Gram-negative Cocci |
Moraxella catarrhalis | Cefuroxime, amoxicillin-clavulanic acid | Ceftriaxone, cefuroxime axetil, a fluoroquinolone,1 a macrolide,2 a tetracycline,3 TMP-SMZ4 |
Neisseria gonorrhoeae (gonococcus) | Ceftriaxone + azithromycin or doxycycline | Cefixime + azithromycin or doxycycline5 |
Neisseria meningitidis (meningococcus) | Penicillin6 | Ceftriaxone, ampicillin |
Gram-positive Cocci |
Enterococcus faecalis | Ampicillin ± gentamicin7 | Vancomycin ± gentamicin |
Enterococcus faecium | Vancomycin ± gentamicin7 | Linezolid,8 quinupristin-dalfopristin,8 daptomycin,8 tigecycline,8 tedizolid,8 oritavancin8 |
Streptococcus, hemolytic, groups A, B, C, G | Penicillin6 | Macrolide,2 a cephalosporin,9 vancomycin, clindamycin |
Staphylococcus, methicillin-resistant | Vancomycin | TMP-SMZ,4 doxycycline, minocycline, linezolid,8 tedizolid,8 daptomycin,8 televancin,8 dalbavancin,8 oritavancin,8 ceftaroline, delafloxacin |
Staphylococcus, methicillin-susceptible | Penicillinase-resistant penicillin10 | Vancomycin, a cephalosporin,9 clindamycin, amoxicillin-clavulanic acid, ampicillin-sulbactam |
Streptococcus pneumoniae11 (pneumococcus) | Penicillin6 | A cephalosporin,9 vancomycin, clindamycin, a tetracycline,3 respiratory fluoroquinolones1 |
Viridans streptococci | Penicillin6 | Cephalosporin,9 vancomycin |
Gram-negative Rods |
Acinetobacter | Imipenem, meropenem | Tigecycline, minocycline, doxycycline, aminoglycosides,12 colistin, cefiderocol |
Bacteroides, gastrointestinal strains | Metronidazole | Ampicillin-sulbactam, piperacillin-tazobactam, ertapenem |
Brucella | Doxycycline + rifampin3 | TMP-SMZ4 ± gentamicin; ciprofloxacin + rifampin |
Burkholderia mallei (glanders) | Streptomycin + tetracycline3 | Chloramphenicol + streptomycin |
Burkholderia pseudomallei (melioidosis) | Ceftazidime | Tetracycline,3 TMP-SMZ,4 amoxicillin-clavulanic acid, imipenem or meropenem |
Campylobacter jejuni | Azithromycin | A fluoroquinolone1 |
Enterobacter | Ertapenem, imipenem, meropenem, cefepime | Aminoglycoside, a fluoroquinolone,1 TMP-SMZ4 |
Escherichia coli (uncomplicated outpatient urinary infection) | Nitrofurantoin, fosfomycin | Fluoroquinolones,1 TMP-SMZ,4 oral cephalosporin |
Escherichia coli (sepsis)13 | Cefotaxime, ceftriaxone | Ertapenem,13 imipenem13 or meropenem,13 aminoglycosides,12 aztreonam, ticarcillin-clavulanate, piperacillin-tazobactam, ceftazidime-avibactam,13,15 ceftolozane-tazobactam,13,14 meropenem/vaborbactam,15 imipenem/cilastatin-relebactam13,14,15 |
Haemophilus (respiratory infections, otitis) | Ampicillin-clavulanate | Doxycycline, azithromycin, ceftriaxone, cefuroxime, cefuroxime axetil, TMP-SMZ4 |
Haemophilus (serious infection) | Ceftriaxone | Aztreonam |
Helicobacter pylori | Proton pump inhibitor (PPI), clarithromycin, amoxicillin, and metronidazole | PPI, clarithromycin, and amoxicillin or metronidazole |
Klebsiella13 | Ceftriaxone | TMP-SMZ,4 aminoglycoside,12 ertapenem,13 imipenem13 or meropenem,13 a fluoroquinolone,1 aztreonam, ticarcillin-clavulanate, piperacillin-tazobactam, ceftazidime-avibactam,13 ceftolozane-tazobactam,13,14 meropenem/vaborbactam,15 imipenem/cilastatin-relebactam13,14,15 |
