Infectious Disease Bug-Drug Table –© 2019 Dr.

Jessica Louie
PEK = Proteus, E.coli, Klebsiella, HN = Haemophilus, Neisseria
CAPES = Citrobacter, Acinetobacter, Providencia, Enterobacter, Serratia

(MRSE 70-80%)
MSSE (20-30%)

Frequency (hr)
CAPES (AmpC)

Common dose
Grp A & B Strep)

Pseudomonas
Strep viridans
Mouth anaerobes = Peptostreptococcus, Fusobacterium, Prevotella

Enterococcus
Staph aureus

(similar cov. Of
pneumoniae

(respiratory)

Static/Cidal

Time/Conc.
Renal/Liver
Atypicals = Mycoplasma, Chlamydia, Legionella

anaerobe
Staph epi

B. fragilis

Max/day
Others: Pneumocystis carinii (PCP), Toxoplasma, Giardia, Trichomonas, etc.

(faecalis,
faecium)

Atypical
Mouth
Italicized: usual activity is cidal, but italic is static for that specific organism

MRSA

Route
Other
Strep
DLR: dapto & linezolid resistant, MR: methicillin resistant

PEK

CSF
HN
VRE: vanco resistant enterococcus, U: urine
GPC: gram positive coverage, GN: gram negative coverage
DOC: Meningococci, Clostridium, Treponema, R Yes Cidal T IV, PO,
Natural-PCN Penicillin Pen VK Acinetomyces . S. pneumo S. pyogenes, IM (IM-
+/- BL + DOC ++ +/- ++ - Borrelia, Leptospira syph, RF) 250-500 6-8
Omnipen-N, DOC: Listeria, Proteus R Yes Cidal T
Ampicillin
Amino-PCN Polycillin-N Extended Coverage: G (-) bacilli IV, PO 250-500 6 14
Amoxicillin Amoxil +/- BL + + DOC +/- PE +/- ++ - EC, Proteus, H. inf, PO 250-875 8-12 -
Ampicillin/Sulbactam Unasyn R Yes Cidal T IV, IM 6 12
1.5-3
PCN + Beta- Amoxicillin/Clavulanate Augmentin + + + ++ +/- ++ ++ ++ PO 250 -875/125 8-12 -
lactamase Less active vs Pen G against G (+) Anti-
Oxacillin, Nafcillin Bactocill L Yes Cidal T
Inhibitor staphylococcal
Dicloxacillin Dynapen DOC - + R=ox IV, IM 1-2gm 4-6
Piperacillin/Tazobactam Zosyn ++ Extended gram(-) R Yes Cidal T 2.25-
Ticarcillin/Clavulanate Timentin + ++ + Ticar (-) ++ ++ ++ ++ ++ ++ Very good vs. anaerobes IV 4.5gm 6
Surgical px (except colorectal), cellulitis, R NO Cidal T
1s t Cefazolin (1st) Ancef, Kefzol DOC soft-tiss infxn, post-op
(MIC 2-4) + + ++ +/- ++ IV 0.5-2gm 6-8 12
Zinacef, Gains gram(-) but less gram(+) activity. R NO Cidal T
2nd Cefuroxime (2nd) Kefurox + ++ ++ ++ DOC ++ Use for RTI IV 0.75-1.5 8 9
Surg px (colorectal), abd infxn, DM foot ulcers, R NO Cidal T
Cefoxitin (2nd) Mefoxin
2nd Cefox may have act. Vs. Mycobacterium
Cefotetan (2nd) Cefotan
+ - ++ ++ ++ ++ ++ chelonae, abscessus, fortiuitum IV 1-2gm 6-8 12
Cefotaxime, Excellent vs Strep DOC CAP, CTX+Flagyl=Erta R Yes Cidal T IV
