Antibiotic Choice

Infection: Acute bacterial endocarditis
Microorganism(s): Staph., Strep., enterococci
First choice: pen.G + clox,+ gentamicin
Next choice: vancomycine + gentamicin

Infection: Subacute bacterial endocarditis
Microorganism(s):Strep.viridans, enterococci
First choice: pen.G + gentamisin
Next choice: vancomycine + gentamicine

Infection: Cystitis
Microorganism(s): E.coli, proteus, staphylococci
First choice: cotrimoxazole, ampicillin
Next choice: nitrofurantoin, fluoroquinolone

Infection: Pyelonephritis
Microorganism(s): coliform bact.
First choice: cotrimoxazole, ampicillin
Next choice: fluoroquinolone

Infection: Gonorrhoea
Microorganism(s): N.gonorrhoeae
First choice: pen.G, ampicillin, ceftriaxone
Next choice: erithromycin, doxycycline, fluoroquinolone

Infection: Nonspecific Urethritis
Microorganism(s): Chlamydia
First choice: tetracyclinc/doxycycline
Next choice: erithromycin

Infection: Lymphogranuloma venereum.
Microorganism(s): Chlamydia
First choice: tetracycline/doxycycline
Next choice: sulfonamide, erithromycin

Infection: Infiltrate/furunculosis
Microorganism(s): Str.pyogenes, staphylococci
First choice: pen.G, erythromycin, (flu)cloxacillin
Next choice: spiramycin, clindamycin

Infection: Erysipelas
Microorganism(s): Str.pyogcnes
First choice: pen.G.
Next choice: erithromycin, clindamycin

Infection: Impetigo
Microorganism(s): Str.progenes, Staph. aureus
First choice: pen.G, pen.V.
Next choice: erithromycin, spiramycin, flucloxacillin

Infection: Mouth/Teeth infection
Microorganism(s): Aerob + anaerobic microorg.
First choice: pen V, pen G, erythro, macrolide
Next choice: + metronidazol (chronic infection)

Infection: Oral Candidiasis
Microorganism(s): Candida
First choice: mycostatin lozenges/suspension
Next choice: amphotericin lozenges

Infection: Acute Tonsillitis
Microorganism(s): Streptococcus
First choice: pen.G, pen.V, erythromycin
Next choice: spiramycin, clindamycin

Infection: Acute Pharyngitis
Microorganism(s): Virus (> 90%), Str.pyogenes
First choice: without antibiotic
Next choice: pen.V, pen.G, erithromycin (only when secondary infection is evident)

Infection: Common cold, flu
Microorganism(s): Virus
First choice: without antibiotic
Next choice: amoxycillin, erithromycin, doxycycline (only when secondary infection is evident)

Infection: Measles
Microorganism(s): Virus
First choice: without antibiotic
Next choice: amoxycillin, erithromycin, doxycycline (only when secondary infection is evident)

Infection: Chicken pox
Microorganism(s): Virus
First choice: without antibiotic-bath regularly
Next choice: amoxycillin, erithromycin, doxycycline (only when secondary infection is evident)

Infection: Parotitis epidemica
Microorganism(s): Virus
First choice: no antibiotic-chew on chewing gum is most effective
Next choice: -

Infection: Adult Pneumonia
Microorganism(s): Str.pneumoniae
First choice: pen.G, erythromycin
Next choice: chloramphenicol, clindamycin + aminoglyc

Infection: Child Pneumonia
Microorganism(s): H.influenzae
First choice: amoxycillin
Next choice: chloramphenicol, cotrimoxazole

Infection: Otitis media
Microorganism(s): H.influenzae. streptococci
First choice: ampicillin
Next choice: erithromycin, cotrimoxazole

Infection: Septicemia.
Microorganism(s): Anything possible
First choice: cephalosporin G3 (+ aminoglyc.)
Next choice: clindamycin + aminoglyc

Infection: Intra-abdominal septicemia
Microorganism(s): Coliform, Bacteroidcs
First choice: aminoglyc. + penicillin + metronid.
Next choice: clindamycin + cephalosporin G3

Infection: Tetanus
Microorganism(s): Cl.tetani
First choice: pen.G
Next choice: clindamycin, chloramphenicol + metronid

Infection: Gas gangrene
Microorganism(s): Cl.perfringens
First choice: pen.G
Next choice: clindamycin, chloramphenicol

Infection: Diphteria
Microorganism(s): C.diphteriae
First choice: pen.G
Next choice: erithromycin

Infection: Nonspecific Diarrhea
Microorganism(s): Virus, food, or bacteria (rare)
First choice: without antibiotic - bistmuth salt
Next choice: tetracycline (when bacterial [V.cholerae])

Infection: Typhoid fever
Microorganism(s): S.typhi, S.paratyphi
First choice: chloramphenicol, ampicillin
Next choice: cotrimoxazole, fluoroquinolone

Adapted from Katzung B, ed. Basic and Clinical Pharmacology, 4th ed., 1989:619-21, Gilman AG, Goodman LS, Rail TW, Murad F, cd.
The Pharmacological Basis of Therapeutics, 8lh ed., 1990, 1024-33, and Antibiotic Guidelines, 6th ed 1990-91, Health Department of Victoria,
Australia.