ANTIBIOTICS WITH ANAEROBE COVERAGE - Antibiotics Class Overview 1. Metronidazole (Flagyl)(PO and IV) 2. Clindamycin – classically for infections above the diaphragm, as it also has activity vs microaerophilic streptococci; avoid in intraabdominal infections due high rates of resistance among Bacteroides species (up to 40% or more). 3. Combined PCN/Beta-Lactamase inhibitors: Augmentin, Unasyn, Zosyn, Timentin – all have excellent anaerobic activity, so no need to add Metronidazole (unless for C.diff). Unasyn better for anaerobic infections above the waist, less so for intraabdominal infections (due to high rate of resistance in E.coli). 4. Carbapenems (Imipenem, Meropenem, Ertapenem, Doripenem) – all have excellent anaerobic activity. 5. 2nd Generation Cephalosporins (Cephamycins): Cefoxitin, Cefotetan – beware increasing resistance of Bacteroides (Cefoxitin is better than Cefotetan, but avoid both for serious intraabdominal infections) 6. Moxifloxacin – has data to support its use in intraabdominal infections, but beware increasing resistance among Bacteroides (up to 40%!) 7. Tigecycline – excellent anaerobic activity. #Pharmacology #Antibiotics #Review #Overview #Anaerobe #Anaerobic #Metronidazole #Flagyl #Clindamycin