Claforan
+ DOC oral anaerobes, meningitis d/t enterics, L IV, IM 1-2gm 8-12 12
3rd Ceftriaxone Rocephin
MIC 2-8 (no DOC DOC Neisseria, nosoc. Pneumonia, sepsis, UTI 1-2gm 24 (tri ) 4
(IM in ED)
Ceftizoxime( 3rd) Cefizox
(high) ceftiz) ++ (septic) (CAP) ++ ++ Ceftri + Amp may have synergy vs. E. faecalis R IV 1-2gm 8-12
Not reliable against gram(+) R Yes Cidal T
Ceftazidime (3rd) Fortaz, Tazidime,
3rd Meningitis d/t G (-) enterics, pneumonia, IV 1gm 6-8 16
Monobactam Aztreonam Tazicef, Azactam
++ ++ ++ ++ sepsis, febrile neutropenia IV, IM 1-2 6-12 8
+ Cefotax + Ceftaz, some BL resist. R Yes Cidal T
4th Cefepime (4th) Maxipime 2gm IV q8hr for GN (1gm IV q6hr can work)
MIC 4-8 ++ ++ ++ ++ + ++ ++ IV 1-2gm 8-12 6
1st/only BL vs. MRSA, <50 Yes Cidal T 600mg
5 th
Ceftaroline (5th) Teflaro - (poss No Prevotella, Bacteroides 31-50: 400
+++ ++ ++ ++ Faecalis) ++ ++ ++ + IV 15-30: 300 12
(almo Imi: better vs. gram(+), Enterococcus, Acineto, <20 Yes Cidal* T
Primaxin, I:
Faecalis st as Mycobacteria, Nocardia, higher MIC for (-) D<50 I/M I: 500mg I: 6 4g/d,
Imi/Mero/Dori Merrem, good Mer: better vs. Acineto, Pseudomonas
Carbapenem Doribax (no as No D M: 500mg M: 6 50mg
++ ++ ++ faecium) ++ ++ DOC ++ ++ ++ Dori: slightly better vs. Pseud ALL good 4 ESBL IV D: 500mg D: 6 /kg/d
Flagyl)
Similar to Ceftri + Flagyl <20 UK Cidal T
Ertapenem Invanz
+/- ++ ++ ++ ++
+/-
++ ++ No Pseudo, Acinetobacter, Enterococcus IV, IM 1gm 24 1
CPES
Vancocin, Coryne; C.diff (PO), R Yes Cidal T IV, PO,
Glycopeptide Vancomycin Lyphocin ++MR ++ ++ ++ ++ GPC Surgical ppx w/prosthetics; Endocarditis Thecal 500-1000 6-48
++MR hVISA, VISA 50, NO Cidal C
Lipoglycopeptide Telavancin Vibativ
/DLR ++ ++ ++ ++ GPC 30 IV 10mg/kg 24
H (in- Coryne, Listeria, M ct, Legionella, Cdiff, L Yes Static T 600
Oxazolone Linezolid Zyvox
++MR ++ ++ ++ ++VRE GPC C. perfringens, Oral 4 MRSA infxn IV, PO F=1 po 12
vitro)
Quinupristin/ ++VRE Static T
Streptogramin Syncercid
Dalfopristin ++MR ++ ++ ++ Faecium GPC Static vs. faecium L Yes IV 7.5mg/kg 8-12
Lipopeptide Daptomycin Cubicin ++MR + ++ ++VRE GPC No activity in lung b/c surfactant in lungs breaks it down <30 Yes Cidal C IV 4-6mg/kg 24
IV: 1.5mg/kg 8 5mg/k
Cidal IV, Inh,
Polymixin Polymixin B & E Colistin Inh: 75mg 12 150mg
HEK CAE ++ Last line for Pseudomonas R Yes Thecal Inthec 10mg 24 20mg

Norfloxacin (1s t) Noroxin + + + Quinolones: Mycobacteria coverage R UK Cidal C PO 400-800 12

