Choice of antibiotics for specific microorganisms

Written by Dr.Md.Redwanul Huq (Masum)
Wednesday, 10 August 2011 06:12

The most appropriate antibiotic should be chosen on the basis of the identification of the microorganism(s) causing the infection. Here a tableis given for the practicing doctors, which contains the choice of antibiotics (according to chronology of efficacy) for specific microorganisms.

Table : The choice of antibiotics (according to chronology of efficacy) for specific microorganisms:

 

 MICROORGANISMS (Bacteria) ANTIBIOTICS (according to chronology of efficacy)
Acinetobacter spp Gentamicin, Tobramycin, Imipenem-Cilastatin, Ticarcillin-Clavulonate, Piperacillin-Tazobactam, Ceftazidime, Meropenem, Ciprofloxacin, Levofloxacin, Cefotaxime, Ceftizoxime, Ceftriaxone, Cefepime, Amikacin, Moxifloxacin.
Bacteroides fragilis Metronidazole, Ampicillin-Sulbactam, Piperacillin-Tazobactam, Ertapenem, Imipenem-Cilastatin, Meropenem, Tigecycline, Amoxicillin-Clavulonate, Ticarcillin-Clavulonate, Cefotetan, Cefoxitin, Clindamycin, : Moxifloxacin, Chloramphenicol, Doxycycline.
Bordetella pertussis Azithromycin, Clarithromycin, Erythromycin, Ciprofloxacin, Chloramphenicol, Levofloxacin, Moxifloxacin, Vancomycin.
Brucella spp Cefotetan, Cefoxitin, Cefuroxime, Cefotaxime, Ceftazidime, Ceftriaxone, Gentamicin, Chloramphenicol, Doxycyline, Vancomycin, Cefazolin, Cefprozil, Azithromycin, Clarithromycin, Erythromycin, Ciprofloxacin.
Camphylobacter jejuni Ciprofloxacin, Moxifloxacin, Levofloxacin, Imipenem-Cilastatin, Meropenem, Azithromycin, Clarithromycin, Erythromycin, Amoxicillin-Clavulonate, Ticarcillin-Clavulonate, Clindamycin, Doxycycline.
Chlamydia pneumonia Doxycycline, Azithromycin, Clarithromycin, Erythromycin, Ciprofloxacin, Moxifloxacin, Levofloxacin.
Chlamydia trachomatis Azithromycin, Doxycycline, Erythromycin, Moxifloxacin, Levofloxacin, Dirithromycin, Rifampin, Ciprofloxacin, Clindamycin, Nitrofurantoin.
Citrobacter spp Imipenem, Meropenem, Ertapenem, Tobramycin, Gentamicin, Cefepime, Moxifloxacin, Levofloxacin, Ciprofloxacin, Aztreonam, Ceftazidime, Amikacin.
Clostridium difficile Antibiotic for Clostridium difficile: Metronidazole, Vancomycin (oral).
Clostridium perfringens Antibiotic for Clostridium perfringens: Penicillin G with or without Clindamycin.
Clostridium tetani Metronidazole, Penicillin G, Azithromycin, Doxycyline, Clindamycin.
Corynebacterium diphtheriae Erythromycin, Penicillin G, Clindamycin, Vancomycin.
Enterobacter spp Imipenem, Meropenem, Ertapenem, (Piperacillin-tazobactam + Gentamicin), Cefepime.
Enterococcus faecalis Antibiotic for Enterococcus faecalis: Penicillin, Ampicillin, Vancomycin, Nitrofurantoin(if UTI), Gentamicin, Levofloxacin, Moxifloxacin, Linezolid, Daptomycin, Piperacillin-tazobactam, Imipenem, Meropenem.
Enterococcus faecalis [Vancomycin-resistant] Linezolid, Nitrofurantoin (if UTI).
Escherichia coli Antibiotic for Escherichia coli:Cefazolin, Cephalexin, Cefotaxime, Ceftriaxone, Gentamicin, Tobramycin, Piperacillin-tazobactam, Aztrenonam, Ceftazidime, Cefepime, Ciprofloxacin, Moxifloxacin, Levofloxacin, Ampicillin, Trimethoprim+Sulfamethoxazole.
Gardnerella vaginalis Metronidazole, Clindamycin.
Hemophilus infuenzae Cefotaxime, Ceftizoxime, Ceftriaxone, Azithromycin, Clarithromycin, Trimethoprim+Sulfamethoxazole, Oral 3rd generation Cephalosporins, Piperacillin-tazobactam, Impenem, Meropenem, Ertapenem, Cefotetan, Cefoxitin, Oral 2nd generation Cephalosporins, Ciprofloxacin, Moxifloxacin, Levofloxacin.
Helicobacter pylori Antibiotic for Helicobacter pylori:a)1. A Strip containing-

