Broad spectrum
- Fosfomycin broadest spectrum, use in last resort with no alternatives
+Ve
-
Glycopeptide: Vancomycin narrow only for MRSA, Streptococci, Pseudomembranous colitis Red neck syndrome, ototoxicity
-
Lipoglycopeptide: Dalbavancin & Oritavancin,Telavancin, Teicoplanin Dalba/Orita; I.V. long-acting = 2 weeks ~ MRSA/Streptococci Tele; false response to vancomycin with its side effects + taste disturbance & foamy urine
-
Lipopeptides: Daptomycin staphylococcal endocarditis - not for pneumonia due surfactant I.V. once daily - adjust renal may express high CK & eosinophilic pneumonia
CLOSTRIDIOIDES DIFFICILE – SPECIFIC AGENTS
- Fidaxomicin, Bezlotoxumab Fidamoxicin; cidal, kill organism in gi tract Bezlotuxumab; monoclonal antibody - prophylaxis to recurrent infections mixed w/ Fidaxomicin or Vancomycin
+Ve & few -Ve
- Polypeptides or (cyclic peptide): Bacitracin and cycloserine Bacitracin; limited use due nephrotoxicity, may be combined w/ neomycin & polymxin-b or hydrocortisone Cycloserine;1st line Anti-tuberculus resistance mycobacteria + coliforms may cause nervous toxicity - D-alanine analong
-Ve
- POLYMYXINS; Bladder irigant; topical skin, eye, ear P.aeruginosa Coliform