ANTIMICROBIAL SUSCEPTIBILITY PROFILES
Good = organisms susceptible to low concentrations
Moderate = organisms susceptible but to high therapeutic concentrations
Resistant = organisms either completely resistance or with a high incidence of acquired resistance.
| Penicillins | ||
|---|---|---|
| Penicillin G (Benzyl Penicillin G) | ||
| Good | Aerobic: all beta-hemolytic Streptococci; B. anthracis; most corynebacteria; E. rhusiopathiae, most L. monocytogenes. Anaerobic: Clostridium, Fusobacterium, and some Bacteroides |
|
| Moderate | Actinobacillus, Borrelia, Brucella, Haemophilus, Leptospira, Moraxella, Pasteurella, Proteus, T. equigenitalis, Treponema sp. | |
| Resistant | Constitutive: Enterobacteriaceae (except a few Proteus), Bacteroides fragilis, Bordetella, most Campylobacter, Nocardia. Acquired: Many strains of S. aureus, S. intermedius |
|
| Ampicillin, Amoxicillin (Broad Spectrum Aminobenzyl Penicillins) | ||
| Good | as for benzyl penicillin but also Borrelia,Leptospira,Moraxella | |
| Moderate | as for benzyl penicillin and Campylobacter, R. equi, and enterococci | |
| Resistant | Constitutive: Bacteroides fragilis, B. bronchiseptica, Citrobacter, Enterobacter, Klebsiella, other Proteus, P. aeruginosa, Serratia, Y. enterocolitica. Acquired: Actinobacillus, E. coli, P. mirabilis, and Salmonella, and widespread resistant by Enterobacteriaceae (though they are considered part of the general spectrum). | |
| Carbenicillin, Ticarcillin (Carboxypenicillins) | ||
| Good | gram negative activity especially against P. aeruginosa, and Proteus. (Temocillin is beta-lactamase resistant member of class but not available here). | |
| Methcillin, Oxacillin, Cloxacillin, Nafcillin (Penicillinase-resistant Penicillins) | ||
| Good | Penicillinase producing Staphylococci. | |
| Moderate | Other Gram postives (that are MORE susceptible to Penicillin G and Ampicillin) | |
| Resistant | Most Gram (-) | |
| Mecillinam (Amidinopenicillins) | ||
| Good | Citrobacter, Enterobacter, E. coli, K. pneumoniae, Proteus, Yersinia. | |
| Resistant | Little gram positive activity. | |
| Piperacillin (Acylaminopenicillins - Ureidopenicillins) | ||
| Good | Noted for increase activity against gram-negative bacteria compared to carbenicillin or ampicillin especially Klebsiella, and P. aeruginosa. | |
| Resistant | These are susceptible to beta-lactamases so resistance among Enterobacteriaceae is unpredicatable and most Enterobacter and Serratia are resistant. | |
| Potentiated Penicillin Combinations | ||
| Amoxicillin - Clavulanic Acid (Clavamox, Augmentin) | ||
| Good | S. aureus, beta hemolytic Streptococci. Actinobacillus, Bordetella, Haemophilus, Pasteurella, Enterobacteriaceae are usually susceptible; all anaerobes including B. fragilis (penicillinase production varies). | |
| Variable | some E. coli, and Klebsiella | |
| Resistant | Citrobacter, Enterobacter, P. aeruginosa, Serratia, methicillin resistant S. aureus | |
| Ampicillin - Sulbactam (Unasyn) | ||
| activity is slightly broader (a few more isolates) than Clavulanic Acid - Amoxicillin but the overall activity is somewhat less (lower potency, slower kills etc.) | ||
| Ticarcillin - Clavulanic acid (Timentin) | ||
| Advantage (over Clavamox) is greater activity of ticarcillin against Enterobacter and P. aeruginosa. | ||
| Good | Ticarcillin resistant Enterobacteriaceae, S. aureus, Anaerobes including B. fragilis, and P. aeruginosa. |
|
| Moderate | activity against many Enterobacteriaceae is at the high end of the sensitive or in the moderately susceptible MIC range. | |