1 Cap Lansoprazole 30mg,1 Tab. Clarithromycin 500mg and 2 Cap Amoxycillin 500 mg;

-1 strip -bd- (½ HBM) for 7 – 14 Days

Then, Cap.Omeprazole (20/40 mg)

1+0+1 (½ HBM) for 1 / 2 Months

Or,

b)1. Cap. Amoxycillin 500 mg

2+0+2 (AM) for 14 Days

2.Tab.Claricin (500 mg)

1+0+1 (AM) for 14Days

3. Cap. Omeprazole (20/40 mg)

1+0+1 (½ HBM) for 1 / 2 Months

Or,

c)1. Tab. Azithromycin 500 mg

0+0+1 (½ HBM) for 7 Days

2.Tab.Levofloxacin (500 mg)

0+0+1 (± M) for 7 Days

3. Tab. Esomeprazole (20/40 mg)

1+0+1 (½ HBM) for 1 / 2 Months

Or,

d)1.Cap. Amoxycillin 500 mg

2+0+2 (AM) for 14 Days

2.Tab.Levofloxacin (500 mg)

0+0+1 (± M) for 7 Days

3. Cap. Omeprazole (20/40 mg)/ Tab. Esomeprazole (20/40 mg)

1+0+1 (½ HBM) for 1 / 2 Months

Or,

e)1.Cap. Amoxycillin 500 mg

2+0+2 (AM) for 14 Days

2.Tab.Metronidazole (400 / 500 mg)

1+0+1 (AM) for 14 Days

3. Cap. Omeprazole (20/40 mg)/ Tab. Esomeprazole (20/40 mg)

1+0+1 (½ HBM) for 1 / 2 Months

 

