Antibiotics

 I had a bout of insomnia so here this is, ask me about this on rounds: 

oversimplified hospital guide gm negatives + gm neg ctx, anaerobics flagyl, pseudomonas zosyn, esbl carbapenems

U/A showed leukocyte esterase, nitrate negative.

UCX showed klebsiella

Nitrate producing organisms include proteus, e. coli, and klebsiella

Pseudomonas: Etx: pneumonia, sepsis, echthyma gangrenosum, UTI, diabetes, osteomyelitis, mucoid polysaccharide capsule, otitis externa, nosocomial infection, addicts (drug abusers), skin infections. Coverage: CAMPFIRE: carbapenems, aminoglycosides, monobactams, polymixins, fluoroquinolones, thIRd gen cephalosporins (cefepime, ceftazidime, extended spectrum penicillins

levofloxacin has pseudomonas coverage

MRSA: oral BCTL: Bactrim, clinda, tetracyclines, linezolid

IV: Vanc, dapto, linezolid, ceftarolin

CRE: Ceftazidime avibactam

VRE: Dapto, linezolid

New MDR gm (-)

fetroja (cefedirocol) similar to cefepime

zerbaxa (ceftolozane-tazobactam) 

Avycaz (ceftazidime avibactam)

Vabomere (meropenem vaborbactam)

Iminpenm cilastatin-relebactam (recarbrio)

Faecalis more virulent than faecium

Faecalis more likely endocaridits

more susptible to beta lactam agents

susceptible to ampicillin

resistant to quinupristin

Infections due to Enterococcus faecalis tend to be more virulent than infections due to Enterococcus faecium. In addition, bacteremia due to E. faecalis is more likely to be associated with endocarditis than bacteremia due to E. faecium. Clinical isolates of E. faecalis tend to be considerably more susceptible to beta-lactam agents than clinical isolates of E. faecium, with isolates of E. faecalis testing susceptible to ampicillin, whereas most E. faecium isolates are resistant to ampicillin (minimum inhibitory concentration ≥16 mcg/mL). Another susceptibility trait that helps distinguish these two species is that isolates of E. faecalis are resistant to quinupristin-dalfopristin while E. faecium isolates are usually susceptible to quinupristin-dalfopristin.

https://msh.careteamapp.com/guides