| Resistant | mostly by induction of non-bound beta-lactamases in Gram negatives such as Enterobacter, P. aeruginosa, and Serratia. | |
| Carbapenams | ||
| Imepanam | ||
| Good | most gram-positive cocci (including enterococci), some Mycobacterium sp., Anaerobes including B. fragilis, Most activity of beta-lactam antibiotics against gram-negative bacteria including beta-lactamase producing fastidious organisms, Enterobacteriaceae and most P. aeruginosa. |
|
| Resistant | Pseudomonas cepacia, P. maltophila, some S. faecium, some methicillin-resistant S. aureus. | |
| Monobactams | ||
| Aztreonam | ||
| Good | almost all gram-negative aerobic bacteria, particularly fastidious organisms (Haemophilus, etc.) and Enterobacteriaceae. Susceptibility of P. aeruginosa is variable. | |
| Resistant | Gram-positive bacteria, anaerobic bacteria, Pseudomonas, Citrobacter, and Enterobacter are often resistant. | |
| Cephalosporins and Cephamycins | ||
| Cefadroxil, Cephalexin (1st Generation Oral) | ||
| Good | Aerobic: Many gram positive including S. aureus, S. intermedius, Streptococci (not enterococci), Actinomyces, Bacillus, Corynebacteria, E. rhusiopathiae, most L. monocytogenes, B. avium, Haemophilus, Pasteurella. Anaerobic: some Bacteroides, most Clostridium, most Fusobacterium. |
|
| Variable | due to acquired resistance by E. coli, Klebsiella, Proteus, Salmonella Cefachlor and Cefpodoxime is most active against this group. Cefpodoxime is better absorbed than Cefachlor | |
| Moderate | Actinobacillus, Brucella, some Bacteroides | |
| Resistant | Acenetobacter, B. fragilis, B. bronchiseptica, Campylobacter, Citrobacter, Enterobacter, Nocardia, S. faecalis (enterococci), P. aeruginosa, R. equi, Serratia, Yersinia | |
| Cefachlor (2nd Generation Oral) | ||
| Good | E. coli, Klebsiella, Proteus, Salmonella (though there is acquired resistance among these) | |
| Moderate | Aerobic: Many gram positive including S. aureus, S. intermedius, Streptococci (not enterococci), Actinomyces, Bacillus, corynebacteria, E. rhusiopathiae, most L. monocytogenes, B. avium, Haemophilus, Pasteurella. Anaerobic: some Bacteroides, most Clostridium, most Fusobacterium (The list that was GOOD for 1st Generation Oral) |
|
| Cefpodoxime (3rd Generation Oral) | ||
| Better absorbed than Cefachlor but similar activity (expect better results clinically) | ||
| Cephalothin, Cephazolin, Cefapirin, Cephradine (1st Generation Parenteral) | ||
| Share the general characteristics of orally administered 1st generation cephalosporins. They tend to have good activity against Gram positive organisms and variable to poor activity against gram negatives. May be more active against bacteria in VARIABLE and MODERATE categories because they reach better plasma/tissue concentrations. | ||
| Cefamandole (1st or 2nd generation), Cefmenoxime (2nd generation), Cefotaxime, Ceftriaxone, Ceftiofur, Cefuroxime (3rd Generation) | ||
| These tend to have better activity against Gram negative bacteria and lesser activity against gram positive bacteria than the Group I parenterals. The 3rd generation drugs tend to have longer half-lives and can be dosed less frequently than Group I parenterals, but this can vary by species (don't count on it). | ||
| Good | Gram (+) Streptococci(not enterococci), moderate activity against S. aureus (cefamandole more active). Good against many other gram-positive (penicillin G sensitive). Gram (- ) E. coli, Klebsiella, and Salmonella, most Proteus to cefotaxime group (cefotriaxone, ceftiofur). Actinobacillus, Haemophilus, Pasteurella are all susceptible (including penicillinase producing strains). Anaerobes Clostridium, and Fusobacterium susceptible, Bacteroides, resistant. | |
