Drugs of Choice and First Line Agents

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Beta Lactams

Penicillin G

Infections caused by
Streptococci
Meningococci
Enterococci
Penicillin-susceptible pneumococci
Non-B-lactamase producing staphylococci
(-) Treponema pallidum, other spirochetes
Clostridium spp.
(-) Actinomyces
Other g+ rods and non-B-lactamase producing g- anaerobic organisms
Moderate to severe leptospirosis

Benzathine Pen G

Syphilis

Cefazolin

Surgical prophylaxis

Amoxicillin, Penicillin, Doxycycline

Early stages of Lyme disease

Ceftriaxone

All forms of gonorrhea

Severe forms of Lyme disease
Typhoid

Cefotaxime, ceftriaxone

Meningitis caused by
H. influenzae
S. pneumoniae
N meningitidis
g- enteric bacteria

Ceftazidime

Pseudomonas meningitis

Carbapenems

Infections caused by extended spectrum B lactam (ESBL) producing g- organisms

B lactam antibiotic of choice for Enterobacter infections

Meropenem

Carbapenem for people with seizures

3rd gen Cephalosporins

Serious
-

infections caused by
Klebsiella
Enterobacter
Proteus
Providencia
Serratia
Haemophilus

Tetracyclines
Tetracyclines

Infections with Mycoplasma pneumoniae, Chlamydiae, Rickettsiae

Doxycycline, Amoxicillin, Penicillin

Early stages of Lyme disease

Doxycycline

Mild leptospirosis
Oral tetracycline of choice
(1st line) anthrax prophylactic, post-exposure
Primary stage if Lyme disease in adults and children 8<

Erythromycin

Corynebacterial infections
Respiratory, neonatal, ocular or genital chlamydial infections
Treatment of CAP

Sulfonamides
Cotrimoxazole PO

Pneumocystis jiroveci pneumonia

Toxoplasmosis
Nocardiosis

Cotrimoxazole IV

Moderately severe to severe pneumocystis pneumonia

Sodium stibogluconate

Leishmaniasis

Pyrimethamine-Sulfadiazine

Acute toxoplasmosis

Fluoroquinolones
- typohoid
Ciprofloxacin

Prophylaxis and treatment of anthrax

Antivirals
Acyclovir

herpes infections in immunocompromised patients

herpes simplex encephalitis, neonatal HSV infection

Drugs of Choice and First Line Agents

Ganciclovir
Foscarnet

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-

CMV infections
HSV infections in cases of acyclovir resistance
CMV retinitis in cases of ganciclovir resistance
(1st line) treatment for CMV retinitis (either alone or in combination with ganciclovir)

Antifungals
Amphotericin B

Fluconazole

Mainstay treatment of systemic fungal infections

Molds (Pulmonary Aspergillus infections)
Blastomycoses & Coccidioides Infections
Yeasts (Candida & Cryptococcus spp.)
Endemic mycoses (Histoplasma)
for CNS infections involving: Cyptococcus and Candida meningitis

Antiprotozoals
Chlorquine

Primaquine
Metronidazole

Quinine

Pyrimethamine &
Sulfadiazine/Clindamycin
Sodium stibogluconate and
Meglumine antimoniate
Suramin
Melarsoprol
Luminal agent:
Diloxanide furoate or Iodoquinol
or Paromomycin
Metronidazole or Tinidazole plus
luminal agent
Metronidazole or Tinidazole plus
luminal agent
Metronidazole or Tinidazole plus
luminal agent
Albendazole

Praziquantel

treatment of nonfalciparum and sensitive falciparum malaria

(preferred) chemoprophylactic agent in malarious regions w/o resistant falciparum
malaria
for the eradication of dormant liver forms of P. vivax and P. ovale
treatment of all tissue infections with E. histolytica
giardiasis
trichomoniasis
(1st line) therapy for Chloroquine-resistant falciparum malaria
(1st line) therapy in the treatment of infection with Babesia microti or other human
babesial infections
(1st line) therapy in the treatment of toxoplasmosis

(1st line) agents for cutaneous and visceral leishmaniasis

(1st line) therapy for early hemolymphatic African trypanosomiasis

(1st line) therapy for advanced CNS African trypanosomiasis
Asymptomatic intestinal infection

Mild to moderate intestinal infection

Severe intestinal infection

Hepatic abscess, ameboma, and other extraintestinal disease

All nematode infectiion / roundworms:

Ascaris lumbricoides (roundworm)
Trichuris trichiura (whipworm)
Necator americanus (hookworm)
Ancylostoma duodenale (hookworm)
Trichinella spiralis (trichinosis)
Cutaneous larva migrans (creeping eruption)
Visceral larva migrans
Angiostrongylus cantonensis
Capillaria philippinensis (intestinal capillariasis)
EXCEPT:
Ivermectin: Strongyloides stercoralis / threadworm
Ivermectin: Onchocerca volvulus / onchocerciasis
Mebendazole: Enterobius vermicularis / pinworm
Mebendazole: Trichostrongylus sp.
Metronidazole: Dracunculus medinensis / guinea worm
All trematode infection / flukes:
Schistosoma haematobium (bilharziasis)
Schistosoma mansoni
Schistosoma japonicum
Clonorchis sinensis (liver fluke)
Opisthorcis sp.
Paragonimus westermani (lung fluke)
Fasciolopsis buski (large intestinal fluke)
Heterophyes heterophyes
Metagonimus yokogawai (small intestinal fluke)
EXCEPT:
Bithionol or Triclabendazole: Fasciola hepatica / sheep liver fluke

Drugs of Choice and First Line Agents

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Niclosamide

All cestode infection / tapeworms:

Taenia saginata (beef tapeworm)
Taenia solium (pork tapeworm)
Diphyllobothrium latum (fish tapeworm)
EXCEPT:
Albendazole: Cystericosis / pork tapeworm larval stage
Albendazole: Echinociccus granulosus / hydatid disease, Echinococcus multilocularis
Praziquantel: Hymenolepsis nana / dwarf tapeworm

Pilocarpine

Glaucoma, drops for closed-angle, gel for open-angle

Tricyclic Antidepressants
Monoamine Oxidase Inhibitors

Major depressive episodes

antidepressant of choice
! MAOIs are not the DOC for major depression due to potential adverse and hazardous
effects

Lithium

Treatment and prevention of bipolar disorder

Halothane
Midazolam
Propofol

Inhalational anesthetic for children

For parenteral administration
Ambulatory surgery

Phenobarbital
Ethosuximide
Diazepam

Febrile seizures
Absence seizures
Status epilepticus

Morphine

(1ST line) moderate to severe pain

(2nd line) Butorphanol, Nalbuphine, Buprenorphine
(3rd line) pentazocine

Adrenergics
Antidepressants

Antimanics
Anesthetics

Antiepileptics

Opioids