Anti-microbials

22/8/10

Medsafe

PY Mindmaps

A-Z

Format:

TYPE OF PATHOGEN

Name (alphabetical order)

- class

- activity against

- dose

- issues with use

-> gaps in cover

ANTI-BACTERIALS

Amikacin

- aminoglycoside

- Gram –ve organisms (including Pseudomonas) + some Gram +ve cover

- 7.5mg/kg Q12 hrly (titrated to troughs)

- nephrotoxic, ototoxic, peripheral neuritis, neuromuscular blockade potentiation

->

Amoxycillin

- moderate-spectrum penicillin

- gram +ve + improved cover against gram –ve bacilli

- 1g Q4 hrly

- rash with EBV

-> staphylococcus and gram negatives

Amoxycillin-clavulanate

- broad spectrum penicillin

- gram +ve’s, anaerobes, aerobic gram –ve bacilli

- 1.2g Q6 hrly

- platelet dysfunction, blood dyscrasias

-> MRSA

Ampicillin

- broad spectrum penicillin

- Gram +ve and Gram –ve organisms (ineffective against Beta-lactamase producers)

- 500mg IV Q4 hourly

- GI upset, rash

-> staphylococcus and gram negatives

Azithromycin

- macrolide

- anaerobes and non-enteric gram negatives

- 10mg/kg LD Q24hrly -> 5mg/kg on subsequent days

- nephritis, hepatitis

-> gram positive, atypical mycobacteria and Toxoplasma

Aztreonam

- monobactam

- aerobic gram –ve including Pseudomonas

- 2g Q6 hrly

- phlebitis, hepatitis, thrombocytopaenia

-> gram positives

Benzylpenicillin

- a narrow spectrum penicillin

- gram +ve (streptococcus pneumoniae, listeria)

- 1-5g/day in divided doses

- increased Na+, decreased K+, GI upset – pseudomembranous colitis, seizures, nephritis, blood dyscrasias

-> inactivated by beta-lactamases -> most staph’s are resistant

-> streptococcus pneumonia increasing resistance

Cefepime

- 4th generation cephalosporin

- gram +ve and gram –ve cover and anaerobes

- 2g Q8 hourly

- GI upset, rash

Ceftazidime

- 3rd generation cephalosporin (beta-lactam)

- gram –ve and anaerobes, some gram +ve

- 2-6g/24 hours in 2 to 3 divided doses (30-100mg/kg/day in divided doses)

-> reduced gram positive cover

Cefuroxime

- 2nd generation cephalosporin with anti-haemophilus cover

- gram +ve’s + improved gram –ve cover

- adults 1.5g Q8 hrly, paediatrics 50mg/kg Q6hrly

Ceftriaxone

- 3rd generation cephalosporin

- reduced gram +ve with improved gram –ve cover (improved CSF penetration)

- 50mg/kg Q24hrs

- reduce in renal failure

Cephazolin

- 1st generation cephalosporin + beta lactam resistant, all induce ESBL producers

- gram +ve and some gram –ve cover

- 15mg/kg Q8 hrly

- 3-6% cross reactivity with penicillins

Ciprofloxacin

- 2nd generation quinolone

- predominately gram –ve cover (Pseudomonas)

- 300mg Q12 hourly

- growing cartilage damage, achilles tendonitis, QT prolongation

-> no anaerobic or gram positive cover

Clarithromycin

- macrolide

- helicobacter pylori and mycobacterium avium complex

- 500mg Q12 hrly

- hepatitis

Clindamycin

- lincosamide

- gram +ve’s, anaerobes, some non-enteric gram negative (Helicobacter), intracellular organisms (mycobacterium avium complex)

- high bone, bile and urine concentrations)

- 2-4mg/kg Q6 hrly

- GI upset, elevated LFT’s, blood dyscrasias

Colistin (polymyxin E)

- polymixin antibiotic

- gram –ve rods and New Delhi metallo-B-Lactamase mutli-resistant Enterobacteriaceae

- two forms with different dosing regimes

- nephrotoxic and neurotoxic

-> gram negatives not reliably covered: Proteus, Providencia, Serratia, Neisseria, Moraxella, Helicobacter, Brucella, Burkholderia, Stenotrophomonas (some strains)

Co-trimoxazole

- sulphamethoxazole + trimethoprim

- sulphonamide

- gram +ve and gram –ve cover and protozoan

- covers Pneumocystitis jiroveci, Stentrophomonas maltophila, Listeria monocytogenes, Norcardia

- 25-100mg/kg of sulphamethoxazole Q6 hrly (dose varies -> consult ID)

- SJS, blood dyscrasias, influenzae like symptoms,

Doxycycline

- tetracycline

- gram +ve and gram –ve but widespread resistance

- good cover for Chlamydophila, Mycoplasma, Rickettseiae, Spirocheataes, Brucella, Coxiella brunetii

- 200mg LD -> 100mg Q24 hrly

- oesophagitis, tooth discolouration in kids, photosensitivity, pancreatitis, hepatitis

