| Pathogen
|
Type1
|
Therapy
|
Supplemental
|
Alternative
|
Bacteria
|
|
|
|
|
Acinetobacter
|
-,
r
|
piperacillin
|
ceftazidime
| |
| aminoglycoside
|
piperacillin/
| |||
| TMX/SMX
|
tazobactam
| |||
| imipenem
|
||||
| Actinobacillus
|
-,
c-b
|
ampicillin
|
aminoglycoside
|
chloramphenicol
|
| actinmycetemcomitans
|
||||
| Actinoyces
|
+,
r
|
penicillin
G
|
clindamycin
| |
| tetracycline
| ||||
| Aeromonas
|
-,
r
|
aminoglycoside
|
TMP/SMX
| |
| hydrophila
|
||||
| Arizona
|
-,
r
|
ampicillin
|
TMP/SMX
| |
| Bacteroides
|
-,
r
|
clindamycin
|
piperacillin
| |
| fragilis
|
metronidazole
|
mezlocillin
| ||
| ampicillin/
|
cefoxitin
| |||
| sulbactam
|
chloramphenicol
| |||
| piperacillin/
|
amoxicillin/
| |||
| tazobactam
|
clavulanate
| |||
| ticarcillin/
| ||||
| clavulanate
| ||||
| Bacteroides
|
-,
r
|
penicillin
G
|
piperacillin
| |
| melaninogenicus
|
clindamycin
|
mezlocillin
| ||
| cefoxitin
|
tetracyline
| |||
| metronidazole
(if
|
amoxicillin/
| |||
| beta-lactamase
|
clavulanate
| |||
| producer)
|
ticaracillin/
| |||
| ampicillin/sulbactam
|
clavulante
| |||
| piperacillin/
|
||||
| tazobactam
|
||||
| Bordatella
|
-,
c-b
|
erythromycin
|
ampicillin
| |
| Borrelia
|
s
|
tetracyline
|
chloramphenicol
| |
| Borrelia
|
s
|
early
diagnosis:
|
if
allergic to
| |
| burgdorferi
|
tetracycline
|
penicillin
or tetracycline
| ||
| doxycycline
|
then
erythromycin
| |||
| penicillin
V
|
cefuroxime
| |||
| erythromycin
|
axetil
| |||
| amoxicillin
w/ or w/o
|
||||
| probenecid
|
||||
| late
diagnosis:
|
||||
| IV
penicillin
|
||||
| ceftriaxone
|
||||
| Brucella
|
-,
r
|
tetracycline
|
streptomycin
|
TMP/SMX
|
| Campylobacter
|
-,
r
|
quinolone
|
TMP/SMX
| |
| erythromycin
|
tetracycline
| |||
| Capnocytophaga
|
-,
r
|
penicillin
|
erythromycin
|
|
| clindamycin
|
||||
| Chlamydia
|
tetracycline
|
erythromycin
| ||
| ofloxacin
|
sulfonamides
| |||
| clarithromycin
| ||||
| Chlamydia
|
doxycycline
|
erythromycin
| ||
| trachomatis
|
tetracycline
|
minocycline
| ||
| ofloxacin
|
azithromycin
| |||
| Chromobacterium
|
-,
r
|
chloramphenicol
|
tetracyline
| |
| violaceum
|
||||
| Citrobacter
|
-,
r
|
chloramphenicol
|
piperacillin
| |
| diversus
|
aztreonam
|
mezlocillin
| ||
| 3rd
generation
|
piperacillin/
| |||
| cephalosporin
|
tazobactam
| |||
| quinolones
|
||||
| Citrobacter
|
-,
r
|
aminoglycosides
|
piperacillin/
| |
| freundi
|
quinolones
|
tazobactam
| ||
| Clostridium
|
+,
r
|
antitoxin
|
||
| botulinum
|
||||
| Clostridium
|
+,
r
|
vancomycin
|
stop
AB
|
cholestyramine
|
| difficile
|
metronidazole
PO
|
|||
| Clostridium
|