Legionella species (pneumonia) | Azithromycin, or fluoroquinolones1 ± rifampin | Doxycycline ± rifampin |
Prevotella, oropharyngeal strains | Clindamycin | Metronidazole |
Proteus mirabilis | Ampicillin | TMP-SMZ,4 a fluoroquinolone,1 a cephalosporin9 |
Proteus vulgaris and other species (Morganella, Providencia) | Ceftriaxone | Ertapenem, imipenem or meropenem, TMP-SMZ,4 a fluoroquinolone1 |
Pseudomonas aeruginosa | Piperacillin-tazobactam or ceftazidime or cefepime, or imipenem or meropenem or doripenem or aztreonam ± aminoglycoside12 | Ciprofloxacin (or levofloxacin) ± piperacillin-tazobactam; ciprofloxacin (or levofloxacin) ± ceftazidime; ciprofloxacin (or levofloxacin) ± cefepime; ceftazidime-avibactam13; ceftolozane-tazobactam,13 cefiderocol, imipenem/cilastatin-relebactam |
Salmonella (bacteremia) | Ceftriaxone | A fluoroquinolone1 |
Serratia | Carbapenem | TMP-SMZ,4 a fluoroquinolone,1 ceftriaxone |
Shigella | Azithromycin, ciprofloxacin, or ceftriaxone | TMP-SMZ4 |
Vibrio (cholera, sepsis) | A tetracycline3 | TMP-SMZ,4 a fluoroquinolone1 |
Yersinia pestis (plague) | Streptomycin ± a tetracycline3 | Chloramphenicol, TMP-SMZ5 |
Gram-positive Rods |
Actinomyces | Penicillin6 | Tetracycline,3 clindamycin |
Bacillus (including anthrax) | Penicillin6 | A macrolide,2 a fluoroquinolone1 |
Clostridium (eg, gas gangrene, tetanus) | Penicillin6 | Metronidazole, clindamycin, imipenem, or meropenem |
Corynebacterium diphtheria | Macrolide2 | Penicillin6 |
Corynebacterium jeikeium | Vancomycin | Linezolid |
Listeria | Ampicillin ± aminoglycoside12 | TMP-SMZ4 |
Acid-fast Rods |
Mycobacterium avium complex | Clarithromycin or azithromycin + ethambutol, ± rifabutin | Amikacin, ciprofloxacin |
Mycobacterium fortuitum-chelonei | Cefoxitin + clarithromycin | Amikacin, rifampin, sulfonamide, doxycycline, linezolid |
Mycobacterium kansasii | INH + rifampin ± ethambutol | Clarithromycin, azithromycin, ethionamide, cycloserine |
Mycobacterium leprae | Dapsone + rifampin ± clofazimine | Minocycline, ofloxacin, clarithromycin |
Mycobacterium tuberculosis16 | Isoniazid (INH) + rifampin + pyrazinamide ± ethambutol | Other antituberculous drugs (see Tables 9–14 and 9–15) |
Nocardia | TMP-SMZ4 | Minocycline, imipenem or meropenem, linezolid |
Spirochetes |
Borrelia burgdorferi (Lyme disease) | Doxycycline, amoxicillin, cefuroxime axetil | Ceftriaxone, penicillin, azithromycin |
Borrelia recurrentis (relapsing fever) | Doxycycline3 | Penicillin6 |
Leptospira | Penicillin6 | Doxycycline,3 ceftriaxone |
Treponema pallidum (syphilis) | Penicillin6 | Doxycycline, ceftriaxone |
Treponema pertenue (yaws) | Penicillin6 | Doxycycline |
Mycoplasmas | Azithromycin or doxycycline | A fluoroquinolone1 |
Chlamydiae |
C pneumoniae | Doxycycline3 | Azithromycin, a fluoroquinolone1,17 |
C psittaci | Doxycycline | Chloramphenicol |
C trachomatis (urethritis or pelvic inflammatory disease) | Doxycycline or azithromycin | Levofloxacin, ofloxacin |
Rickettsiae | Doxycycline3 | Chloramphenicol, a fluoroquinolone1 |