Microorganism, susceptibility | Standard therapy | Alternative therapies¶ |
Streptococcus pneumoniae |
Penicillin MIC |
≤0.06 mcg/mL | Penicillin G or ampicillin | Third-generation cephalosporinΔ, chloramphenicol |
≥0.12 mcg/mL |
Third-generation cephalosporinΔ MIC <1 mcg/mL | Third-generation cephalosporinΔ | Cefepime, meropenem |
Third-generation cephalosporinΔ MIC ≥1 mcg/mL | Vancomycin plus a third-generation cephalosporinΔ◊ | Fluoroquinolone§ |
Neisseria meningitidis |
Penicillin MIC |
<0.1 mcg/mL | Penicillin G or ampicillin | Third-generation cephalosporinΔ, chloramphenicol |
0.1 to 1.0 mcg/mL | Third-generation cephalosporinΔ | Fluoroquinolone, meropenem, chloramphenicol |
Listeria monocytogenes | Ampicillin¥ or penicillin G¥ | Trimethoprim-sulfamethoxazole |
Streptococcus agalactiae (group B Streptococcus) | Ampicillin or penicillin G | Third-generation cephalosporinΔ |
Escherichia coli and other Enterobacteriaceae‡ | Third-generation cephalosporinΔ | Aztreonam, fluoroquinolone, meropenem, trimethoprim-sulfamethoxazole, ampicillin |
Pseudomonas aeruginosa‡ | Cefepime or ceftazidime | Aztreonam, ciprofloxacin, meropenem |
Acinetobacter baumannii | Meropenem | Colistin (usually formulated as colistimethate sodium)† or polymyxin B† |
Haemophilus influenzae |
Beta-lactamase negative | Ampicillin | Third-generation cephalosporinΔ, cefepime, fluoroquinolone, aztreonam, chloramphenicol |
Beta-lactamase positive | Third-generation cephalosporinΔ | Cefepime, fluoroquinolone, aztreonam, chloramphenicol |
Staphylococcus aureus |
Methicillin susceptible | Nafcillin or oxacillin | Vancomycin, meropenem, linezolid, daptomycin |
Methicillin resistant | Vancomycin** | Trimethoprim-sulfamethoxazole, linezolid, daptomycin |
Staphylococcus epidermidis | Vancomycin** | Linezolid |
Enterococcus species |
Ampicillin susceptible | Ampicillin plus gentamicin | ... |
Ampicillin resistant | Vancomycin plus gentamicin | ... |
Ampicillin and vancomycin resistant | Linezolid | ... |