+,
r
|
penicillin
G
|
tetracycline
| |
| perfringens
|
chloramphenicol
| |||
| cefoxitin
| ||||
| clindamycin
| ||||
| piperacillin/
| ||||
| tazobactam
| ||||
| Clostridium
|
+,
r
|
penicillin
|
immunization
| |
| tetani
|
antitoxin
| |||
| Corynebacterium
|
+,
r
|
penicillin
|
antitoxin
|
erythromycin
|
| diphtheriae
|
erythromycin
|
|||
| (for
carrier)
|
||||
| Escherichia
coli
|
-,
r
|
ampicillin
|
TMP/SMX
| |
| (UTI)
|
quinolone
| |||
| (noscomial)
|
aminoglycoside
|
ampicillin
| ||
| aztreonam
|
ticarillin/
| |||
| cephalosporin
|
clavulanate
| |||
| TMP/SMX
|
piperacillin
| |||
| quinolone
|
||||
| piperacillin/
|
||||
| tazobactam
|
||||
| Eikenella
|
-,
r
|
tetracycline
|
aminoglycoside
| |
| corrodens
|
ampicillin
|
|||
| Enterococcus
|
+,
c
|
ampicillin
|
aminoglycoside
|
vancomycin
|
| faecalis
& faecium
|
penicillin
G
|
piperacillin
| ||
| ampicillin/
| ||||
| sulbactam
| ||||
| piperacillin/
| ||||
| tazobactam
| ||||
| doxycycline
| ||||
| Enterobacter
|
-,
r
|
imipenem
|
TMP/SMX
| |
| piperacillin
|
ticarillin/
| |||
| mezlocillin
+
|
clavulante
| |||
| aminoglycoside
|
3rd
generation
| |||
| aztreonam
|
cephalosporin
| |||
| ciprofloxacin
|
pipericillin/
| |||
| ofloxacin
|
tazobactam
| |||
| Eubacteria
|
+,
r
|
penicillin
|
clindmycin
| |
| tetracycline
| ||||
| cefoxitin
| ||||
| Flavobacteriae
|
-,
r
|
3rd
generation
|
pipericillin
| |
| cephalosporin
|
mezlocillin
| |||
| aminoglycoside
|
||||
| ciprofloxacin
|
||||
| Francisella
|
-,
c-b
|
streptomycin
|
tetracycline
|
chloramphenicol
|
| tularensis
|
||||
| Fusobacteriae
|
-,
r
|
penicillin
G
|
clindamycin
| |
| tetracycline
| ||||
| cefoxitin
| ||||
| pipercillin/
| ||||
| tazobactam
| ||||
| Haemophilus
|
-,
r
|
cephalothin
|
aminoglycoside
|
piperacillin
|
| aphrophilus
|
penicillin
G
|
quinolones
| ||
| Haemophilus
|
-,
r,c,b
|
ampicillin
|
chloramphenicol
| |
| influenzae
|
cefixime
|
|||
| cefuroxime
|
||||
| amoxicillin/
|
||||
| clavulanate
|
||||
| ticarcillin/
|
||||
| clavulanate
|
||||
| clarithromycin
|
||||
| azithromycin
|
||||
| 2nd
or 3rd generation
|
||||
| cephalosporins
|
||||
| TMP/SMX
|
||||
| aztreonam
|
||||
| ciprofloxacin
|
||||
| ofloxacin
|
||||
| piperacillin/
|
||||
| tazobactam
|
||||
| Haemophilus
|
-,
r
|
erythromycin
|
if
resistant
|
minocycline
|
| ducreyi
|
TMP/SMX
|
rifampin
|
ofloxacin
| |
| sulfonamide
|
cefoxitin
|
|||
| ofloxacin
|
||||
| Haemophilus
|
-,
r
|
ampicillin
|
chloramphenicol
| |
| parainfluenzae
|
TMP/SMX
| |||
| Gardnerella
|
-,
r
|
metronidazole
|
ampicillin
|
|
| vaginalis
|
||||
| JK-Diptheroids
|
+,
r
|
