REVISED ANTIBIOTIC PANEL- 2010

1. URINE:
FIRST LINE SECOND LINE THIRD LINE
GRAM NEGATIVE BACILLI
Ampicillin(only for OBG) Cefotaxime Piperacillin/Tazobactum
Cefuroxime Ceftazidime Imipenem
Cotrimoxazole Netilmicin Meropenem
Nitrofurantoin Amikacin Ticarcillin/Clavlanic acid
Gentamicin Piperacillin/Tazobactum
Nalidixic acid Cefaperazone/Sulbactum
Norfloxacin Piperacillin
Ciprofloxacin

FOR PSEUDOMONAS SPECIES

Ceftazidime Imipenem
Ciprofloxacin Meropenem
Gentamicin Piperacillin/Tazobactum
Netilmicin
Amikacin

ENTEROCOCCI
Ampicillin Piperacillin NIL
Gentamicin(HLG) Vancomycin
Nitrofurantoin Teicoplanin
Imipenem
Meropenem
Amoxycillin/Clavlanic acid
Piperacillin/Tazobactam

STAPHYLOCOCCUS AUREUS/STAPHYLOCOCCI FOR MRSA

Cefoxitin Teicoplanin NIL
Cefazolin Netilmicin
Gentamicin Rifampicin
Norfloxacin Vancomycin

β - HAEMOLYTIC STREPT *
Pencillin NIL NIL
Cefazolin

ESBL detection: For Klebsiella and Escherichia coli put Ceftazidime/Clavulanic acid disc
 REVISED ANTIBIOTIC PANEL- 2010
3. CSF/FLUIDS:
FIRST LINE SECOND LINE THIRD LINE
GRAM NEGATIVE BACILLI
Ampicillin Amikacin Ertapenem
Cefotaxime Piperacillin/Tazobactum
Ceftazidime
Chloramphenicol (Neonates only)
Cotrimoxazole Meropenem
Gentamicin Imipenem

HAEMOPHILUS INFLUENZAE:
Ampicillin Amoxycillin/Clavlanic Ceftriazone
Chloramphenicol (Ascitic and Synovial fluid)
Cefotaxime

STREPTOCOCCUS PNEUMONIAE/α STREP.

Cefotaxime Teicoplanin
Chloramphenicol Vancomycin
Oxacillin
Pencillin

β - HAEMOLYTIC STREPTOCOCCUS
Penicillin NIL NIL
Bacitracin (Identification)

N. MENINGITIDIS
Penicillin Rifampicin
Cefotaxime
Chloramphenicol

STAPHYLOCOCCUS AUREUS/STAPHYLOCOCCI FOR MRSA

Cefoxitin Vancomycin NIL
Cefazolin Rifampicin
Gentamicin Erythromycin
Chloramphenicol Clindamycin
Cefoperazone Linezolid

ENTEROCOCCI; (Both 1st and 2nd line)

Pencillin Amikacin NIL
Ampicillin Vancomycin
Gentamicin Meropenem
Teicoplanin
Piperacillin/Tazobactum

ESBL detection: For Klebsiella and Escherichia coli put Ceftazidime/Clavulanic acid disc
 4: SPUTUM
FIRST LINE SECOND LINE THIRD LINE
GRAM NEGATIVE BACILLI
Ampicillin Cefotaxime Ofloxacin
Cephalothin Cefipime/Tazobactum Imeipenem
Tetracycline (on request) Pazufloxacin Meropenem
Co-trimoxazole Amikacin
Chloramphenicol Ciprofloxacin
Gentamycin Ceftriaxone
Cefoperazone/Sulbactum
Piperacillin/Tazobactum
Cefoperazone/Tazobactum

PSEUDOMONAS SPECIES/ NFGB

Ciprofloxacin Imipenem Colistin
Gentamicin Meropenem Polymixin-B
Amikacin Cefoperazone/Sulbactum
Ceftazidime Piperacillin/Tazobactum
Piperacillin Aztreonam
Cefoperozone

HAEMOPHILUS INFLUENZAE:
Ampicillin Cefotaxime NIL
Amoxycillin/Clavulanic Ciprofloxacin
Cefuroxime Ceftriaxone
Azithromycin
Erythromycin

STAPHYLOCOCCUS AUREUS/STAPHYLOCOCCI FOR MRSA

Cefoxitin Vancomycin NIL
Cephalothin Teicoplanin
Erythromycin Amikacin
Gentamicin Clindamycin
Netilmicin Rifampicin
Cefoperazone

β - HAEMOLYTIC STREPTOCOCCUS
Penicillin NIL NIL
Erythromycin
Bacitracin (Identification)

STREPTOCOCCUS PENUMONIAE: (Both 1st an 2nd line)

