Fluconazole (Diflucan) is an intravenous and oral antifungal medication that inhibits ergosterol synthesis (an important component of fungal cell membranes). As an intensivist, I most often use this medication to cover Candida albicans infections (especially symptomatic cystitis given fluconazole’s excellent urine penetration); however, it doesn’t cover C. krusei and has…
Lefamulin (Xenleta) is an intravenous and oral antibiotic approved for community acquired bacteria pneumonia (CABP). Similar to antibiotics like clindamycin and linezolid, lefamulin inhibits bacterial protein synthesis by acting on the 50S ribosomal subunit. What’s wonderful about this new antibiotic is that is has activity against the most common causes…
Azithromycin (Zithromax) is an oral and intravenous macrolide antibiotic I most commonly use to treat atypical and community-acquired pneumonias (CAP) in the intensive care unit. Outside of the ICU, the classic “Z-Pak” consists of a 500 mg load on day 1 followed by 250 mg daily on days 2-5. Similar…
Ceftriaxone (Rocephin) is an intravenous/intramuscular third generation cephalosporin that provides decent aerobic gram positive coverage (ie, pneumococcus although bacterial resistance is growing) but wonderful gram negative coverage against organisms like E. coli, Klebsiella, H. flu, and Proteus. Anaerobic bacteria and Pseudomonas are NOT covered by ceftriaxone.
Meropenem (Merrem) is a broad spectrum intravenous antibiotic and member of the carbapenem β-lactam drug class. These antibiotics are often reserved for multidrug resistant organisms (MDR) causing a wide variety of serious infections like hospital acquired pneumonia, intraabdominal infections, neutropenic fever, complicated soft tissue infections, and gram negative sepsis.
Zosyn (pipercillin-tazobactam or “pip-tazo”) is an intravenous combination of a β-lactam antibiotic with a β-lactamase inhibitor. β-lactamase is an enzyme implicated in antibiotic resistance that breaks down penicillins, cephalosporins, etc., so inhibiting it may make the antibiotic more efficacious in settings where it would be rendered inactive. Zosyn has gram…
Cefepime (Maxipime) is a broad-spectrum intravenous antibiotic commonly used to treat infections in inpatient and intensive care settings. Cefepime exerts its antibacterial effect by inhibiting bacterial cell wall synthesis. Specifically, it binds to penicillin-binding proteins (PBPs), essential for cell wall synthesis’s final stages. This results in the inhibition of bacterial…
Ciprofloxacin (Cipro) is a relatively inexpensive intravenous, oral, and topical fluoroquinolone antibiotic used to treat a myriad of conditions ranging from complicated urinary tract infections (UTIs) and infectious diarrhea to intraabdominal infections and even the plague and inhalational anthrax post-exposure. This class of bactericidal medications works by inhibiting DNA gyrase…
