR FQ+metronidazole
Diverticulitis (enterobacteriaceae) Ertapenem (Invanz)
Pertonitis Zosyn
Blood stream Sepsis (GU) e. coli, proteus, klebsiella, Ceftriaxone (Rocephin)
other GNR Ciprofloxacin or levofloxacin
Other abx that cover e. coli (like a
carbapenem)
Sepsis (GI) GNR Tx source
Sepsis (resp) Pneumococcus Ceftriaxone + azithromycin
Endocarditis Strep/Staph Oxacillin+gent
Ceftriaxone+gent
Vanco+gent
MRSA (seen with IV drug Vanco+gent Vanco unless CA-
users) Linezolid MRSA (Bactrim)
Daptomycin (Cubicin) (heroin user)
Genitourinary PID (14d) Gonococcus, chlamydia, GNR Levo+metronidazole Always tx chlamydia
(proteus, e. coli) Ceftriaxone+metro+doxy unless ruled out
Clinda+gent+doxy
Amp/sulb+doxy
STD Gonorrhea Ceftriaxone (single dose w/ 1000 FQ no longer
mg of azithryomycin) recommended. Treat as
if the pt has co-infection
with chlamydia (GN
cocci).
Syphilis PCN (DOC in preg women)
Ceftriaxone (if PCN allergy – IM
daily for 10-14 days)
Doxycycline
Epididymitis (males only) Ceftriaxone (once)+doxycycline Tx empirically for 10d
(10d)
Levofloxacin (10d)
Trichomonas Metronidazole (PO or vaginal Prefer topical if
topical) pregnant b/c fetus
Chlamydia trachomatis Azithromycin Atypical bacteria; treat
(urethritis/cervicitis) Doxycycline (10d) the partner too.
Levofloxacin (10d)
Cancroid Azithromycin H.ducreyi is the bacteria
Ceftriaxone
Ciprofloxacin (10d)
Mycoplasma Genitalium Azithromycin+ceftriaxone
(urethritis/cervicitis) Doxycycline (10d)
Levofloxacin (10d)
Bacterial Vaginosis Metronidazole (gel or oral) Gardnerella vaginalis;
Clindamycin (gel or oral) treat the partner too.
Lile
Type Treatment
Fungal Systemic Amphotericin B (Fungizone)
infections
Fluconazole (Diflucan)
Terbinafine (Lamisil)
Itraconazole (Sporanox)
Superficial Ketoconazole (2% cream or
infection shampoo)
Terbinafine (1% cream)
Nystatin (Myconazole powder
–for skin folds-, cream,
ointment, oral suspension –for
thrush-)
Viral Topical, PO, IV acyclovir
Famiciclovir (Famvir)
Valacyclovir (Valtrex)
Acyclovir
Imiquimod (Aldara) cream,
Podophylox, Gardicil vaccine
Permethrin cream (Nix)
NRTI = zidovudine (Retrovir,
AZT), lamivudine (Epivir)
NNRTI = efavirenz (Sustiva)
PI = indinavir (Crixivan),
ritonavir (Norvir)
FI = enfuviritide (Fuzeon)
NRTI = nucleoside reverse transcriptase inhibitors
NNRTI = non-nucleoside reverse transcriptase inhibitors
PI = protease inhibitors
FI = fusion inhibitors
Organisms/Virus
Serious fungal infections
(fungemia, pneumonia, abscesses,
etc.)
Candida albicans, other candida
infections.
Fungal nails infections, some
candida albicans infections;
doesn’t work on cytochrome p450
Many candida infections
(especially non-albicans
infections), aspergillus,
histroplasma (birds),
onychomycosis (nail infections)
Herpes simplex (oral lesions,
genital/oral lesions, viral
meningitis respectively)
Herpes zoster (chicken pox)
HPV (genital warts)
Scabies and pediculosis pubis
(lice)
HIV
Bai 3
Other notes
Can be used for
bladder funguria. Can
have infusion rxns,
nephrotoxicity,
hypokalemia,
hypomagnesemia.
Single dose for
vaginal candidiasis, GI
effects, liver effects.
GI effects, headaches.
Less durg interactions
with terbinafine.
GI effects, liver
effects, headaches.
This inhibits human
cytochrome p450;
requires food for absor
Topical acyclovir
doesn’t work well.
May shorten the
duration and severity
of it. Benadryl may
help with itching, but
may make kids
hyperactive.
May not kill the eggs.
General tx
recommendations = 2
reverse transcriptase
inhibitors with 1
protease inhibitor,
consult most recent
CDC guidelines or
UCSF tx protocols.
You can get a
susceptibility report
for viral load.