Best FQ vs. Pseudomonas, anthrax Mix UK Cidal C PO 250-750 12 PO
Ciprofloxacin (2nd) Cipro
+/- +/- urine +++ + +++ +++ ++ H.influ, M. cat, Legionella, N. gonor. IV 200-400 8-12 80%
Quinolone
Levofloxacin (3rd) Levaquin +/- +/- ++ ++ urine ++ +++ ++ ++ ++ More respiratory/atypicals R UK Cidal C IV, PO 500-750 24 1:1
Moxifloxacin (3rd) Avelox Better vs. S. pneumo, Stenotrophomonas L UK Cidal C
+/- +/- +++ +++ urine ++ +++ ++ ++ ++ ++ IV, PO 400 24
Gentamicin/ Garamycin/ Amikacin: mycobacteria R NO Cidal C
AMG IV,
Tobramycin/Amikacin Nebcin/Amikin syn syn syn syn syn ++ HPEK ++ ++ Streptomycin: M. avium Thecal 2mg/kg 8-24
Erythromycin Erythrocin + + + + L NO Static T IV, PO 250-500 6-12
H. influ, H.pylori, Myco. Avium, M. catarrhalis
Macrolide Clarithromycin/ Biaxin,
H (Azith), A>C>E intracellular>extracellular
(Az=N <30 NO Static T
Azithromycin Zithromax STD (Az preferred): C. trach, N. gonor, PO 250-500
+/-MR +/-MR +/- R + ) + ++ U. urealyticum L IV, PO 250-500 24
Tetracycline - + + +R + + H.pylori, Protozoa (Plasmodium), Rickettsia R NO Static T PO 250-50 6
Minocycline Minocin + + +R + + + + Burkholderia cefaciae, Rickettsia R NO Static T IV, PO 100-200 12
Tetracycline
DOC walk pneumo M.,Chlamydia pneumo., L NO Static T
Doxycycline Vibramycin
++MR ++MR +/- R + + +/- R +/- R + ++ Rickettsia; Oral 4 MRSA infxn IV, PO 100 12-24
+HNE No cov of PPP (Proteus, Providencia, L NO Static T
Glycylcycline Tigecycline Tygacil +/- LD
++MR ++ ++ ++ ++VRE +EK K CAES ++ ++ ++ Pseudomonas), in-vitro C.diff. IV 50 12 100
+MR *May need D-test – resistance-induced L NO Static T PO 150-450 6-8
Streptogramin Clindamycin Cleocin Peptococci, Propionibac, Actin, C. perfringens
(D) +/-R ++ ++ ++ +R C, strep IV 100-900 6-12
Prevotella, Peptococcus, Peptostreptococcus, <10 Yes Cidal C
Other Metronidazole Flagyl
H.pylori, C.diff, Trichomonas vaginalis, Giardia
++ GN DOC lamblia, Entamoeba histolytica IV, PO 500 6-8
PCP (DOC), Toxoplasma gondii, Salmonella <30 Yes Static C 80/400-
Trimethoprim/
Sulfonamide Bactrim (hole in Shigella, Strenotrophomonas maltophilia 160/800
Sulfamethoxazole ++MR ++ +/- ++ UTI cov) ++ ++ ++ (DOC); Oral 4 MRSA infxn, uncomplic’d UTI IV, PO ~10mg/kg/d 12
Furadantin, Saprophyticus, DOC for UTI (Cystitis) R NO Cidal C
Other Nitrofurantoin (urine) Macrobid ++U ++U ++U EK U +/-U Not vs. Proteus, anaerobic, parasitic PO 100 12
 Infectious Disease Bug-Drug Table –© 2019 Dr. Jessica Louie Adverse Effects
Drugs NOT cleared Renally Renal Dose Adjust Nephrotoxic Drug Hepatotoxic Drugs Hypersensitivity Bone Marrow Suppression Photosensitivity Teeth/Bone Development
Hepatic CL: All renally cleared • Vancomycin • Imipenem, Meropenem, Doripenem (minor • Class: Penicillin & Cephalosporins • (see hematologic below…) – • Class: Quinolones… • Class: Tetracycline (caution <8 y/o)
• Oxacillin medications EXCEPT • Televancin increase AST/ALT) • Ertapenem IM – hypersen to amide ↓ plts (thrombocytopenia) d/t halogenation at C8 – inhibition of bone & teeth