Hemophilus ducreyi Ceftriaxone, Azithromycin, Erythromycin, Ciprofloxacin, Levofloxacin.
Klebsiella pneumoniae Cefotaxime, Ceftizoxime, Ceftriaxone, Gentamicin, Ciprofloxacin, Moxifloxacin, Levofloxacin, Augmentin, Unasyn, Timentin, Piperacillin-tazobactam, Imipenem, Meropenem , Cefazolin.
Legionella pneumophilia Azithromycin, Clarithromycin, Erythromycin, Ciprofloxacin, Levofloxacin, Moxifloxacin, Doxycycline, Trimethoprim + Sulfamethoxazole.
Listeria monocytogenes Ampicillin,Trimethoprim + Sulfamethoxazole, Piperacillin-tazobactam, Amikacin, Tobramycin, Erythromycin.
Mycoplasma pneumoniae Azithromycin, Clarithromycin, Erythromycin, Ciprofloxacin, Levofloxacin, Moxifloxacin, Doxycycline.
Neisseria gonorrhoeae Ceftriaxone, Cefixime, Spectinomycin, Cefotaxime, Cefpodoxime.
Neisseria meningitidis Pencillin G, Ampicillin , Cefotaxime, Ceftriaxone, Ciprofloxacin, Moxifloxacin, Chloramphenicol.
Peptostreptococcus spp Penicillin G or V, Ampicillin, Amoxicillin, Piperacillin-tazobactam, Cefazolin, Cephalexin, Cefuroxime, Doxycycline.
Proteus mirabilis Ampicillin, Amoxicillin, Cefotaxime, Ceftizoxime, Ceftriaxone, Gentamicin, Tobramycin, Piperacillin, Augmentin, Unasyn, Piperacillin-tazobactam, 1st and 2nd generation Cephalosporins, Ciprofloxacin, Levofloxacin, Moxifloxacin, Trimethoprim + Sulfamethoxazole.
Proteus vulgaris Cefotaxime, Ceftizoxime, Ceftriaxone, Gentamicin, Tobramycin, Piperacillin-tazobactam, Aztreonam, Ciprofloxacin, Levofloxacin, Moxifloxacin, Trimethoprim + Sulfamethoxazole, Imipenem, Meropenem.
Providencia stuartii Cefotaxime, Ceftizoxime, Ceftriaxone, Ceftazidime, Piperacillin-tazobactam, Aztreonam, Cefepime, Amikacin, Gentamicin, Tobramycin, Ciprofloxacin, Levofloxacin, Imipenem, Meropenem.
Pseudomonas aeruginosa Antibiotic for Pseudomonas aeruginosa:Piperacillin-tazobactam, Imipenem, Meropenem, Ceftazidime or Piperacillin with Gentamicin, Cefepime, Amikacin, Tobramycin, Ciprofloxacin, Aztreonam, Levofloxacin, Amphotericin B.
Salmonella spp Ceftizoxime, Ceftriaxone, Ciprofloxacin, Trimethoprim + Sulfamethoxazole, Imipenem, Meropenem, Chloramphenicol.
Serratia spp Ceftizoxime, Ceftriaxone, Cefepime, Gentamicin, Timentin, Piperacillin-tazobactam, Aztreonam, Ertapenem, Imipenem, Meropenem, Ceftazidime, Amikacin, Ciprofloxacin, Levofloxacin, Trimethoprim + Sulfamethoxazole.
Shigella spp Ciprofloxacin, Levofloxacin, Ceftizoxime, Ceftriaxone, Cefepime, Impenem, Meropenem, Ampicillin, Trimethoprim + Sulfamethoxazole, Doxycycline.
Staphylococcus aureus Antibiotic for Staphylococcus aureus:Flucloxacillin, Dicloxacillin, Nafcillin, Oxacillin, Cefuroxime, Cefazolin, Cephalexin, Vancomycin, Timentin, Piperacillin-tazobactam, Azithromycin, Clarithromycin, Erythromycin, Levofloxacin, Moxifloxacin, Trimethoprim + Sulfamethoxazole, Ertapenem, Meropenem, Imipenem.
Staphylococcus aureus [Methicillin-resistant] – MRSA Vancomycin, Linezolid, Daptomycin, Trimethoprim + Sulfamethoxazole.
Streptococcus agalactiae [Group B] Pencillin, Ampicillin, Amoxicillin, 1st-3rd generation Cephalosporins, Azithromycin, Clarithromycin, Erythromycin, Quinolones.
Staphylococcus epidermidis Vancomycin with or without Rifampin, Methicillin-sensitive: Nafcillin, Oxacillin,Ciprofloxacin + Rifampin.
Staphylococcus epidermidis [Methicillin resistant] Vancomycin with or without Gentamicin, Linezolid, Daptomycin.
Streptococcus [Group D] Ampicillin, Amoxicillin, Penicillin G or V, Ticarcillin, Piperacillin, Timentin, Piperacillin-tazobactam, Cefazolin, Cephalexin, Imipenem, Meropenem.
Streptococcus pyogenes [Group A] Ampicillin, Amoxicillin, Penicillin G or V, Piperacillin-tazobactam, 1st-3rd generation Cephalosporins, Macrolides (Erythromycin, Azithromycin, etc), Vancomycin, Clindamycin, Levofloxacin, Moxifloxacin.
Streptococcus pneumoniae Antibiotic for Streptococcus pneumoniae:Ampicillin, Amoxicillin, Penicillin G or V, Piperacillin-tazobactam, 1st-3rd generation Cephalosporins, Macrolides (Erythromycin, Azithromycin, etc), Vancomycin, Clindamycin, Levofloxacin, Moxifloxacin.
Streptococcus pneumoniae [PCN resistant] Vancomycin, Levofloxacin, Moxifloxacin, Imipenem, Ertapenem, Meropenem, Ceftriaxone, Cefepime, Linezolid, Synercid, Clindamycin.
Streptococcus viridans Vancomycin, Unasyn, Timentin, Piperacillin-tazobactam, Imipenem, Meropenem, Cefazolin, Cephalexin, Ceftriaxone, Cefepime, Levofloxacin, Moxifloxacin, Clindamycin, Trimethoprim + Sulfamethoxazole.
Treponema pallidum Penicillin G, Ceftriaxone, Doxycycline, Azithromycin, Erythromycin.
Ureaplasma urealyticum Azithromycin, Clarithromycin, Erythromycin, Ciprofloxacin, Moxifloxacin.
Vibrio cholerae Doxycycline, Azithromycin, Ciprofloxacin, Erythromycin.
Xanthomonas maltophilia Trimethoprim + Sulfamethoxazole, Moxifloxacin, Piperacillin, Ticarcillin, Piperacillin-tazobactam, Ciprofloxacin, Levofloxacin.

To know the Generic and Trade names of the above mentioned drugs and their available formulations in Bangladesh click here.

 


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