Is this list of Anti-Bacterial DOC outdated?

[purplelife]

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I know from FA the DOC for chlamydia trachomatis is doxcycline/ erythromycin eye drops for eye infection and here it says its macrolides? I was searching for a quick list of DOC on google and came across this. Does anyone have a better list of all DOC to share?

Anti-Bacterial Drug of Choice
Source: revised from Katzung & Trevor Pharmacology


01. Enterococcus: Ampicillin + Gentamicin
02. Staphylococcus aureus (methicillin-susceptible): Nafcillin
03. Staphylococcus aureus (methicillin-resistant): Vancomycin
04. Streptococcus pneumonia (penicillin-susceptible): Penicillin G, Amoxicillin
05. Streptococcus pneumonia (penicillin-resistant): Vancomycin + Ceftriaxone
06. Neisseria gonorheae: Ceftriaxone (IV), Cefixime (oral)
07. Treponema pallidum: Penicillin G
08. M. meningitidis: Penicillin G
09. Moraxella catarrhalis: Cefuroxime, Fluoroquinolones
10. Clostridium difficile: Metronidazole
11. Bacteroides fragilis: Metronidazole
12. Mycoplasma pneumoniae: Macrolide
13. Chlamydia trachomatis: Azithromycin or other Macrolides
14. Klebsiella pneumoniae: 3rd generation cephalosporin
15. Enterobacter: Carbapanem, Cefipime
16. Escherichia coli: 3rd generation cephalosporin
17. Campylobacter jejuni: Macrolide
18. Gardnerella vaginalis: Metronidazole
19. Proteus mirabilis: Ampicillin
20. Proteus indole positive: 3rd generation cephalosporin
21. Salmonella typhi: Ceftriaxone
22. Shigella: Fluoroquinolone
23. Serratia: Carbapanem


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http://www.usmle-forums.com/usmle-step-1-bits-pieces/20869-anti-bacterial-drug-choice.html

 

[thehundredthone]

Chlamydia causes more than just conjunctivitis. Also, erythromycin is a macrolide.

 

[USMLEstudent01]

I'm also having issues with DOCs. On a question if they give me Borrelia burgdorferi (Lyme Disease) and 2 choices -macrolides and tetracyclin, which one should I go with?

Are these all DOCs for that infection or are they DOC in particular situations?

For ---
Moraxella catarrhalis: Cefuroxime, Fluoroquinolones---
also PC G or TMP-SMX or 3rd Gen Cephalo?

Salmonella typhi: Ceftriaxone---- Sal Typoid fever= Ciprofloxacin?

For salmonella- Fluoroquinolones /TMP-SMX/ Ciprofloxacin in Infectious Diarrhea (Salmonella, shigella),


For Shigella: Fluoroquinolone-------- I have TMP-SMX or azithro or ceftrixone?

For--- Serratia: Carbapanem----- I have Cephalosporin 3rd Gen---??

For septicemia, is the DOC Genatmycin?

For osteomylitis I have either Fluroquino or Clindamycin?

For H. Influ is it both 3rd Gen and Clarithromycin?

 

[SBR249]

The drug of choice for Chlamydia is azithromycin because it's 1 oral dose and you are done. Doxycycline treatment requires 2 oral doses a day for 7 days which leads to lower patient compliance. Also remember that you must also give ceftriaxone for N. gonorrhoeae as Chlamydia and gonorrhea are often concurrent infections and failure to treat for both could lead to PID leading to infertility. So the standard treatment for either Chlamydia or gonorrhea in the US is azithromycin+ceftriaxone for purposes of the USMLE.

Erythromycin eye drops are most commonly used as prophylaxis and treatment in neonates who may have been exposed during vaginal delivery.

 

[Transposony]

They will always give you some contraindication/complication in the clinical scenario to guide you towards the correct choice.
It is entirely up to you to pick up the subtle clues.

 

[notbobtrustme]

I'm also having issues with DOCs. On a question if they give me Borrelia burgdorferi (Lyme Disease) and 2 choices -macrolides and tetracyclin, which one should I go with?

Are these all DOCs for that infection or are they DOC in particular situations?

For ---
Moraxella catarrhalis: Cefuroxime, Fluoroquinolones---
also PC G or TMP-SMX or 3rd Gen Cephalo?

Salmonella typhi: Ceftriaxone---- Sal Typoid fever= Ciprofloxacin?

For salmonella- Fluoroquinolones /TMP-SMX/ Ciprofloxacin in Infectious Diarrhea (Salmonella, shigella),


For Shigella: Fluoroquinolone-------- I have TMP-SMX or azithro or ceftrixone?

