Bacterial Treatments at a Glance

Original article by Adam Pope | Last updated on 28/6/2014
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Please note that microbial sensitivities vary between regions & countries, as well as over time. Individual hospital guidelines very widely, and this is just an overview of general sensitivies. Please check your local hospital guidelines for specific advice when prescribing.
 

Gram positive

Cocci

Catalase positive - Staphylococcus
  • S. aureus – flucloxacillin
  • S.saprophyticus – Penicillin
  • S. Epidermin - Vancomycin
Catalase negative - Streptococcus
  • Group A B-haemolytic strep: S. Pyogenes
  • GBS – agalactiae
  • Alpha-haemolytic – S.viridians and S.pneumoniae
  • Gamma-haemolytic – enteroccus
  • Treat above with penicillin
 

Rods

  • Clostridium – metronidazole then vancomycin
  • Listeria – ampicillin, ceftriaxone, cotrimoxazole
  • Bacillus: anthracis – penicillin, doxycycline, ciprofloxacin, levofloxacin
  • Bacillus: cereus – no antibiotics
  • Corynebacterium diptheriae – penicillin/erythromycin
 

Gram Negatives

Cocco-bacilli

  • Haemophilus influenza – serious (cefotaxime/ceftriaxone) less serious (ampicillin/amoxicillin)
  • Brucella – tetracyclines, rifampicin, aminoglycasides
  • Legionella – erythromycin + rifampicin
  • Pertussis – erythromycin in early stage
  • Diplococci
  • Neisseria meningitides – ceftriaxone/penicillin G (close contacts Rifampicin)
  • Neisseria gonorrhoeaceftriaxone
 

Rods

Lactose positive
  • E. coli – avoid abx
  • Enterobacter
  • Klebsiella -3rd generation cephalosporin
Lactose negative
  • Bacteriodes fragilis – ceftriaxone
Lactose negative oxidase positive
  • Vibrio cholera
  • Pseudomonas – Pitazobactam or ciprofloxacin +gentamycin
  • Campylobacter – fluoroquinolones/erythromycin
Lactose negative oxidase negative
  • H. pylori – PPI + amoxicillin + clarythromycin
  • Shigella – fluoroquinolones
  • Salmonella – ciprofloxacin/ceftriaxone
  • Yersinia – no antibiotics