Erythromycin

- macrolide

- gram +ve, anaerobes, non-enteric gram –ve infections, intracellular organisms

- 20mg/kg/day in divided doses

- long QT, monomorphic VT, pancreatitis, nephrotoxicity, hepatitis

Flucloxacillin

- narrow spectrum penicillin with anti-staph cover

- staph (beta lactamase resistant)

- 50-100mg/kg/day

- cholestatic jaundice

Fusidic acid

- chemically related to the cephalosporins

- penicillin resistant staphylococcal infections (endocarditis and bone infections)

- 1g Q8hrly

- GI upset, jaundice, rashes

Gentamicin

- aminoglycoside

- aerobic gram –ve’s + pseudomonas coverage

- 3-5mg/kg LD -> titrate to trough

- nephrotoxic, ototoxic, peripheral neuritis, neuromuscular blockade potentiation

Imipenem-cilastatin

- carbapenem

- broad spectrum gram +ve, gram –ve and anaerobic cover

- 500mg Q6 hrly

- hepatitis, CNS stimulation, rashes

-> MRSA, VISA, VRSA, atypical pneumonia’s.

Linezolid

- oxazolidinone

- gram +ve’s (including multi resistant staphylococci and enterococci)

- 600mg Q12 hrly

- blood dyscrasias, GI upset, headache, dry mouth

Meropenem

- carbapenem

- broad spectrum gram +ve, gram –ve and anaerobic cover

- up to 2g Q8 hrly (40mg/kg)

- hepatitis, CNS stimulation, rashes

-> MRSA, VISA, VRSA, Enterococcus faecium, Stenotrophomonas and many Pseudomonas, atypical pneumonia’s

Metronidazole

- nitroimidazole

- anaerobes and protozoa (including Trichomonas, Giardia and Entamobea)

- 7.5mg/kg Q8 hrly

- GI upset, rash, dark urine

Moxifloxacin

- 3rd generation quinolone

- gram –ve, gram +ve, anaerobic and intracellular organisms of atypical pneumonia

- 400mg Q24 hrly

- growing cartilage damage, achillies tendonitis, QT prolongation

-> Pseudomonas

Nitrofurantoin

- E.coli, Enterococcus, Staph aureus, Citerobacter, Klebsiella

- 100mg QID PO (5-7mg/kg/day)

- GI upset, headache, flatus

Norfloxacin

- 2nd generation quinolone

- predominantly gram –ve cover

- 400mg Q12 hourly

- growing cartilage damage, Achilles tendonitis, QT prolongation

Pipericillin-Tazobactam (Tazocin)

- broad spectrum penicillin

- gram +ve’s, anaerobes, aerobic gram –ve bacilli (superior enterococcal cover)

- 4.5g Q8hrly

- platelet dysfunction, blood dyscrasias

-> MRSA, VISA, VRSA, multi-resistant gram negatives

Quinupristin/dalfopristin

- streptogramins

- VRSA, VRE, gram positive bacilli (Enterococcus faecium), gram negative aerobes (Neiserria and Moraxella), intracellular organisms

- 7.5mg/kg Q8 hrly

- arthalgia, myalgia, GI upset, headaches

Rifampicin

- rifamycin

- gram +ve and gram –ve, mycobacterium tuberculosis and atypical mycobacteria

- 10-20mg/kg/day

- drug reactions: warfarin, OCP, cyclosporine, orange secretions, hepatitis, nephritis, thrombocytopaenia

Roxithromycin

- macrolide

- gram +ve, anaerobes and some non-enteric gram-negative infections, intracellular organisms

- 300mg Q24 hrly

- hepatitis

Teicoplanin

- glycopeptide

- MRSA, MRSE, gram +ve, good cover against streptococcus pneumoniae and C.difficile

- 400mg LD -> 400mg @ 12 hours -> 400mg Q24 hrs

- nephrotoxicity, blood dyscrasias, ototoxicity

Telavancin

- derivative of vancomycin

- gram +ve’s (including MRSA)

- 10mg/kg Q24 hrs

- GI upset, metallic taste, headache, foamy urine

Tetracycline

- tetracyclines

- chlamydia, rickettsia, spirochaete, brucella, mycoplasma, leptospirosis

- 500mg Q12hrly

- stained teeth in children, renal impairment, GI upset, hepatic impairment

Tigecycline

- glycylcycline

- gram +ve’s (VRE, MRSA, MRSE), gram –ve’s (ESBL), anaerobes

- 100mg LD -> 50mg Q12 hrly

- GI upset, similar to tetracyclines

Tircarcillin

- carboxypenicillin (often in combination with clavulanate)

- gram –ve organisms (especially Pseudomonas)

- 3000mg/200mg (tircarcillin/clavulanate) Q4-8 hourly

- increased Na+, decreased K+, GI upset – pseudomembranous colitis, seizures, nephritis, blood dyscrasias

Tobramycin

- aminoglycoside

- aerobic gram –ve’s + Pseudomonas coverage

- 3-5mg/kg/day in 3 divided doses -> monitor

- nephrotoxic, ototoxic, peripheral neuritis, neuromuscular blockage prolongation