• Ceftriaxone Cefepime • Colistin • Class: Quinolones (rare ↑ LFTs, fulminant • Vancomycin: rash/anaphylaxis • Penicillinase-R PCNs (Nafcillin, (spar>lome>cipro=oflox=nor>levo> discoloration – most common
• Linezolid • Aminoglycosides failure) • Metronidazole: urticarial, flushing, Oxacillin) – high dose, long duration gati=moxi=0) w/TCN, less w/Doxy
• Synercid (but UH adjusts Cefepime Other Renal Problems: • Erythromycin (inc. LFTs) erythematous rash • Linezolid • Class: Tetracyclines (more common
• Moxifloxacin < 30) • Quinolones – crystalluria, interstitial nephritis • Telithromycin Cross-sen w/PCN: 5-15% ceph, 50% • Bactrim w/TCN, NOT allx rxn!)
• Erythromycin • Tetracyclines – AFR, azotemia, renal damage • Clindamycin (inc. LFTs) carbapenems, 1-2% aztreonam • Quinolones • Doxycycline
• Azithromycin reported (renal dose adjust all except doxy) • Tetracyclines • Tigecycyline
• Doxycycline • Metronidazole – urethral burning, cystitis, • Synercid (hyperbilirubinemia up to 25%, • Bactrim
• Tigecycline polyuria, incontinence, urine discoloration reversible LFT incr.) Cartilage Toxicity Arthralgia/Myalgia/Myopathy/Tendons Infusion-Related
• Clindamycin • Bactrim – caution in renal insuff, keep hydrated • Linezolid (incr. LFTs) • Class: Quinolones • Class: Quinolones – BBW for tendon • Nafcillin (thrombophlebitis)
• Ciprofloxacin – mixed renal/hepatic CL to prevent crystalluria • Nitrofurantoin ( Alk Phos, AST/ALT, hepatitis) (animal data) rupture/tendonitis (athletes, pt • Cephalothin – 1s t gen IV CEPH (thrombophlebitis)
CSF Penetration Drugs BacterioSTATIC Drugs Concentration-Dependent Drugs w/corticosteroid use, pt >60 yr) • Cephalosporins
(everything else CIDAL) (everything else Time-dependent) Cardiac (QT prolongation) • Synercid • Carbapenems (inflam, inject site rxn, pruritis/rash)
• Pencillin • Imipenem/Meropenem • Linezolid • Televancin o May be up to 40% in debilitated pt w/ • Vancomycin/Telavancin: Red-Man Syndrome (d/t rapid infusion or large dose) –
• Telavancin comorbidities,
• Ampicillin/Amoxicillin • Vancomycin • Synercid • Daptomycin prevent w/prolong infusion time, dilute conc, pre-med Benadryl
• Quinolones: o May require analgesics for pain control
• Unasyn/Augmentin • Linezolid • Erythromycin, Clarithromycin, • Norfloxacin, Ciprofloxacin, Levofloxacin, Moxifloxacin • Gemifloxacin rash (incr. in female<40, postmeno w/HRT, tx duration >7days)
levo, gati, moxi, gemi o Extend dose q8 to q12
• Oxacillin • Synercid Azithromycin • Aminoglycosides • Tetracyclines: rare skin conditions/allergies (anaphylaxis, urticarial, pruritus,
• Macrolides • Daptomycin – CK elevations (2.8%) – monitor
• Piperacillin/Tazobactam (Zosyn) • Daptomycin • Tetracycline, Minocycline, Doxycycline • Metronidazole exfoliative dermatitis, rashes)
• Telithromycin (ketolide) weekly
• Cefotaxime, Ceftriaxone, Ceftizoxime • Colistin • Tigecycline • Bactrim • Tigecycline: injection site rxn (8.2%)
o Dapto targets cell membranes, statins also • Synercid: thrombophlebitis, rash, infusion site rxn