| Variable | acquired resistance in Enterobacteriaceae | |
| Moderate | Citrobacter, Enterobacter, P. aeruginosa, Serratia susceptible (only) to cefotaxime group. | |
| Resistant | Bordetella, some Enterobacter, and Serratia, some P. aeruginosa (all for cefuroxime, cefamandole, some for cefotaxime group), enterococci, methicillin-resistant S. aureus. | |
| Cefoperazone, Ceftazidime (3rd Generation Parenteral) | ||
| These have the best gram negative activity of the cephalosporins. Both have excellent activity against P. aeruginosa. Otherwise similar to Group II Parenteral Cefotaxime group above. | ||
| Cefoxitin, Cefotetan (2nd Generation Parenteral), Moxalactam (3rd Generation Parenteral) | ||
| cefoxitin | Resistant to most bacterial beta-lactamases, gram negative activity is less compared to cefotaxime group above, greater than Group I parenterals above. Gram positive activity is less than Group I parenterals. Good activity against Bacteroides fragilis. | |
| cefotetan | NO LONGER MARKETED IN US. greatest activity against gram negatives of this group but P. aeruginosa is resistant. Small portion of Bacteroides fragilis are resistant. | |
| moxalactam | similar to cefotaxime, ceftiofur above but better activity against B. fragilis. Not particularly active against S. aureus. Some Pseudomonas aeruginosa, are resistant. Noted for activity against anaerobic organisms. | |
| Aminoglycosides | ||
| Streptomycin | ||
| Good | mycobacteria, some mycoplasma, some gram-negative rods including Brucella, and some S. aureus. (least active aminoglycoside except vs. mycobacteria). Leptospira, F. tularensis, and Y. pestis, and most Campylobacter fetus subsp venerealis. | |
| Resistant | widespread acquired resistance among Gram (-) organisms. | |
| Neomycin (Dihydrostreptamine aminoglycosides) | ||
| Good | Gram (-) pathogens, more active than streptomycin, less active than gentamicin, tobramycin and amikacin. some S. aureus. | |
| Resistant | widespread acquired resistance among Gram (-) organisms. | |
| Gentamicin, Kanamycin, Tobramycin, Apramycin, Netilmycin, Sisomici (Kanamycin Group) | ||
| Good | , Serratia, Yersinia, Brucella, Campylobacter, Haemophilus, and Pasteurella most P. aeruginosa. Gram (+) S. aureus is usually susceptible though acquired resistance is becoming more common. Prototheca susceptible. | |
| Resistant | Constitutive: many gram-positive aerobes, all anaerobes, some Pseudomonas Acquired:Enterobacteriaceae including Enterobacter, E. coli, Klebsiella, Proteus and S. aureus | |
| Amikacin | ||
| Slightly less active and slightly less toxic than gentamicin but resistant to most bacterial enzymes that inactivate other aminoglycosides. | ||
| Apramycin | ||
| Appears to have similar activity to other aminoglycosides though literature studies of spectrum are lacking. Used for E. coli, Salmonella, Treponema in piglets and calves. | ||
| Spectinomycin | ||
| Similar activity to other aminoglycosides. Because of resistance in the population, activity against gram negative aerobes is probably less predictable than gentamicin. (in a study of Pasteurella isolates, about half were classified as resistant). | ||
| Tobramycin | ||
| Active against more isolates of P. aeruginosa than is gentamicin (2/3 of Gentamicin resistant organisms are susceptible). | ||
| Polymyxins, Glycopeptides, Mupirocin, Bacitracin | ||
| Polymixin B, Colistin | ||
| Good | Good activity against many species of Gram (-) bacteria | |
| Resistant | No activity against Proteus, Serratia, Providencia, Gram (+) organisms. Acquired resistance rare except P. aeruginosa. | |
| Vancomycin (Glycopeptides) | ||