Vancomycin

- glycopeptide derivative

- MRSA, MRSE, gram +ves, pencillin resistant streptococcus pneumoniae and C.difficile

- 10mg/kg LD -> dose of plasma concentration

- red man syndrome, ototoxic, nephrotoxic

ANTI-VIRAL

Acyclovir

- guanosine analogue

- viral DNA polymerase inhibitor

- anti-HSV

- 10mg/kg Q8hrly

- rashes, GI upset, hepatic and renal impairement, blood dyscrasias, CNS symptoms

Alpha-interferon

- interferon

- used hepatitis B and C and many other diseases

- SC injection

- complex dosing

- flu like symptoms, GI upset, haemodynamic instability, blood dyscrasias

Amantadine

- M2 channel inhibitor -> disruption of dissociation of viral matrix and riobnucleoprotein

- anti-viral and anti-parkinsonian drug

- anti-HSV and anti-influenza

- for anti-influenzae: 100mg/day

- GI upset, convulsions, hallucinations

Famciclovir

- guanosine analogue

- anti-HSV

- 1500mg OD PO (requires renal adjustment)

- well tolerated

Foscarnet

- guanosine analogue

- inhibitor of viron DNA polymerase

- anti-CMV

- 20mg/kg IV LD -> 20-120mg/kg according to renal function

- GI upset, renal failure, hypocalcaemia, convulsions

Gancicilovir

- inhibition of CMV DNA polymerase

- anti-CMV

- administered as a prodrug (valganciclovir)

- 5mg/kg Q12hrly IV

- blood dyscrasias, rash, hepatorenal impairment, GI upset

Valaciclovir

- guanosine analogue

- anti-HSV

- 1000mg TDSPO

- headache, nausea, SOB

Oseltamivir

- neuraminidase inhibitor

- anti-influenzae

- 75mg BD PO

- GI upset

Ribavirin

- guanosine analogue

- DNA synthesis inhibitor -> active against many RAN and DNA viruses

- RSV and Lassa fever

- 20mg/mL nebulised for 12-18 hours for 3-7 days

- anaemia, worsening respiratory failure
ANTI-FUNGALS

Amphortericin B

- polyene

- all Candida species except C.lustanae + anti-protozoan

- 0.5-1mg/kg Q24 hr

- nephrotoxic, hepatotoxic, GI upset, blood dyscrasias

Caspafungin

- echinocandin

- all Candida species, Aspergillus

- 70mg LD -> 50mg Q24 hrly

- GI upset, headache, myalgia, increase in LFT’s,

Fluconazole

- azole

- Candida albicans and Cryptococcus

- 50-400mg Q24 hr

- GI upset, hepatic dysfunction, arrhythmias

Itraconazole

- azole

- broader anti-fungal activity than fluconazole but not as much as voriconazole – Candida albicans, Cryptococcus, aspergillus

- 200mg Q12 hrly for 4 doses -> 200mg Q24 hrly

- increased LFT’s, GI upset

Nystatin

- polyene

- Candida albicans

- topical application

Voriconazole

- azole

- broadspectrum anti-fungal – Candida albicans, glabrata, krusei, Cryptococcus, Aspergillus

- 6mg/kg Q12 hourly (loading for 24 hours) -> 4mg/kg Q12 hourly

- transient visual disturbance, fever, rash, GI upset

ANTI-PARASITES

Albendazole

- benzimidzole

- anti-nematode and cestode (worms)

- 800mg PO in divided doses (give with fatty meal or grape juice -> increases bioavailability)

- GI upset, headache, dizziness, hepatic impairment, pancytopaenia

Ivermectin

- synthetic antibiotic derivative

- anti-nematode

- 200-400mcg/kg

- side effects related to parasitic load in host

Mebendazole

- benzimidzole

- anti-nematode and cestode (worms)

- 100mg OD PO

- minimal side-effects

Metronidazole

- nitroimidazole

- anaerobes and protozoa (including trichomonas, giardia and entamobea)

- 7.5mg/kg Q8 hrly

- GI upset, rash, dark urine

ANTI-PROTOZOANS

Aretemether + Lumefantrine

- anti-malarial

- 20/120mg

- complex dosing

Artesunate

- IV anti-malarial

- 2.4mg/kg IV Q 12 hrly

Atrovaquone+proguanil

- anti-malarial

- 250/100mg

- complex dosing

Clindamycin

- lincosamide

- gram +ve’s and anaerobes (high bone, bile and urine concentrations)

- 2-4mg/kg Q6 hrly

- GI upset, elevated LFT’s, blood dyscrasias

Doxycycline

- tetracycline

- gram +ve and gram –ve but widespread resistance

- 200mg LD -> 100mg Q24 hrly

- oesophagitis, tooth discolouration in kids, photosensitivity, pancreatitis, hepatitis

Mefloquine

- anti-malarial

- 15mg/kg LD -> 500mg Q6 hrly

Quinine sulphate

- anti-malarial

- IV 20mg/kg LD over 4 hours -> 10mg/kg Q 8hourly

- take with doxycycline or clindamycin or atovaquone+proguanil or mefloquine

Jeremy Fernando (2011)