• Ceftazidime, Aztreonam • Metronidazole • Nitrofurantoin
target cell membranes – both have • Bactrim: generalized skin eruption (maculopapular rash/urtiaria), Steven
• Cefepime • Bactrim myopathy SE Johnson’s Syndrome (SJS), Toxic Epidermal Necrolysis (TEN)
• Ceftaroline
Routes of Administration • Nitrofurantoin: macular, urticarial rashes
Intrathecal: IM: Cephalosporin Options: Abx in Pregnancy CI in Children Electrolyte Imbalances
• Vancomycin • Penicillin Gen. IV PO Category B Category C • Quinolones: previously CI in kids <16 • Ticarcillin (high Na load)
• Aminoglycosides • Unasyn • B-lactams • Vancomycin (IV) but evidence say that CF kids use • Penicillin VK (high K load)
1st Cefazolin Cephalexin (Keflex) 250-500mg Q6h
• Colistin • Oxacillin Cephradine • Marolides • Telavancin (CI – limb/digit malform) FQ as DOC w/o complications • Cipro/gatifloxacin (glucose
• Ceftriaxone Cefadroxil • Clindamycin • Linezolid • Tetracyclines: caution < 8yrs d/t bone disturbance, avoid
Inhalation: • Synercid • Telithromycin formation & teeth discoloration w/glyburide)
• Aztreonam 2nd Cefuroxime Cefuroxime
• Colistin • Ertapenem Cefoxitin Cefaclor • Daptomycin • Quinolones (avoid d/t possible cartilage toxicity)
IV ONLY: PO ONLY: Cefotetan Cefprozil • Vancomycin (Oral) • Colistin
• Piperacillin/Tazobactam (Zoysn) • Amoxicillin 3rd Cefotaxime Cefixime • Metronidazole • Bactrim (avoid 1st & 3rd trimesters)
Ceftriaxone Cefpodoxime 100-200 mg Q12h (avoid 1s t trimester) Category D
• Imipenem, Meropenem, Doripenem • Augmentin
Ceftazidime Cefdinir • Nitrofurantoin • Aminoglycosides
• Telavancin • Norfloxacin
Ceftibuten (at term 38-42 weeks) • Tetracyclines
• Synercid • Clarithromycin
4th Cefepime - & <1 month old • Tigecycline
• Daptomycin • Tetracycline
infants • Voriconazole
• Aminoglycosides • Nitrofurantoin 5th Ceftaroline -
• Tigecycline Hematologic Lung
Spectrum of Activity Increased bleeding • Bactrim: dose related (limit to 15mg/kg) • Nitrofurantoin:
Mycobacteria Parasites Others • Ticarcillin / Cefotetan o Agranulocytosis, aplastic anemia, o Interstitial lung dz
• Amikacin • Toxoplasma: • Spirochetes: (Treponema, Borrelia, Leptospira) • Interferences w/coagulation tests: Telavancin hemolytic anemia, thrombocytopenia o Pulmonary edema
• Clarithryomycin/Azithromycin (M. avium) o Bactrim o Peniicillin (DOC) (does NOT interfere w/coag tho) • Nitrofurantoin o Pulmonary fibrosis (rare)
• Giardia: o Doxycycline • Quinolones: rare-anemia, neutropenia, thrombocytopenia o Anemia, hemolytic anemia, eosinophilia, Lupus
o Metronidazole • Rickettsia: • Linezolid: neutropenia • Minocycline: drug-induced lupus
• Entamoeba: o Tetracycline, Minocycline, Doxycycline (DOC) o Thrombocytopenia • Metronidazole reported
o Metronidazole • Plasmodium (Protozoa): o Anemia o Reversible neutropenia (rare) Taste Disturbances (metallic)
• Trichomonas o Tetracycline o Leucopenia / Pancytopenia • Telavancin
o Metronidazole • Pneumocystis: opportunistic infxn in immunocompromised o ↑risk w/ duration of Rx (2wk or longer), concomitant meds • Clarithromycin