Oxacillin Cefotaxime Vancomycin
Erythromycin Ciprofloxacin
Teicoplanin
Optochin (Identification)

MOREXELLA CATARRHALIS:
Amoxyclav NIL NIL
Ciprofloxacin
Erythromycin
Tetracyclilne
Co-trimoxazole

* ESBL detection: For Klebsiella and Escherichia coli (LF) put both Ceftazidime/Clav and Cefotaxime/Clav discs
* E.Coli and Kleb: Ertapenem
 S.B EYE:
FIRST LINE SECOND LINE THIRD LINE
STAPHYLOCOCCUS AUREUS
Cefoxitin Vancomycin Nil
Cefazolin Teicoplanin
Chloramphenicol Gentamycin
Norfloxacin Clindamycin
Cefoperazone

PSEUDOMONAS SPECIES:
Aztreonam NIL Nil
Gentamicin
Ceftazidime
Cefotaxime
Ciprofoaxacin
Norfloxacin

GRAM NEGATIVE BACILLI : (BOTH 1ST & 2ND LINE)

Gentamicin Ofloxacin Nil
Tetracycline
Chloramphenicol
Norfloxacin
Ciprofoaxacin

STREPTOCOCCUS PNEUMONIAE:
Oxacillin Vancomycin Nil
Cefazolin Teicoplanin
Chloramphenicol
Optochin(identification)

N.GONORRHOEAE
Penicillin Ciprofloxacin Nil
Cefazolin Ceftriaxone
Chloramphenicol
 6.PUS/GENITAL
FIRST LINE SECOND LINE THIRD LINE
STAPHYLOCOCCUS AUREUS/ STAPHYLOCOCOCCI FOR MRSA
Cefoxitin Vancomycin Nil
Cephalothin Teicoplanin
Chloramphenicol Netillin
Gentamicin Rifampicin
Cefoperazone Clindamycin
Erythromycin

B-HAEMOLYTIC STREPTOCOCCI:
Penicillin Nil Nil
Erythromycin
Bacitracin (Identification)

STREPTOCOCCUS PNEUMONIAE:
Oxacillin Cefotaxime Vancomycin
Cephalothin Teicoplanin
Erythromycin
Optochin (Identification)

C.DIPHTHERIAE:
Penicillin Nil Nil
Erythromycin

GRAM NEGATIVE BACILLI: (Both 1st and 2nd line)

Ampicillin Ceftazidime Imipenem
Cefuroxime Amikacin Meropenem
Chloramphenicol Ciprofloxacin Etrapenem
Cefotaxime Piperacillin/Tazobactum
Ofloxacin Cefoperazone/Sulbactum
Gentamicin
Piperacillin
PSEUDOMONAS AERUGINOSA/ NFGNB
Gentamicin Imipenem Colistin
Amikacin Meropenem Polymixin-B
Ciprofloxacin Piperacillin/Tazobactum
Ceftazidime Cefoperazone/Sulbactum
Cefoperazone
Piperacillin

ENTEROCOCCI:
Ampicillin Vancomycin Nil
Erythromycin Teicoplanin
Chloramphenicol Amikacin
Gentamicin(HLG)
ESBL detection: For Klebsiella & Escherichia coli put Ceftazidime/Clavlanic acid disc.
 6.PUS/GENITAL
FIRST LINE SECOND LINE THIRD LINE
HAEMOPHILUS INFLUENZAE ;
Ampicillin Amox/Clav Nil
Cefuroxime Cefotaxime
Choramphenicol Ciprofloxacin
Erythromycin Ofloxacin

Group B Streptococcus:
Penicillin Nil Nil
Erythromycin
Cefotaxime
Gentamicin
Ampicillin
Vancomycin
Clindamycin

BURKHOLERIA ANTIBIOTICS - EXUDATE

Gentamicin, Amikacin, Cefaperazone/Sulbactum, Ceftazidime, Cefotaxime, Ciprofloxacin,
Piperacillin/Tazobactum, Co-trimoxazole, Piperacillin, Amoxyclav, Imipenem, Meropenem

DIPHTHEROIDES - EXUDATE
Penicillin, Erythromycin, Amoxyclav, Vancomycin, Ofloxacin, Ciprofloxacin
Cephalothin
 7.FAECES:
FIRST LINE SECOND LINE THIRD LINE
VIBRIO CHOLERAE/ SHIGELLA SPECIES:
Ampicillin Amikacin Nil
Tetracycline Ciprofloxacin
Cotrimoxazole Ofloxacin
Nalidixic acid Cefotaxime
Norfloxacin Ceftazidime
Gentamicin

GRAM NEGATIVE BACILLI:

Ampicillin Nil Nil
Norfloxacin
Nalidixic acid
Gentamicin

SALMONELLA SER. TYPHI AND SALMONELLA SER. PARATYPHI A:

