| Streptococcus | MRSA | Staph saprophyticus | Enterococcus | E coli | Other GNRs | Pseudomonas | Anaerobes | |
|---|---|---|---|---|---|---|---|---|
| Macrobid Urinary pathogens only |
No | No | Yes | Yes | Yes | Yes | No | No |
| Bactrim | Yes | Yes | Yes | No | Yes | Yes | No | Yes |
| Levaquin/Cipro | No | No | No | No | Yes | Yes | Yes | No |
| Zosyn/Augmentin | Yes | No | Yes | Yes | Yes | Yes | No | Yes |
| 1st gen Ceph Cefazolin/Cephalexin |
Yes | No | Yes | No | Yes | Yes | No | No |
| 2nd gen Ceph Cefuroxime/Cefoxitin |
Yes | No | Yes | No | Yes | Yes | No | Yes |
| 3rd gen Ceph Ceftriaxone/Cefpodoxime |
Yes | No | Yes | No | Yes | Yes | Yes (Ceftazidime only) | No |
| 4th gen Ceph Cefepime |
No | No | No | No | Yes | Yes | Yes | No |
| 5th gen Ceph Ceftaroline |
No | Yes | No | No | Yes | Yes | No | No |
| Carbapenems | Yes | Yes | Yes | No | Yes | Yes | Yes | No |
| Aminoglycosides | No | No | No | No | Yes | Yes | Yes | No |
| Vancomycin | Yes | Yes | Yes | Yes (except VRE) | No | No | No | No |
| Linezolid | Yes | Yes | Yes | Yes (including VRE) | No | No | No | No |
| Fosfomycin | Yes | Yes | Yes | Yes | Yes | Yes | Yes | No |
| Antibiotic | Normal Dosing | Side Effects | Tips |
|---|---|---|---|
| Nitrofurantoin (Macrobid) | 100mg BID | GI effects Peripheral neuropathy Hemolysis if G6PD Pulmonary hypersensitivity reaction (rare) |
Only works well for GU infections (not tissue) Don't give if GFR < 50 (inadequte excretion) Caution in elderly patients Do not take with quinolones, Mg, or probenecid |
| Trimethoprim/Sulfamethoxazole (Bactrim) | Double-Strength (800/160mg) BID | Rashes GI effects Hyperkalemia Stevens Johnson syndrome (rare) |
Avoid in pregnancy Can exacerbate effects of warfarin |
| Fosfomycin | 3g sachet x1 | Headache GI effects Vaginitis |
Not used frequently in US due to cost ($70-90) |
| Ciprofloxacin (Cipro) | 500mg BID | GI effects, dizziness, photosensitivity CNS effects Tendon rupture |
Avoid in children or pregnancy Decreased oral absorption with iron, zinc, or antacid (separate by 2hrs) Can lower seizure threshold |
| Levofloxacin (Levaquin) | 250mg BID or 750mg daily | ||
| Cefuroxime (Ceftin) | 500mg BID | Diarrhea Rash Elevated LFTs |
Do not use if patient has prior immediate hypersensitivity to penicillins Use with caution if delayed hypersensitivity to penicillins |
| Cephalexin (Keflex) | 250mg QID or 500mg BID | ||
| Ampicillin/Sulbactam (Augmentin) | 875/125mg BID | Hypersensitivity rash Diarrhea |
Rash more likely when viral disease present |