o Use of Vit B6 may ↓ risk of developing toxicity • Metronidazole
• Chlamydia trachomatis: “MD Questions” pts
o Bactrim (DOC) o Monitor CBC weekly
o Macrolides
o Doxycycline CNS Adverse Effects
o Quinolones Seizures Peripheral Neuropathy Ototoxicity
Drug-Interactions • Penicillin G Neuromuscular blockade (CI in myasthenia gravis): • Vancomycin: Cp>50-80 mg/L
1A2: 3A4: 3A4: 3A4: • Imipenem (NTE 4gm/day), Mero/Dori also but • Aminoglycosides • Aminoglycosides (25% incidence, irreversible)
• Quinolones inhibit it • Macrolides inhibit it: • Telithromycin strong inhibitor of it • Synercid inhibits it not as significant as Imi • Colistin o Auditory: Amikacin
o Dec. CL of concomitant agent: Ery ~ Cla, no Azith (ketolide, like macrolide) o CCB (amlodipine) increased • Quinolones (rare) Peripheral neuropathy: o Vestibular: Strep, Gentamycin
Theophylline, Caffeine, Warfarin • ↑ levels of: Drug Effect/Rec amlodipine toxicity • Metronidazole • Colistin (perioral paresthesias, tingling sensation in fingers) o Both: Tobramycin
o Enox>>cipro, grepa>>>levo, nor, o CBZ o Statins: ↑myopathy • Bactrim • Linezolid • Erythromycin
Simvastatin ↑ cmax 5.3-8.9x
oflox, spar, trova>gati, moxi o Cimetidine suspend statin o Calcineurin inhibitors • Nitrofurantoin (long-term use and/or renal insufficiency) • Minocycline: vertigo reported (extreme dizziness)
o Cipro>levo>moxi o Cyclosporine Midazolam ↑cmax 2-6x (tacrolimus, cyclosporine) • Metronidazole (numb/paresthesias)
o Digoxin USE CAUTION ↑ levels, ↑toxicity Other Random Notes
o Phenytoin Digoxin ↑cmax 73%, - Metronidazole also • All drugs against Enterococcus are D-test • CAPES – Cefepime DOC b/c induce beta • Erythromycin – looks like human-
o Ritonavir monitor dig closely causes toxicity bacterioSTATIC, cidal effects are • Used for Clindamycin lactamase and will break down less motilin so has motilin-effect
o Tacrolimus Metoprolol ↑cmax 38%, w/calcineurin gained with synergy with AMG • When put disk of clinda on plate, usu stable cephalosporins • Tigecycline
o Theophylline inhibitors • VRE mostly d/t Faecium see zone of inhibition as circle – • Usually see CAPES in hospital o Indicated for CAP, SSTI
caution in HF pts
o Statins • S. epidermidis usu. methicillin- but when add Macrolide disk pneumonia – thus, prefer to use o NO bacteremia – lipophilic
o Valproic acid resistant (thus grouped with nearby to Clinda disk – may see Cefepime b/c do not want to wipe and doesn’t distribute into
Theophylline ↑ GI effects,
o Warfarin MRSA) “D” zone of inhibition (missing out gut flora with Zosyn blood well
admin 1 hr apart
Levels of macrolides ↓’d with rifampin • ESBL: resistance of beta-lactams, part of circle) – if see D in this test • When resistance to Pseudomonas, • Oral MRSA infxn agents:
Food: Bile Acid Sequestrants: tetrayclines • Probenacid: MAO inhibitor: Linezolid is a reversible, o usu found in E.coli, Klebsiella – it is considered induced usually resistance to all drugs for o Bactrim
