Antibiotics… Simplified!

Spectrum of Bacteria
Gram Negative Gram Positive

AEROBES

Serratia
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella
Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

-fragilis (gut) Actinobacillus Peptostreptococcus difficile
Prevotella Viridans Group Strep
Campylobacter
Fusobacterium
Eikenella

ANAEROBES
 Natural Penicillins
Gram Negative Gram Positive

AEROBES

Penicillin G (IV) / Penicillin VK (oral)

Serratia
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella
Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

E. faecalis only

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 Synthetic Penicillins
Gram Negative Gram Positive

AEROBES

Ampicillin (IV, oral) /

Serratia Amoxicillin (oral)
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella
Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 Synthetic Penicillins + Beta-Lactamase Inhibitor
Gram Negative Gram Positive

AEROBES

Ampicillin-sulbactam (Unasyn®, IV) /

Serratia Amoxicillin-clavulanate (Augmentin®, oral)
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella
Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 Anti-Staphylococcal Synthetic Penicillins
Gram Negative Gram Positive

AEROBES

Nafcillin (IV) / Methicillin /

Serratia Oxacillin (IV) / Dicloxacillin (oral)
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella
Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 Anti-Pseudomonal Penicillins
Gram Negative Gram Positive

AEROBES

Piperacillin-tazobactam (Zosyn®, IV) /

Serratia Ticarcillin-clavulanate (Timentin®, IV)
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

E. faecalis only

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 “First” Generation Cephalosporins
Gram Negative Gram Positive

AEROBES

Cephalexin (Keflex®, oral) / Cefazolin

Serratia (Ancef®, IV) / Cefadroxil (Duricef®, oral)
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 “Second” Generation Cephalosporins
Gram Negative Gram Positive

AEROBES

Cefuroxime (Ceftin®, IV& oral) / Cefoxitin

Serratia (Mefoxin®, IV) / Cefotetan (Cefotan®, IV)
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Cefuroxime

Cefoxitin & Cefotetan ONLY

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 “Third” Generation Cephalosporins
Gram Negative Gram Positive

AEROBES
Ceftriaxone (Rocephin®, IV) / Cefdinir (Omnicef®, oral) /
Cefpodoxime (Vantin®, oral) / Cefotaxime (Claforan®, IV)
Serratia
/ Ceftazidime (Fortaz®, IV)
Pseudomonas
Klebsiella E. coli
Acinetobacter
Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE
Ceftazidime ONLY

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 “Third” Generation Cephalosporin + Beta-lactamase Inhibitor
Gram Negative Gram Positive

AEROBES

Ceftazidime-avibactam
Serratia (Avycaz®, IV)
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

Should be combined with metronidazole to treat intra-abdominal infections

ANAEROBES
 “Fourth” Generation Cephalosporins
Gram Negative Gram Positive

AEROBES

Cefepime (Maxipime®, IV)

Serratia
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 “Fifth” Generation Cephalosporins
Gram Negative Gram Positive

AEROBES

Ceftaroline (Teflaro®, IV)

Serratia
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

E. faecalis only

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 “Fifth” Generation Cephalosporin + Beta-lactamase Inhibitor
Gram Negative Gram Positive

AEROBES

Ceftolozane-tazobactam
Serratia (Zerbaxa®, IV)
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

Should be combined with metronidazole to treat intra-abdominal infections

ANAEROBES
 Carbapenems
Gram Negative Gram Positive

AEROBES

Meropenem (Merrem®, IV) / Doripenem (Doribax®, IV) /

Serratia Imipenem-cilastatin (Primaxin®, IV) / Ertapenem (Invanz®, IV)
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Ertapenem does NOT cover Pseudomonas or Acinetobacter

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 Carbapenem + Beta-lactamase Inhibitor
Gram Negative Gram Positive

AEROBES

Meropenem-vaborbactam (Vabomere®, IV)

Serratia
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Niche for KPC-producing CRE due to the addition of vaborbactam

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 Monobactams
Gram Negative Gram Positive

AEROBES

Aztreonam
Serratia (Azactam®, IV)
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 Aminoglycosides
Gram Negative Gram Positive

AEROBES

Gentamicin (IV) / Tobramycin (IV)

Serratia / Amikacin (IV) / Plazomicin (IV)
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Plazomicin

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

Gentamicin can also be used with a gram positive antibiotic for synergy against enterococcus,
strep, and staph

