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MEDICAL DISCLAIMER:The contents are under continuing development and improvements and despite all efforts may contain errors of omission or fact. This is not to be used for the assessment, diagnosis or management of patients. It should not be regarded as medical advice by healthcare workers or laypeople. It is for educational purposes only. Please adhere to your local protocols. Use the BNF for drug information. If you are unwell please seek urgent healthcare advice. If you do not accept this then please do not use the website. Makindo Ltd

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Version Jan 2023

Gram-positive organisms

Enterococcus faecalis Ampicillin, vancomycin/teicoplanin
Enterococcus faecium Vancomycin/teicoplanin, linezolid Glycopeptide-resistant enterococci Linezolid, tigecycline, daptomycin
MRSA Clindamycin, vancomycin, rifampicin (never used as monotherapy), linezolid, daptomycin, tetracyclines, tigecycline, co-trimoxazole
Staphylococcus aureus Flucloxacillin, clindamycin
Streptococcus pyogenes Penicillin, clindamycin, vancomycin
Streptococcus pneumoniae Penicillin, cephalosporins, levofloxacin, vancomycin
Gram-negative organisms

Escherichia coli, coliforms (enteric Gram-negative bacilli) Amoxicillin, Trimethoprim, cefuroxime, Ciprofloxacin, Co-Amoxiclav
Enterobacter spp., Citrobacter spp. Ciprofloxacin, meropenem, ertapenem, aminoglycosides
ESBL-producing Enterobacteriaceae Ciprofloxacin, meropenem, ertapenem (if sensitive), temocillin, aminoglycosides
Carbapenemase-producing Enterobacteriaceae Ciprofloxacin, aminoglycosides, tigecycline, colistin
Haemophilus influenzae Amoxicillin, Co-Amoxiclav, macrolides, cefuroxime, cefotaxime, Ciprofloxacin
Legionella pneumophila Azithromycin, levofloxacin, doxycycline
Neisseria gonorrhoeae Ceftriaxone/cefixime, spectinomycin
Neisseria meningitidis Penicillin, cefotaxime/ceftriaxone, chloramphenicol
Pseudomonas aeruginosa Ciprofloxacin, piperacillin-tazobactam, aztreonam, meropenem, aminoglycosides, ceftazidime/cefepime
Salmonella typhi Ceftriaxone, azithromycin (uncomplicated typhoid), chloramphenicol (resistance common)
Strict anaerobes

Bacteroides spp. Metronidazole, clindamycin, Co-Amoxiclav, piperacillin-tazobactam, meropenem
Clostridioides difficile Metronidazole, vancomycin (oral), fidaxomicin
Clostridium spp. Penicillin, Metronidazole, clindamycin
Fusobacterium spp. Penicillin, Metronidazole, clindamycin
Other organisms

Chlamydia trachomatis Azithromycin, doxycycline
Treponema pallidum Penicillin, doxycycline

Gram-positive organisms
Enterococcus faecalis	Ampicillin, vancomycin/teicoplanin
Enterococcus faecium	Vancomycin/teicoplanin, linezolid Glycopeptide-resistant enterococci Linezolid, tigecycline, daptomycin
MRSA	Clindamycin, vancomycin, rifampicin (never used as monotherapy), linezolid, daptomycin, tetracyclines, tigecycline, co-trimoxazole
Staphylococcus aureus	Flucloxacillin, clindamycin
Streptococcus pyogenes	Penicillin, clindamycin, vancomycin
Streptococcus pneumoniae	Penicillin, cephalosporins, levofloxacin, vancomycin
Gram-negative organisms
Escherichia coli, coliforms (enteric Gram-negative bacilli)	Amoxicillin, Trimethoprim, cefuroxime, Ciprofloxacin, Co-Amoxiclav
Enterobacter spp., Citrobacter spp.	Ciprofloxacin, meropenem, ertapenem, aminoglycosides
ESBL-producing Enterobacteriaceae	Ciprofloxacin, meropenem, ertapenem (if sensitive), temocillin, aminoglycosides
Carbapenemase-producing Enterobacteriaceae	Ciprofloxacin, aminoglycosides, tigecycline, colistin
Haemophilus influenzae	Amoxicillin, Co-Amoxiclav, macrolides, cefuroxime, cefotaxime, Ciprofloxacin
Legionella pneumophila	Azithromycin, levofloxacin, doxycycline
Neisseria gonorrhoeae	Ceftriaxone/cefixime, spectinomycin
Neisseria meningitidis	Penicillin, cefotaxime/ceftriaxone, chloramphenicol
Pseudomonas aeruginosa	Ciprofloxacin, piperacillin-tazobactam, aztreonam, meropenem, aminoglycosides, ceftazidime/cefepime
Salmonella typhi	Ceftriaxone, azithromycin (uncomplicated typhoid), chloramphenicol (resistance common)
Strict anaerobes
Bacteroides spp.	Metronidazole, clindamycin, Co-Amoxiclav, piperacillin-tazobactam, meropenem
Clostridioides difficile	Metronidazole, vancomycin (oral), fidaxomicin
Clostridium spp.	Penicillin, Metronidazole, clindamycin
Fusobacterium spp.	Penicillin, Metronidazole, clindamycin
Other organisms
Chlamydia trachomatis	Azithromycin, doxycycline
Treponema pallidum	Penicillin, doxycycline

PLEASE NOTE LEGAL ADVICE: The contents are under continuing development and improvements and may contain errors of omission or fact. The official launch will be at the end of 2018. Feedback vital and always welcome at drokane at gmail.com. This is not to be used for the assessment, diagnosis or management of patients. It should not be regarded as medical advice. It is only for educational purposes. Please adhere to your local protocols. If you are unwell please seek healthcare advice from your doctor. This does not replace senior or specialist advice. If you do not accept this then please do not use the website. If you need medical advice, please consult a doctor or other appropriate medical professional. If you are a medical professional and you need advice then speak to your senior or colleagues.

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