Organism 1

st
Drug of Choice 2
nd
Drug of Choice Alternative for allergy or
resistance
Streptococcus spp.
pneumoniae
pyogenes (group A)
viridans group
agalactiae (group B)
Penicillin G Ceftriaxone
Clindamycin
Vancomycin
Levofloxacin
Moxifloxacin
Doxycycline
Minocycline
Staphylococcus aureus Nafcillin Cefazolin Vancomycin
TMP/SMZ
Clindamycin
Doxycycline/Minocycline
Staphylococcus epidermidis Vancomycin Nafcillin or Cefazolin Vancomycin
Enterococcus spp.
faecalis
faecium
Ampicillin
(combination with
gentamicin or
streptomycin)
Vancomycin
(combination with
gentamicin or
streptomycin)
Daptomycin
Tigecycline
Quinupristin/Dalfopristin
(for faecium only)
Gram (+) Anaerobes (mouth) Penicillin G Clindamycin Ampicillin/Sulbactam
Escherichia coli Ceftriaxone
Fluoroquinolone
TMP/SMZ
Cefotetan (any other
cephalosporin)
Aminoglycoside
Ertapenem (for ESBL
producers and non-
severe pcn allergy)
Haemophilus influenza Ceftriaxone
Cefuroxime
Ampicillin/Sulbactam
Azithromycin
Fluoroquinolone
Doxycycline
SPACE bugs
Serratia marcesens
Pseudomonas aeruginosa
Acinetobacter baumanii
Citrobacter freundii
Enterobacter aerogenes
Piperacillin
Ciprofloxacin
Levofloxacin

Ceftazidime (or
Cefepime)
Aminoglycoside (not
streptomycin)
Meropenem or
aztreonam
Bacteroides fragilis (and
other Gram (-) anaerobes
Metronidazole
Ampicillin/Sulbactam
or other BL/BLI
Carbapenem or
Cefotetan
Clindamycin
Tigecycline
Mycoplasma pneumonia
Chlamydophila pneumoniae
Macrolide
(Azithromycin)
Fluoroquinolone Doxycycline
Legionella pneumophila Fluoroquinolone Macrolide
(Azithromycin)
Doxycycline