ANAEROBES
 Simple Fluoroquinolones
Gram Negative Gram Positive

AEROBES

Ciprofloxacin (Cipro®, IV & oral) /

Serratia Norfloxacin (Noroxin®, oral)
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Norfloxacin not used for systemic infections

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

Fluoroquinolones also cover atypticals (Chlamydia, Legionella, Mycoplasma)

ANAEROBES
 “Respiratory” Fluoroquinolones
Gram Negative Gram Positive

AEROBES
Levofloxacin (Levaquin®, IV & oral)
Moxifloxacin (Avelox®, IV & oral)
Serratia Delafloxacin (Baxdela®, IV & oral)
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE
Moxifloxacin E. faecalis only

Levofloxacin E. faecalis only

Delafloxacin E. faecalis only

Moxifloxacin & Delafloxacin

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides
(not difficile) difficile

Fluoroquinolones also cover atypticals (Chlamydia, Legionella, Mycoplasma)

ANAEROBES
 Macrolides
Gram Negative Gram Positive

AEROBES

Azithromycin (Zithromax®, IV & oral) / Clarithromycin

Serratia (Biaxin®, oral) / Erythromycin (IV & oral)
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

Macrolides also cover atypticals (Chlamydia, Legionella, Mycoplasma)

ANAEROBES
 Lincosamides
Gram Negative Gram Positive

AEROBES

Clindamycin (Cleocin®, IV & oral)

Serratia
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

Clindamycin also covers some non-bacterial pathogens (Toxoplasma)

ANAEROBES
 Tetracyclines
Gram Negative Gram Positive

AEROBES
Doxycycline (IV & oral), Tetracycline (oral),
Minocycline (IV & oral), Omadacycline (IV & oral)
Serratia
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

Tetracyclines also cover atypticals (Chlamydia, Legionella, Mycoplasma, Rickettsia) and some
non-bacterial pathogens (Borrelia species, etc.)

ANAEROBES
 Glycylcylines
Gram Negative Gram Positive

AEROBES

Tigecycline (Tygacil®, IV)

Serratia
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

NOT Proteus

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

Eravacycline also covers atypticals (Chlamydia, Legionella, Mycoplasma)

ANAEROBES
 Fluorocyclines
Gram Negative Gram Positive

AEROBES

Eravacycline (Xerava®, IV)

Serratia
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

NOT Proteus

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

Tigecycline also covers atypticals (Chlamydia, Legionella, Mycoplasma)

ANAEROBES
 Sulfonamides
Gram Negative Gram Positive

AEROBES

Trimethoprim/Sulfamethoxazole (Bactrim®, IV & oral)

Serratia
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

TMP/SMX also covers some non-bacterial pathogens (Toxoplasma) and even some fungal
pathogens (Pneumocystis jirovecii)

ANAEROBES
 Glycopeptides
Gram Negative Gram Positive

AEROBES

Vancomycin (Vancocin®, IV & oral)

Serratia
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 Lipoglycopeptides
Gram Negative Gram Positive

AEROBES

Dalbavancin (IV)/ Oritavancin (IV)

Serratia
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella
Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

E. faecalis only Oritavancin

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 Lipopeptides
Gram Negative Gram Positive

AEROBES

Daptomycin (Cubicin®, IV)

Serratia
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 Oxazolidinones
Gram Negative Gram Positive

AEROBES
Linezolid (Zyvox®, IV & oral)/
Serratia Tedizolid (Sivextro®, IV & oral)
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 Nitroimidazoles
Gram Negative Gram Positive

AEROBES

Metronidazole (Flagyl®, IV & oral)

Serratia
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

Metronidazole also covers some non-bacterial pathogens (Trichomonas, Giardia, Entamoeba

histolytica)

ANAEROBES
 Nitrofurans
Gram Negative Gram Positive

AEROBES

Nitrofurantoin (Macrobid®, oral)

Serratia
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Used only to treat UTIs

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES
 Phosphonic Acid Derivatives
Gram Negative Gram Positive

AEROBES

Fosfomycin (Monurol®, oral)

Serratia
Pseudomonas Klebsiella E. coli
Acinetobacter Moraxella Salmonella
Citrobacter Neisseria Shigella Staph
Enterobacter H. influenzae Proteus Strep Enterococcus (MSSA) MRSA VRE

Used only to treat UTIs

Bacteroides Oral Anaerobes Clostridium sp. Clostridioides

(not difficile) difficile

ANAEROBES