vancomycin
|
erythromycin
| |
| Klebsiella
|
-,
r
|
cephalosporins
|
aminoglycoside
|
piperacillin
|
| pneumoniae
|
ciprofloxacin
|
aztreonam
|
mezlocillin
| |
| ofloxacin
|
ticarcillin/
| |||
| piperacillin/
|
clavulanate
| |||
| tazobactam
|
||||
| Lactobacillus
|
+,
c
|
gentamicin
|
resistant
to
| |
| confusus
|
chloramphenicol
|
vancomycin
| ||
| imipenem
|
||||
| minocycline
|
||||
| Legionella
|
r
|
erythromycin
|
rifampin
|
quinolones
|
| pneumophila
|
tetracycline
|
clarithromycin
| ||
| azithromycin
| ||||
| Leptospira
|
-,
s
|
penicillin
|
tetracycline
| |
| Leuconostoc
|
+,
c
|
minocycline
|
resistant
to
| |
| mesenteroides
|
gentamicin
|
vancomycin
| ||
| chloramphenicol
|
||||
| imipenem
|
||||
| Listeria
|
+,
r
|
ampicillin
|
aminoglycoside
|
chloramphenicol
|
| monocytogenes
|
TMP/SMX
|
|||
| Moraxella
|
-,
c
|
cefixime
|
cefaclor
| |
| catarrhalis
|
cefuroxime
axetil
|
cefprozil
| ||
| amoxicillin/
|
piperacillin/
| |||
| clavulanate
|
tazobactam
| |||
| TMP/SMX
|
||||
| ofloxacin
|
||||
| clarithromycin
|
||||
| azithromycin
|
||||
| Morganella
|
-,
r
|
3rd
generation
|
aminoglycoside
| |
| morganii
|
cephalosporin
|
piperacillin/
| ||
| ciprofloxacin
|
tazobactam
| |||
| ofloxacin
|
||||
| Mycobacteria
|
acid-
|
clarithromycin
|
surgery
|
ansamycin
|
| avium-
|
fast,
r
|
isoniazid
+
|
clofazimine
| |
| intracellulare
|
ethambutol
+
|
|||
| complex
|
rifampin
+
|
|||
| amikacin
|
||||
| M
scrofulaceum
|
same
as above
|
surgery
|
||
| M
kansasii
|
isoniazid
+
|
|||
| ethambutol
+
|
||||
| streptomycin
|
||||
|
or rifampin
|
||||
| M
marinum
|
ethambutol
+
|
surgery
|
tetracycline
+
| |
| rifampin
|
TMP/SMX
| |||
| M
xenopi
|
isoniazid
+
|
amikacin
| ||
| streptomycin
+
|
||||
| rifampin
|
||||
| M
fortuitum
|
diptheroids
|
amikacin
|
||
| M
chelonei
|
rifampin
+
|
ethionamide
+
| ||
| cefoxitin
|
erythromycin
| |||
| Mycoplasma
|
erythromycin
|
quinolones
(adults only)
| ||
| pneumoniae
|
tetracycline
|
azithromycin
| ||
| (adults
only)
|
minocycline
| |||
| clarithromycin
|
||||
| Neisseria
|
-,
c
|
penicillin
G
|
tetracycline
| |
| gonorrhoeae
|
ampicillin
|
ciprofloxacin
| ||
| ofloxacin
|
||||
| PPNG
|
ceftriaxone
|
piperacillin/
| ||
| cefuroxime
|
tazobactam
| |||
| cefotaxime
|
||||
| spectinomycin
|
||||
| TMP/SMX
|
||||
| ciprofloxacin
|
||||
| ofloxacin
|
||||
| Neisseria
|
-,
c
|
penicillin
G
|
chloramphenicol
| |
| meningitidis
|
cefuroxime
| |||
| 3rd
generation
| ||||
| cephalosporins
| ||||
| Nocardia
|
+,
r, a, f
|
sulfonamide
|
erythromycin
|
minocycline
|
| asteroides
|
TMP/SMX
|
|||
| Pasteurella
|
