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Antibiotic Reference

Free reference guide: Antibiotic Reference

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About Antibiotic Reference

This Antibiotic Reference is a clinical quick-reference guide covering major antibiotic drug classes, dosing regimens, antimicrobial spectrum, and resistance patterns. It includes beta-lactams (amoxicillin, cefazolin, ceftriaxone, meropenem), aminoglycosides (gentamicin, amikacin, tobramycin), fluoroquinolones (ciprofloxacin, levofloxacin, moxifloxacin), and macrolides (azithromycin, clarithromycin, erythromycin).

Beyond standard drug classes, the reference covers critical agents like vancomycin (MRSA standard with AUC/MIC TDM), linezolid (VRE/MRSA with platelet monitoring), metronidazole (anaerobes/C.difficile), doxycycline (atypicals/rickettsiae), TMP-SMX (UTI/PCP), and colistin as a last-resort agent for CRE and XDR gram-negative infections.

The resistance section provides essential information on MRSA (mecA/PBP2a mechanism, treatment options), ESBL-producing organisms (carbapenem treatment for E.coli/Klebsiella), CRE (KPC/NDM/OXA-48 enzymes, combination therapy), VRE (vanA/vanB genes, linezolid/daptomycin), and MDR-TB (bedaquiline-pretomanid-linezolid regimens).

Key Features

  • Beta-lactam reference: amoxicillin, amoxicillin/clavulanate, cefazolin (1st gen), ceftriaxone (3rd gen), and meropenem (carbapenem) with dosing
  • Aminoglycoside guide: gentamicin, amikacin, tobramycin with dosing, TDM requirements, and nephrotoxicity/ototoxicity monitoring
  • Fluoroquinolone coverage: ciprofloxacin (gram-negative/Pseudomonas), levofloxacin (respiratory), moxifloxacin (anaerobic activity)
  • Macrolide reference: azithromycin (atypical pneumonia), clarithromycin (H.pylori eradication), erythromycin (penicillin allergy alternative)
  • Critical agent profiles: vancomycin (AUC/MIC TDM), linezolid (platelet monitoring), metronidazole (C.difficile), colistin (last resort)
  • Antibiotic resistance patterns: MRSA, ESBL, CRE, VRE, and MDR-TB with mechanisms, treatment algorithms, and infection control
  • Dosing information for IV and oral routes with specific mg/kg calculations and frequency schedules
  • Clinical indications by infection type: UTI, pneumonia, meningitis, skin/soft tissue, intra-abdominal, and H.pylori eradication

Frequently Asked Questions

What beta-lactam antibiotics does this reference cover?

The reference covers five key beta-lactams: amoxicillin (250-500mg q8h PO for upper respiratory/UTI), amoxicillin/clavulanate (Augmentin, 625mg q8h for beta-lactamase resistant organisms), cefazolin (1-2g q8h IV, 1st gen for surgical prophylaxis/MSSA), ceftriaxone (1-2g q24h IV, 3rd gen for meningitis/pneumonia/UTI with CNS penetration), and meropenem (1g q8h IV, ultra-broad carbapenem excluding MRSA).

How are aminoglycosides presented in this reference?

Three aminoglycosides are covered: gentamicin (3-5mg/kg/day IV for gram-negative aerobes with TDM peak/trough monitoring), amikacin (15mg/kg/day IV for multidrug-resistant gram-negatives with nephrotoxicity/ototoxicity monitoring), and tobramycin (3-5mg/kg/day IV with Pseudomonas activity, also available as inhaled formulation for cystic fibrosis patients).

What fluoroquinolone information is available?

Three fluoroquinolones are covered: ciprofloxacin (500mg q12h PO or 400mg q12h IV, 2nd gen with excellent gram-negative coverage including Pseudomonas, for UTI/enteritis), levofloxacin (500-750mg q24h, respiratory fluoroquinolone for community-acquired pneumonia including atypicals), and moxifloxacin (400mg q24h with additional anaerobic activity for abdominal/skin infections).

What antibiotic resistance patterns are explained?

Five major resistance patterns are covered: MRSA (mecA gene/PBP2a, treated with vancomycin/linezolid/daptomycin, requires contact precautions), ESBL (3rd gen cephalosporin hydrolysis in E.coli/Klebsiella, treated with carbapenems), CRE (KPC/NDM/OXA-48 enzymes, CDC urgent threat, colistin combination therapy), VRE (vanA/vanB genes, linezolid/daptomycin), and MDR-TB (INH+RIF resistant, bedaquiline-pretomanid-linezolid for 18-20 months).

How is vancomycin dosing and monitoring explained?

Vancomycin is presented as the standard MRSA treatment at 15-20mg/kg q8-12h IV. The reference notes the current TDM target of AUC/MIC ratio of 400 or greater, which represents the shift from trough-based monitoring to AUC-guided dosing for optimizing efficacy while minimizing nephrotoxicity in clinical practice.

What information is available on last-resort antibiotics?

Colistin (polymyxin) is documented as the last-resort agent at 2.5-5mg/kg/day IV for CRE and XDR gram-negative infections. Linezolid (600mg q12h PO/IV) is covered for VRE and MRSA with emphasis on platelet monitoring for courses exceeding 14 days. These entries highlight their critical role in treating extensively drug-resistant infections.

Does this reference cover H.pylori eradication therapy?

Yes. Clarithromycin (500mg q12h PO) is specifically noted for H.pylori eradication in combination with a PPI and amoxicillin as triple therapy. Amoxicillin is also referenced for H.pylori treatment. Additionally, metronidazole is mentioned as an alternative agent in eradication regimens for resistant cases.

What clinical indications are covered across the antibiotic entries?

The reference covers antibiotics organized by infection type: UTI (amoxicillin, ciprofloxacin, ceftriaxone, TMP-SMX), pneumonia (levofloxacin, azithromycin, ceftriaxone), meningitis (ceftriaxone, meropenem), skin/soft tissue (moxifloxacin, TMP-SMX for CA-MRSA), intra-abdominal infections (moxifloxacin, metronidazole), and parasitic infections (metronidazole for Giardia/Amoeba).