As in 7.1 : Add Chloramphenicol and Ciprofloxacin
 4B. ENDOTRACHEAL TUBE SUCTION TIP
FIRST LINE SECOND LINE THIRD LINE
GRAM NEGATIVE BACILLI
Ampicillin Ertapenem
Amikacin
Amoxyclav
Cefoperazone/Sulbactum
Cefotaxime
Ceftazidime
Ciprofloxacin
Gentamicin
Imipenem
Meropenem
Piperacillin/Tazobacutm

5A: THROAT SWAB/NASAL/EAR

FIRST LINE SECOND LINE THIRD LINE
B-HAEMOLYTIC STREP.
Penicillin NIL NIL
Rifampicin
Bacitracin(Identification)

C.DIPHTHERIAE
Penicillin NIL NIL
Erythromycin

STAPHYLOCOCCUS AUREUS: / MRSA

Cefoxitin Vancomycin NIL
Erythromycin Netilmicin
Cefoperazone Amikacin
Ofloxacin
Rifampicin
Clindamycin

ESBL detection: For Klebsiella and Escherichia coli put Ceftazidime/Clavulanic acid disc
WHEN ANY GRAM NEGATIVE BACILLI IS PUT FOR VITEK ANTIBIOTIC SENSITIVITY
THE FOLLOWING ANTIBIOTIC DISCS SHOULD BE PUS AS KIRBY BAUER METHOD
ALONG WITH VITEK CARD.

If organisms is LF (lactose fermenter) : Ceferperazone/Sulbactum, Nettillin,

Ofloxacin, Piperacillin, Piperacillin tazobactum, Doripenem

If organisms is NLF (Non-lactose-fermenter)- if oxidase POSITIVE: Polymixin-B,Doripenem

Ticracillin/Clavlanic acid, Piperacillin, Piperacillin/Tazobactum, Netillin, Ofloxacin.

If organisms is NLF (Non-lactose-fermenter)- if oxidase NEGATIVE: Nettillin,

Cefeperazone/Sulbactum, Ofloxacin, Piperacillin, Piperacillin/Tazobacutum,
Nalidixic acid, Chloramphenicol, Cefuroxime,Doripenem

The following Antibiotics sensitive is not claimed in Vitek hence K-B method of sensitivity to
be done in following organisms.
Piperacillin/Tazobactum :- for all Gram negative bacilli's
Amikacin Meropenem : - for Acinetobacter species
Azteronam :- for Pseudomonas
Ampicillin :- Citrobacter species, Enterobacter and Seriatia
Imipenam :- Proteus, Morgenella, Providencia

(DR. SHALINI SHENOY)

 REVISED ANTIBIOTIC PANEL- 2010
2. BLOOD :
FIRST LINE SECOND LINE THIRD LINE
GRAM NEGATIVE BACILLI (OTHER THAN S.TYPHI & S.PARATYUPHI A) (Both 1st and 2nd line)
Ampicillin Piperacillin/Tazobactum Imipenem
Cefotaxime Ticarcillin/Clavulanic acid Meropenem
Ceftazidime Amikacin** Cefaperazone/Sulbactum
Gentamicn
Ciprofloxacin

FOR (LF) E.COLI/KLEB : Ertapenem

SALMONELLA SER. TYPHI & SALMONELLA SER. PARATYPHI A
Ampicillin NIL NIL
Chloramphenicol
Cefuroxime
Ceftriazone
Cotrimoxazole
Ciprofloxacin
Ofloxacin
Nalidixic acid

ENTEROCOCCI: (Both 1st and 2nd line)

Penicillin Piperacillin ON REQUEST
Ampicillin Vancomycin Meropenem
Gentamicin(HLG) Teicoplanin Imipenem
Amikacin

STREPROCOCCUS PNEUMONIAE :
Oxacillin Vancomycin NIL
Chloramphenicol Teicoplanin
Cefotaxime Optochin

STAPHYLOCOCCUS AUREUS/STAPHYLOCOCCI FOR MRSA

Cefoxitin Teicoplanin NIL
Cefazolin Netilmicin
Gentamicin Rifampicin
Cefotaxime Vancomycin
Rifampicin Amikacin
Erythromycin
Clindamycin

β - HAEMOLYTIC STREPT *
Penicillin NIL NIL

N. MENINGITIDIS:
Penicillin Cefotaxime NIL
Chloramphenicol Rifampicin
Cotrimoxazole

H.INFLUENZAE:
Ampicillin NIL NIL
Cefuroxime
Chloramphenicol
Cefotaxime

ESBL detection: For Klebsiella and Escherichia coli put Ceftazidime/Clavulanic acid disc
(DR.SHALINI SHENOY)