Broad-Spectrum Antibiotics for Various Infections

Introduction to Broad-Spectrum Antibiotics

The Infectious Diseases Society of America recommends piperacillin-tazobactam for complicated intra-abdominal infections, neutropenic fever, and serious nosocomial infections 1, 2, 3
The American College of Clinical Pharmacy suggests ampicillin-sulbactam covers Gram-positive cocci including penicillin-susceptible Streptococcus pneumoniae and Staphylococcus aureus, plus many Gram-negative organisms 4, 5

The European Society of Clinical Microbiology and Infectious Diseases recommends meropenem (1 g IV q8h) for its broadest spectrum including Pseudomonas aeruginosa, ESBL-producing Enterobacteriaceae, and most anaerobes 1, 4, 7
The Infectious Diseases Society of America suggests imipenem-cilastatin (500 mg IV q6h or 1 g IV q8h) has a similar spectrum to meropenem and is used for severe nosocomial infections 1, 4, 7

The American Academy of Otolaryngology-Head and Neck Surgery recommends levofloxacin (750 mg IV/PO daily) for its excellent activity against Gram-negative bacteria including Haemophilus influenzae, atypical pathogens (Mycoplasma, Chlamydophila, Legionella), and improved Gram-positive coverage including S. pneumoniae 4, 5, 8
The European Respiratory Society suggests moxifloxacin (400 mg IV/PO daily) has enhanced activity against Gram-positive organisms including S. pneumoniae and anaerobes compared to other fluoroquinolones 4, 5, 8

The Infectious Diseases Society of America recommends ceftriaxone (1-2 g IV q12-24h) for its excellent Gram-negative coverage including H. influenzae and good activity against S. pneumoniae 1, 4, 5, 7
The American College of Clinical Pharmacy suggests cefepime (2 g IV q8-12h) combines the Gram-negative coverage of third-generation agents with improved Gram-positive activity and antipseudomonal coverage 1, 7

The Infectious Diseases Society of America recommends aminoglycoside plus antipseudomonal penicillin or extended-spectrum cephalosporin for neutropenic fever and severe Gram-negative infections 2, 3, 10
The European Society of Clinical Microbiology and Infectious Diseases suggests third- or fourth-generation cephalosporin plus metronidazole provides comprehensive coverage for intra-abdominal infections including anaerobes 1, 6, 7

The National Comprehensive Cancer Network recommends monotherapy with carbapenems, antipseudomonal cephalosporins, or piperacillin-tazobactam as initial empiric therapy for neutropenic fever 2, 3, 10
The Infectious Diseases Society of America suggests community-acquired complicated intra-abdominal infections can be treated with ertapenem, ampicillin-sulbactam, or fluoroquinolone plus metronidazole; nosocomial infections require broader coverage with meropenem, imipenem, or piperacillin-tazobactam 1, 6, 7