-,
r
|
penicillin
G
|
tetracycline
| |
| multocida
|
||||
| Peptococcus
|
+,
c
|
penicillin
G
|
clindamycin
| |
| cefotetan,
cefoxitin,
| ||||
| tetracycline,
| ||||
| amoxicillin/
| ||||
| clavulanate,
| ||||
| pipericallin/
| ||||
| tazobactam,
| ||||
| piperacillin
| ||||
| Peptostreptococcus
|
+,
c
|
penicillin
G
|
clindamycin
| |
| cefotetan,
cefoxitin,
| ||||
| ticarcillin/
| ||||
| clavulanate
| ||||
| amoxicillin
| ||||
| clavulanate,
| ||||
| pipericallin/
| ||||
| tazobactam,
| ||||
| piperacillin
| ||||
| Propioibacterium
|
+,
r
|
tetracycline
|
clindamycin
| |
| acnes
|
minocycline
| |||
| indole
positive
|
-,
r
|
3rd
generation
|
cefoxitin
| |
| Proteus
|
cephalosporins
|
piperacillin
| ||
| aminoglycoside
|
||||
| ciprofloxacin
|
||||
| ofloxacin
|
||||
| ticarillin/
|
||||
| clavulanate
|
||||
| piperacillin/
|
||||
| tazobactam
|
||||
| Proteus
|
-,
r
|
ampicillin
|
cephalosporin
| |
| mirabilis
|
ciprofloxacin
| |||
| ofloxacin
| ||||
| piperacillin/
| ||||
| tazobactam
| ||||
| Providencia
|
-,
r
|
3rd
generation
|
cefoxitin
| |
| cephalosporins
|
piperacillin
| |||
| aztreonam
|
ticarcillin
| |||
| aminoglycoside
|
piperacillin/
| |||
| ciprofloxacin
|
tazobactam
| |||
| ofloxacin
|
||||
| Pseudomonas
|
-,
r
|
tobramycin
or
|
||
| aeruginosa
|
gentamicin
or
|
|||
| aztreonam
+
|
||||
| piperacillin
or
|
||||
| ticarcillin/
|
||||
| clavulanate
or
|
||||
| piperacillin/
|
||||
| tazobactam
|
||||
| cefoperazone
|
||||
| ceftazidime
|
||||
| ciprofloxacin
|
||||
| ofloxacin
|
||||
| Pseudomonas
|
-,
r
|
TMP/SMX
|
chloramphenicol
| |
| cepacia
|
ceftazidime
|
|||
| Rickettsia
|
-,
c-b
|
tetracycline
|
chloramphenicol
| |
| Salmonella
|
-,
r
|
ampicillin
|
TMP/SMX
| |
| ciprofloxacin
|
||||
| ofloxacin
|
||||
| Salmonella
|
-,
r
|
same
as above
|
chloramphenicol
| |
| typhi
|
TMP/SMX
| |||
| Serratia
|
-,
r
|
3rd
generation
|
ciprofloxacin
| |
| cephalosporins
|
ofloxacin
| |||
| aztreonam
|
piperacillin/
| |||
| piperacillin
+
|
tazobactam
| |||
| aminoglycoside
|
||||
| Shigella
|
-,
r
|
ampicillin
|
tetracycline
| |
| ciprofloxacin
|
TMP/SMX
| |||
| ofloxacin
|
||||
| Spirillum
|
-,
r
|
penicillin
|
tetracycline
| |
| Staphylococcus
|
+,
c
|
naficillin
|
aminoglycoside
|
cephalosporin
|
| aureus
|
oxacillin
|
vancomycin
| ||
| (penicillinase
|
ciprofloxacin
| |||
| producing)
|
ofloxacin
| |||
| clarithromycin
| ||||
| azithromycin
| ||||
| amoxicillin/
| ||||
| clavulanate
| ||||
| ticarcillin/
| ||||
| clavulanate
| ||||
| piperacillin/
| ||||
| tazobactam
| ||||
| Staph
aureus
|
+,
c
|
vancomycin
|
rifampin
(?)