| Good | bactericidal to most Gram (+) aerobic cocci and bacilli | |
| Resistant | most Gram (-) bacilli are resistant. | |
| Mupirocin | ||
| Good | Staphylococci and Streptococci | |
| Resistant | most other Gram (+) and Gram (-) bacteria. | |
| Bacitracin | ||
| Good | Gram (+) bacteria. includes C. perfringens (used in pigs and poultry) | |
| Resistant | Gram (-) bacteria | |
| Lincosamides, Macrolides, and Plueromutilins | ||
| Lincomicin, Clindamycin (Lincosamides) | ||
| Good | Gram (+) aerobes: Bacillus, Corynebacterium sp., E. rhusiopathiae, staphylococci, Streptococci (but not enterococci). Gram (-) bacteria: Campylobacter. Anaerobes including Actinomyces, Bacteroides (including B. fragilis) C. perfringens (but not all Clostridium), Fusobacterium, anaerobic cocci and T. hyodysenteriae. | |
| Resistant | all aerobic Gram (-) rods, Nocardia, Mycobacterium sp. | |
| Erythromycin, Tylosin, Spiramycin, Tilmicosin, Tulathromycin, Azithromycin, Clarithromycin (Macrolides) | ||
| Erythromycin | ||
| Good | Gram (+) aerobes: Bacillus, Corynebacterium sp., E. rhusiopathiae, Listeria sp., staphylococci, Streptococci. Gram (-) aerobes:Actinobacillus, Brucella, Campylobacter, Leptospira, Anaerobic bacteria: Actinomyces, Bacteroides(except B. fragilis), Clostridium, some Fusobacterium, anaerobic cocci. | |
| Moderate | Enterococci, some Bordetella, Haemophilus, Legionella, Ehrlichia, Pasteurella | |
| Resistant | Enterobacteriaceae, Pseudomonas, Nocardia, Mycoplasma, Chlamydia psittaci, Mycobacterium sp. other than M. kansasii | |
| Tylosin | Similar spectrum to Erythromycin. Less active against most bacteria except T. hyodysenteriae, but more active against most Mycoplasma. | |
| Spiramycin | Similar spectrum to Erythromycin but less active. Less active against Mycoplasma as tylosin or tiamulin. | |
| Tilmicosin, Tulathromycin, Azithromycin, Clarithromycin | New to veterinary medicine. Restricted list of species/disorders evaluated. Similar spectrum to Erythromycin but higher portion of all bacteria probably susceptible. More active against Mycoplasma than other members of this class. | |
| Tiamulin (Pleuromutilins) | ||
| Similar spectrum to that of tylosin but much greater activity. Active against only a few Gram (-) bacteria and inactive against Enterobacteriaceae. Subinhibitory concentrations are thought to reduce adhesiveness of E. coli. | ||
| Chloramphenicol(s) | ||
| Chloramphenicol, Florfenicol | ||
| Good | Gram (+) aerobic bacteria: A. pyogenes, B. anthracis, Corynebacterium sp., E. rhusiopathiae, L. monocytogenes, Staphylococcus sp., Streptococcus sp. Gram (-) aerobic bacteria: Actinobacillus, B. bronchiseptica, B. canis, Enterobacteriaceae including many E. coli, Klebsiella, Proteus, Salmonella, Haemophilus, Moraxella, Pasteurella All anaerobes. | |
| Moderate | Leptospira, R. equi | |
| Resistant | Mycobacterium sp., Nocardia, Acquired resistance by Enterobacteriaceae described above. | |
| Tetracyclines | ||
| Chlortetracycline, Oxytetracycline, Tetracycline, Doxycycline, Minocycline | ||
| Differences between the tetracyclines is a matter of solubility (hence pharmacokinetics, tissue penetration, etc.). Subtle differences in resistance patterns may exist because drug "exclusion," a primary form of tetracycline resistance, may be overcome by increased lipid solubility (old tetracyclines < doxycycline < minocycline) | ||
| Good | Gram (+) aerobes: Bacillus, Corynebacterium sp., E. rhusiopathiae, L. monocytogenes, Streptococci. Gram (-) bacteria: Actinobacillus, Bordetella ,Brucella, F. tularensis, Haemophilus, P. multocida, Yersinia, Campylobacter fetus, Borrelia, Leptospira Anaerobes: Actinomyces, Fusobacterium also: Mycoplasma, Chlamydia sp. (including C. psittaci), Rickettsia sp., (inluding C. burnetii, Ehrlichia sp., and protozoa (Theileria, Eperythrozoon, and Anaplasma). | |
