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Bugs to Drugs


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group A strep, streptococcus pyogenes
1. penicillin G; 2. penicillin V; 3. erythromycin. For invasive s. pyogenes infections, such as necrotizing fascitis or streptococcal toxic shock syndrome, add clindamycin
group B strep, streptococcus agalactiae
penicillin G
group D strep
1. ampicillin, sometimes combined with an aminoglycoside; 2. resistant to penicillin G; 3. emerging resistance to vancomycin.
streptococcus viridans
penicillin G
streptococcus pneumoniae
1. penicillin G; 2. erythromycin; 3. ceftriaxone; 4. vaccine those who are elderly or asplenic
staphylococcus aureus
1. penicillinase-resistant penicillins; 2. vancomycin; 3. clindamycin
staphylococcus epidermidis
vancomycin (s. epidermidis is resistant to multiple antibiotics)
staphylococcus saprophyticus
bacillus anthracis
1. penicillin G; 2. erythromycin; 3. vaccine for high risk individuals
bacillus cereus
1. vancomycin; 2. clindamycin; 3. resistant to beta lactam antibiotics; 4. no treatment for food poisoning
clostridium botulinum
1. antitoxin; 2. penicillin; 3. hyperbaric oxygen; 4. supportive therapy including intubation and ventilatory assistance
clostridium tetani
1. Tetanus toxoid; 2. antitoxin; 3. clean the wound; 4. penicillin or metronidazole; 5. supportive therapy which may require ventilatory assistance
clostridium perfringens
1. radical surgery; 2. penicillin & clindamycin; 3. hyperbaric oxygen
clostridium difficile
1. metronidazole; 2. oral vancomycin; 3. terminate use of responsible antibiotic
cornyebacterium diphtheriae
1. antitoxin; 2. penicillin or erythromycin 3. vaccine DPT
listeria monocytogenes
1. ampicillin; 2. trimethoprim / sulfamethoxazole
neisseria meningitidis
1. vaccine against capsular antigens: A, C, Y and W-135; 2. penicillin G; 3. ceftriaxone (or other 3rd generation cephalosporins); 4. rifampin used prophylatically for close contacts of infected persons
neisseria gonorrheae
1. 3rd generation cephalosporin such as ceftriaxone (add doxycycline to cover incubating c. trachomatis and syphillis; 2. second line (ex. syphillis): a. fluoroquinolones b. spectinomycin; 3. for ophthalmia neonatorum: a. erythromycin eye drops b. systemic treatment with ceftriaxone
branhamella catarrhalis
1. azithromycin or clarithromycin; 2. amoxicillin with clavulanate; 3. oral second or third generation cephalosporin; 4. trimethoprim / sulfamethoxazole

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