• Tetracycline decr. Absorption w/food • Cholestyramine, colestipol o Carbapenem: incr. serum conc. & nonselective MAO inhibitor o Carbapenem DOC – Ertapenem resistance and DO NOT want to Pseudomonas – pumps efflux out all o Clindamycin
• Nitrofurantoin delayed absorption • May bind TCN and ↓ absorption extend Carbapenem T1/2 o SSRIs + MAOI (Linezolid) → better b/c less broad use Clindamycin for that infxn. the medications – o Doxycycline
Tetracyclines: Oral contraceptives: tetracyclines o Nitrofurantion: ↓ CL of Serotonin Syndrome (avoid use • Colistin is last line use for Pseudomonas o Linezolid
• Separate dose by >2 hrs from: - Efficacy may be reduced, Advise back up nitrofurantoin and ↑ levels w/ w/in 14 days of Linezolid) Pattern of Activity Antibiotics Goal of Therapy PK/PD Parameter Specifics
o Milk Warfarin possible ↑’d ADR o Serotonin syndrome: mild-severe Type I Aminoglycosides Maximize conc. Peak/MIC AMG: Peak/MIC > 10,
o Antacids • Tetracyclines: • Multivalent Cations: Quinolones - Cognitive: HA, agitation, Conc.-dependent killing Ketolides (telithromycin) (or 24hrs-AUC/MIC) AUC24 70-100 (> = toxicity)
o Iron supplements o May cause potentiation of • Digoxin: Macrolides affect biliary CL mental confusion, Moderate-Prolonged persistent Metronidazole
Anticonvulsants: warfarin induced anticoaguln • Sulfonylureas: Bactrim, causes hallucinations, coma effects Amphotericin B
Tetracyclines o Closely monitor INR hypoglycemia through PPB - Autonomic: sweating, Type II Beta-lactams Max duration of T > MIC Beta-Lactams:
• Barbiturates, CBZ, phenytoin • Tigecycline displacement hyperthermia, HTN, Time-dependent killing Macrolides exposure T > MIC > 40-50%
tachycardia, N/V Minimal persistent effects Oxazolidinones (Linezolid) >100% for more severe infxns
• ↑ hepatic metabolism of o Monitor INR • MTX: Bactrim
- Somatic: myoclonus (muscle Flucytosine
TCN…leads to↓ serum levels o NOT Cyp interaction o TMP causes additive inhibition of
twitching), hyperreflexia, Type III Azithromycin Max amt of drug 24hr- AUC/MIC Vancomycin:
Bactrim: • Bactrim DHF reductase and Time-dependent killing Clindamycin Maximize T > MIC
• (Fos)phenytoin: ↓ CL by inhibition o Potentiate effect,↑ bleeding via o SMX may ↑ MTX thru PPB tremor
Moderate-Prolonged persistent Daptomycin AUC24/MIC > 400
of phenytoin metab by TMP ↓ vit K. in gut displacement → ↑MTX toxicity Tyr-containing foods: With Linezolid ↑↑ effects Fluoroquinolones FQ: AUC24/MIC >125 Gram negative
Metronidazole: o Also, displacement warfarin from o MTX = methotrexate BP (avoid these foods) – aged cheese, Streptogramins (Synercid) >30 Gram positive
• Incr. elim of Metro with PPB, and stereo-selective ↑ of meats, soy sauce, beer, red wine, sausage Tetracyclines
Barb/Phenytoin serum levels of S warfarin Pseudoephedrine: Linezolid, ↑ BP Vancomycin
• Decr. CL of phenytoin w/potential enantiomer Disulfuram rxn: Metronidazole
for toxicity • Metronidazole: Inhibits Warfarin,↑ INR (hypersensitivity to alcohol rxn) © 2019 Find Your Script; www.FindYourScript.com