For--- Serratia: Carbapanem----- I have Cephalosporin 3rd Gen---??

For septicemia, is the DOC Genatmycin?

For osteomylitis I have either Fluroquino or Clindamycin?

For H. Influ is it both 3rd Gen and Clarithromycin?

I literally knew none of those and scored a 269.

It's about as low yield as you can get.

Step 1 is rarely about what antibiotic is indicated for what bug but more about the mechanism of action and side effects.

Know the big ones (eg UTI -> TMP/SMX) but pay much more attention to side effects/mechanism of action.

 

[notbobtrustme]

The drug of choice for Chlamydia is azithromycin because it's 1 oral dose and you are done. Doxycycline treatment requires 2 oral doses a day for 7 days which leads to lower patient compliance. Also remember that you must also give ceftriaxone for N. gonorrhoeae as Chlamydia and gonorrhea are often concurrent infections and failure to treat for both could lead to PID leading to infertility. So the standard treatment for either Chlamydia or gonorrhea in the US is azithromycin+ceftriaxone for purposes of the USMLE.

Erythromycin eye drops are most commonly used as prophylaxis and treatment in neonates who may have been exposed during vaginal delivery.

ya, but on the real deal, no question will ask you to differentiate between those two. That tidbit feels more like a Step 2 question instead. Step 1 will ask you "dude is allergic to macrolides, what other drug can you give" or "dude has chlymadia, which of these drugs is indicated that targets the 30S ribosome". No question will ask you about dose, route of administration and course.

 

[SBR249]

ya, but on the real deal, no question will ask you to differentiate between those two. That tidbit feels more like a Step 2 question instead. Step 1 will ask you "dude is allergic to macrolides, what other drug can you give" or "dude has chlymadia, which of these drugs is indicated that targets the 30S ribosome". No question will ask you about dose, route of administration and course.

You are right, Step 1 will not straight up ask you about dosing or regimen, however it is helpful to know why one treatment is generally preferred over the other as the first choice. Most resources will say the treatment for Chlamydia is dox or azithromycin, but they won't tell you why most recommendations only say azithromycin. Even though it's technically not tested, this information is also I believe included in UWorld explanations. The more things make sense to you, the better you'll remember them.

 

[purplelife]

I literally knew none of those and scored a 269.

It's about as low yield as you can get.

Step 1 is rarely about what antibiotic is indicated for what bug but more about the mechanism of action and side effects.

Know the big ones (eg UTI -> TMP/SMX) but pay much more attention to side effects/mechanism of action.

Thanks. After going over my wrong questions from couple NBMEs/UWAs, I learned that it helps me answer questions fast when I know the DOC for the condition and then that helps me quickly come up with MOA. Otherwise, when I'm not sure of the treatment then I find myself stuck.

 

[purplelife]

I'm also having issues with DOCs. On a question if they give me Borrelia burgdorferi (Lyme Disease) and 2 choices -macrolides and tetracyclin, which one should I go with?

Are these all DOCs for that infection or are they DOC in particular situations?

For ---
Moraxella catarrhalis: Cefuroxime, Fluoroquinolones---
also PC G or TMP-SMX or 3rd Gen Cephalo?

Salmonella typhi: Ceftriaxone---- Sal Typoid fever= Ciprofloxacin?

For salmonella- Fluoroquinolones /TMP-SMX/ Ciprofloxacin in Infectious Diarrhea (Salmonella, shigella),


For Shigella: Fluoroquinolone-------- I have TMP-SMX or azithro or ceftrixone?

For--- Serratia: Carbapanem----- I have Cephalosporin 3rd Gen---??

For septicemia, is the DOC Genatmycin?

For osteomylitis I have either Fluroquino or Clindamycin?

For H. Influ is it both 3rd Gen and Clarithromycin?

I'm not sure, I hope someone else with more knowledge can help clear this up.

 

[purplelife]

@notbobtrustme, there was someone who combined UW notes with pathoma/Fa and had it on goolge documents for others to use. Was it you? I think it was some time ago. I'm searching for it and can't find it.

 

[Transposony]

nm..............

 

[notbobtrustme]

@notbobtrustme, there was someone who combined UW notes with pathoma/Fa and had it on goolge documents for others to use. Was it you? I think it was some time ago. I'm searching for it and can't find it.

ya definitely wasn't me. I let Uworld/class/FA guide me on DOC questions. Most were fairly straightforward, from what I can remember.