| Resistant | Constitutive: some Mycobacterium sp., P. vulgaris, P. aeruginosa, Serratia Acquired: staphylococci, enterococci, Enterobacteriaceae. Anaerobes such as Bacteroides, and Clostridium, some Mycoplasma (M. bovis, M. hyopneumoniae are resistant) | |
| Sulfonamides | ||
| Sulfathiazole, Sulfamethazine, Sulfamerazine, Sulfadiazine, etc. | ||
| Good | Actinomyces, Bacillus, Brucella, ,E. rhusiopathiae, L. monocytogenes, Streptococcus sp., Chlamydia sp., coccidia, Pneumocystis carinii, Cryptosporidium sp. | |
| Moderate | (or variable due to acquired resistance): Gram (+) aerobes: staphylococci, enterococci. Gram (-) aerobes: Enterobacteriaceae including Enterobacter, E. coli, Klebsiella, Proteus, Actinobacillus, Haemophilus, Pasteurella, Pseudomonas, Anaerobes: Actinomyces, Bacteroides, Fusobacterium | |
| Resistant | Clostridium, and anaerobic cocci. Mycobacterium sp., Mycoplasma, Rickettsia sp., P. aeruginosa, and spirochetes. | |
| Sulfadiazine-Trimethoprim, Sulfamethoxasole-Trimethoprim, Sulfonamide-Ormetoprim (Sulfonamide THF-Reducatase Inibitor combinations) | ||
| Good | Gram (+) Aerobes: S. aureus, Streptococci, Actinomyces, Corynebacterium sp, E. rhusiopathiae, L. monocytogenes. Gram (-) aerobes: Actinobacillus, Bordetella, Brucella, Enterobacteriaceae such as E. coli, Klebsiella, Proteus, Salmonella, Yersinia, Haemophilus, Pasteurella, Anaerobes: Actinomyces, Bacteroides, Fusobacterium, some Clostridium, Chlamydia sp. | |
| Moderate | some Mycobacterium sp., some Nocardia | |
| Resistant | Rickettsia, Leptospira, P. aeruginosa, Mycoplasma | |
| Sulfonamide - Pyrimethamine | ||
| better activity than trimethoprim against coccidia, Toxoplasma lesser antibacterial activity than trimethoprim | ||
| Fluoroquinolones | ||
| Enrofloxacin, Norfloxacin, Ciprofloxacin, Orbifloxacin | ||
| Good (1) | Gram (-) aerobes including Enterobacteriaceae (E. coli, Klebsiella, Proteus, Salmonella, Actinobacillus, Brucella, Haemophilus, Leptospira, Moraxella, Pasteurella, P. aeruginosa. Mycoplasma, Rickettsia, C. burnetii, Ehrlichia, Gram (+) aerobes are not as susceptible (most S. aureus in moderate range) | |
| Moderate | (or variable) Streptococci. S. agalactiae, S. dysgalactiae, S. suis, S. zooepidemicus, R. equi , Mycobacteria | |
| Resistant | Anaerobic bacteria. P. maltophila | |
| Nitrofurans | ||
| Nitrofurazone, Nitrofurantoin, Furazolidone | ||
| n.b. Susceptibility testing of these compounds is done at a high concentrations (because the dominant therapeutic use of these compounds is for the treatment of urinary tract infections). Very little is known about the real activity of this group against systemic infections. | ||
| Good | Gram (+) Aerobes: S. aureus, Streptococci, many corynebacteria. Gram (-) aerobes E. coli, and Salmonella. Some activity against Mycoplasma, coccidia, giardia, and trypanosomes. | |
| Resistant | Gram (-) most Klebsiella, Proteus, all P. aeruginosa. | |
| Nitroimidazoles | ||
| Metronidazole | ||
| Good | Bactericidal to most Gram (-) and Gram (+) anaerobic bacteria. Protozoa, Giardia, T. hyodysenteriae | |
| Resistant | All aerobic bacteria. | |
| Rifamycins | ||
| Rifampin | ||
| Good | wide spectrum. most bacteria, Chlamydia, Rickettsia, some protozoa, some fungi, and poxviruses. Particularly active against Gram (+) bacteria and Mycobacteria. | |
