infectious diseases
Penicillins
Indications for Penicillins
Penicillin G–like drugs (includingpenicillin V) are primarily used against Gram-positive bacteria Some gram-negative cocci (eg, Meningococcal Diseases ) A minority of gram-negative bacilli are also susceptible to large parenteral doses ofpenicillin G. Most staphylococci, mostNeisseria gonorrhoeae, many anaerobic gram-negative bacilli, and about 30% ofHaemophilus influenzaeare resistant. is the drug of choice for Syphilis , for certain Benzathinepenicillin Gis a long-acting formulation that is available as Pure benzathine penicillin A mixture of equal amounts of benzathine and procainepenicillin G A 3:1 mixture of 0.9 million units benzathine and 0.3 million units procainepenicillin G Of the 3 products, only pure benzathine penicillin is recommended for treating syphilis and preventing Rheumatic Fever . Pure benzathine penicillin and the mixture of equal amounts are indicated for treating upper respiratory infections and These drugs are more active against Enterococcal Infections None Certain gram-negative bacilli, such as non-beta-lactamase–producing Haemophilus Infections , The addition of a beta-lactamase inhibitor (clavulanate or sulbactam) allows use against methicillin-sensitive Staphylococcal Infections , Ampicillinis indicated primarily for infections typically caused by susceptible gram-negative bacteria: Bacterial Urinary Tract Infections None Diseases Caused by Meningococci None Biliary sepsis Respiratory infections Overview of Meningitis None Enterococcal Infections None Some Typhoid Fever and typhoid carriers These drugs (dicloxacillin,nafcillin, cloxacillin, flucloxacillin, andoxacillin) are used primarily for Penicillinase-producing methicillin-sensitiveStaphylococcus aureus These drugs are also used to treat someStreptococcus pneumoniae, group A streptococcal, and methicillin-sensitive coagulase-negative staphylococcal infections. Piperacillin andpiperacillin/tazobactamhave activity against Bacteria susceptible toampicillin Some strains of Klebsiella, Enterobacter, and Serratia Infections and Many strains of Pseudomonas and Related Infections None The addition of a beta-lactamase inhibitor enhances activity against beta-lactamase–producing methicillin-sensitiveS. aureus,E. coli,K. pneumoniae,H. influenzae, and gram-negative anaerobic bacilli but not against gram-negative bacilli that produce AmpC beta-lactamase or KPC and may only partially inhibit ESBL produced by someK. pneumoniae,E. coli, and other Enterobacterales. Broad-spectrum penicillins exhibit synergy with aminoglycosides and are usually used with this class to treatP. aeruginosainfections. 