|
TMP/SMX
|
| (methicillin-
|
||||
| resistant)
|
||||
| Staphylococcus
|
+,
c
|
naficillin
|
||
| epidermis
|
oxacillin
|
|||
| vancomycin
|
||||
| Staphylococcus
|
+,
c
|
vancomycin
|
rifampin
or
|
|
| epidermis
|
gentamicin
|
|||
| (methicillin-
|
||||
| resistant)
|
||||
| Streptococcus
|
+,
c
|
penicillin
G
|
aminoglycoside
|
erythromycin
|
| agalactiae
|
||||
| Streptococcus
|
+,
c
|
penicillin
G
|
cephalosporin
| |
| bovis
|
clindamycin
| |||
| Streptococcus
|
+,
c
|
penicillin
G
|
erythromycin
| |
| pneumoniae
|
vancomycin
|
clindamycin
| ||
| clarithromycin
| ||||
| azithromycin
| ||||
| cephalosporin
| ||||
| amoxicillin/
| ||||
| clavulanate
| ||||
| ticarcillin/
| ||||
| clavulanate
| ||||
| ofloxacillin
| ||||
| piperacillin/
| ||||
| tazobactam
| ||||
| Streptococcus
|
+,
c
|
penicillin
|
same
as above
| |
| pyogenes
|
||||
| Streptococcus
|
+,
c
|
penicillin
G
|
gentamicin
|
cephalosporin
|
| viridans
|
vancomycin
| |||
| clindamycin
| ||||
| Treponema
|
-,
s
|
penicillin
G
|
erythromycin
| |
| pallidum
|
tetracycline
| |||
| Ureaplasma
|
tetracyclines
|
erythromycin
| ||
| urealyticum
|
ofloxacin
| |||
| Vibrio
|
-,
r
|
tetracycline
|
fluids
| |
| cholerae
|
||||
| Vibrio
|
-,
r
|
tetracycline
|
TMP/SMX
| |
| vulnificus
|
quinolones
|
|||
| Yersinia
|
-,
r
|
aminoglycoside
|
quinolones
| |
| enterocolitica
|
TMP/SMX
|
|||
| Yersinia
|
-,
r
|
streptomycin
|
tetracycline
|
chloramphenicol
|
| pestis
|
||||
Fungi
|
|
|
|
|
Aspergillus
|
amphotericin
B
|
tetracycline
|
flucytosine
| |
| itraconazole
| ||||
| Blastomyces
|
amphotericin
B
|
itraconazole
| ||
| dermatitidis
|
||||
| Candida
|
amphotericin
B
|
fluconazole
| ||
| flucytosine
| ||||
| ketoconazole
| ||||
| itraconazole
| ||||
| Coccidioides
|
amphotericin
B
|
ketoconazole
| ||
| immitis
|
itraconazole
| |||
| Cryptococcus
|
amphotericin
B
|
flucytosine
|
fluconazole
| |
| neoformans
|
itraonazole
| |||
| Chromoblastomyces
|
ketoconazole
|
amphotericin
B
| ||
| dermatophytes
|
clotrimazole
|
|||
| ketoconazole
|
||||
| Fusarium
|
amphotericin
B
|
rifampin
|
||
| Histoplasma
|
amphotericin
B
|
itraconazole
| ||
| fluconazole
| ||||
| Mucormycosis
|
amphotericin
B
|
|||
| Paracoccidioides
|
ketoconazole
|
amphotericin
B
|
||
| Penicillium
|
amphotericin
B
|
|||
| Sporotrichum
|
iodide
|
itraconazole
| ||
| amphotericin
B
| ||||
| Phialophora
|
ketoconazole
|
Data from: Conte & Barriere 1992; Isada et al. 1994; Murray 1996; Myers 1995. You should check the most recent publications for newer indications and/or warnings!!! Legends: +: Gram positive, -: Gram negative, r: rod, c: cocci, c-b: cocci-bacillus, a: acid-fast, f: filamentous, s: spiral