Inpatient Antibiotics

Adapted from chalk talks given by Brandon Fainstad, MD and Yilin Zhang, MD
Graphics by Yilin Zhang, MD. 


OBJECTIVES:

  • General understanding of spectrum of coverage for the most commonly used inpatient antibiotics
  • Empiric antibiotic regimens for common sites of infection
  • Optional objectives include:
    • Antibiotics that specifically cover MRSA (additional learning)
    • Review Amp-C inducible organisms and ESBL organisms (additional learning)


Click to skip to Part 2: Sites of Infection


Part 1: Antibiotics and Spectrum of Activity

In evaluating an antibiotic’s spectrum of activity, I ask the following questions:

  1. Does it cover gram positive organisms?
    • Does it cover MRSA?
    • Does it cover Enterococcus? (higher level question)
  2. Does it cover gram negative organisms?
    • Does it cover Pseudomonas?
  3. Does it cover anaerobes?
    • Does it cover Bacteroides (aka intraabdominal anaerobes)?
  4. Does it cover atypical organisms?
    • Mycoplasma, Chlamydophila, Legionella
  5. Does it cover ESBLs (extended spectrum beta-lactamases)? (higher level question)

Board set up: 

Interactive board: Click on each antibiotic section for a pop-up containing teaching script and additional information. 

Final Board: 


Part 2: Sites of Infection

For common sites of infection, draw the general diagram of “antibiotic man” below. Discuss “bugs” or microbiology of each infection and have your learners use the antibiogram above to choose empiric antibiotic regimens. Listed in the table are some possible regimens. 

 


ADDITIONAL LEARNING:

Review Microbiology 

Antibiotics that cover MRSA 


REFERENCES:

Antibiogram created from review of Sanford guide antibiogram.

Microbiology of common infections from IDSA guidelines on CAUTI, Uncomplicated cystitis and pyelonephritis and Skin and soft tissue infections.