Antimicrobial Therapy

 

 

1.        Penicillins

 

Penicillin – used as the drug of choice for S. pyognes,  S. Pneumoniae, N. Meningitidis, N. gonorrhoea, B. anthracis, C. diptheriae, T. pallidum, P. multicoda, and certain anaerobes.

 

Methicillin group (Penicillinase-resistant) – used for S. Aureus

 

Ampicllin/amoxycillin – for haemophillus and other gram-negative organisms

 

2.        Cephalosporins

 

1st generation e.g. cephalexin – very active against gram-positive cocci

 

2nd generation e.g. cefuroxime – additional activity against H. influenza, M. catarrhalis, N. menigitidis and Gonorrhoea.

 

3rd generation – active against gram-negative bacilli. Some e.g. ceftazadime are active against pseudomonads as well.

 

3.        Imipenam

 

(another B lactam antibiotic) – active against a wide range of bacteria

 

Its is most useful against ESBL organisms

 

4.        Aminoglycosides

 

Streptomycin, gentamycin, kanamycin, amikacin

Used against gram-negative bacilli including pseudomonads

 

5.    Rifamycins

 

Rifampin is used against MTB and also as prophylaxis against N. menigiditis

 

6.    Metronidazole

 

Used against anaerobes and certain parasitic infections

 

7.        Erthromycin and other macrolides

 

Used mainly as a second line drug for penicillin. Used first line for legionella and sometimes for chlamydial and mycoplasmal infections

 

Clindamycin is mainly used in the treatment of anaerobic infections.

 

8.        Vancomycin

 

For MRSA infections

 

9.        Tetracyclines

 

Tetracycline and doxyclyine are used for a wide variety of bacterial, chlamydial, and rickettsial infections

 

10.    Sulphonamides

 

Sulphonamides are often used in conjunction with trimethroprim. It is used for treating UTI and respiratory infections

 

11.    Quinolones

 

Ciprofloxacin and Ofloxacin are active against a large umber of gram-negative bacilli including P. aeruginosa.