| Resistant | high-level resistance develops in almost any bacterial population so rapidly that the drug, used alone, is of little value in infectious disease therapy. | |
| Arsenic containing antimicrobials | ||
| Arsanilic Acid, Sodium Arsanilate, 3-Nitro-4-hydroxyphenylarsanilic acid (Arsenicals) | ||
| There is little recent evidence available to evaluate the activity of arsenicals. They are used to promote growth in pigs and poultry and to treat swine dysentery (low efficacy for the latter). They are also used in a non-specific manner to control chronic diarrhea of unknown etiology in swine. | ||
| Miscellaneous | ||
| Carbadox | ||
| Good | Clostridium, T. hyodysenteriae, and against facultative aerobic bacteria under anaerobic conditions. | |
| Resistant | Plasmid mediated resistance has been described but its significance is not known. | |
| Isoniazid | ||
| Good | M. tuberculosis, M. bovis, Actinomyces bovis | |
| Resistant | M. aviumintracellulare, R. equi, C. pseudotuberculosis, S. zooepidemicus | |
| Methenamine | ||
| Good | ALL urinary tract pathogens if sufficient concentrations are produced. | |
| Resistant | most urease-producing bacteria (urine too alkaline for action). | |
| Novobiocin | ||
| Good | S. aureus | |
| Moderate | Streptococci, fastidious Gram (-) bacteria | |
| Resistant | Enterobacteriaceae and Pseudomonas | |
| Virginiamycin | ||
| Good | Gram (+) aerobic and anaerobic bacteria. Gram (-) aerobes: Leptospira, T. hyodysenteriae, and Haemophilus, Mycoplasma, Toxoplasma | |
| Resistant | Most Gram (-) bacteria | |
| Antifungal drugs | ||
| Topical Antifungal Drugs | ||
| Natamycin | ||
| Good | wide range of filamentous and dimorphic fungi, yeasts. Including Taenea, Candida, Fusarium, Aspergillus | |
| Nystatin | ||
| Good | Candida, Pityrosporum, Cryptococcus, dermatophytes, some filamentous fungi and some dimorphic fungi, Prototheca | |
| Resistant | several Candida other than C. albicans | |
| Clotrimazole, Miconazole (Azole antibiotics) | ||
| Good | wide range of filamentous fungi, including Aspergillus and dermatophytes, yeasts and dimorphic fungi. Malassezia | |
| Systemic antifungal | ||
| Griseofulvin | ||
| Good | all dermatophytes | |
| Resistant | all other hyphal fungi, yeasts, dimorphic fungi and bacteria | |
| Amphotericin B | ||
| Good | in decreasing order of susceptibility: Blastomyces dermatitidis, Histoplasma capsulatum, Cryptococcus neoformans, Candida, Sporothrix schenckii, Coccidioides immitis, Aspergillus. many yeasts are also susceptible as is Prototheca. | |
| Resistant | some resistant Candida, C. immitis, Mucor, Aspergillus | |
| Flucytosine | ||
| Good | C. neoformans, Candida, Torulopsis, Cladosporium a few Aspergillus. | |
| Resistant | Dermatophytes, filamentous fungi, and dimorphic fungi. Most yeast isolates from bovine mastitis are resistant. | |
| Azole antifungal drugs (Ketoconazole, Itraconazole, Fluconazole) | ||
| Ketoconazole | ||
| Good | wide range of filamentous fungi (including dermatophytes), yeasts, dimorphic fungi. C. albicans, Malessezia canis, some Aspergillus. | |
| Resistant | some acquired resistance reported, some Aspergillus. Prototheca are resistant in vitro but respond in vivo. C. tropicalis | |
| Itraconazole | ||
| Good | in addition to organisms susceptible to ketoconazole: dimorphic fungi, Cryptococcus, Sporothrix, Alternaria, most Aspergillus, C. tropicalis | |
| Variable | Candida, dermatophytes. | |
| Fluconazole | ||
| Good | probably similar to ketoconazole. Still being evaluated. | |
| Iodides | ||
| Iodides have been used for years to treat mycotic infections. Efficacy has never clearly been documented. Often included with other antifungal therapies. | ||