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Aerobic and Facultatively Anaerobic Gram-Positive Cocci Bacteremia, intraabdominal abscess, urinary tract Penicillin/ampicillin/piperacillin or vancomycin; faecalis and faecium infection, endocarditis combined with gentamicin for endocarditis or severe infection Cutaneous infections: impetigo, folliculitis, Nafcillin; vancomycin (for methicillin-resistant furuncles, carbuncles, wound; disseminated infections: pneumonia, empyema, osteomyelitis, septic arthritis; toxin-mediated infections: toxic shock syndrome, scalded skin syndrome, food poisoning Opportunistic pathogen causing infections on Nafcillin; vancomycin (for methicillin-resistant foreign bodies (e.g., catheters, shunts, prosthetic strains) joints and heart valves); urinary tract infections (e.g., S. saprophyticus) Suppurative infections: pharyngitis, scarlet fever, Penicillin, macrolides, cephalosporins, clindamycin, sinusitis, skin and soft-tissue infection (impetigo, vancomycin; surgical débridement for necrotizing erysipelas, cellulitis, necrotizing fasciitis), toxic shock-like syndrome; nonsuppurative infections: Neonatal disease (early onset, late onset; Penicillin, macrolides, cephalosporins, clindamycin, agalactiae (group B) bacteremia, pneumonia, meningitis); urinary tract vancomycin; penicillin and aminoglycoside for Pharyngitis, otitis, sinusitis, skin and soft-tissue Penicillin (drug of choice), macrolides, infection, impetigo, erysipelas, cellulitis, cephalosporins, clindamycin, vancomycin; surgical Streptococcus bovis Bacteremia, endocarditis Viridans streptococci Abscess formation; septicemia in neutropenic Penicillin; penicillin combined with aminoglycoside patients; subacute endocarditis; odontogenic infections; dental caries Pneumonia and other respiratory tract infections; Penicillin; levofloxacin, cephalosporins, clindamycin meningitis; spontaneous bacterial peritonitis, endocarditis, septic arthritis; bacteremia Aerobic or Facultatively Anaerobic Gram-Positive Rods Fluoroquinolones (ciprofloxacin); penicillin, doxycycline, erythromycin, or chloramphenicol as alternative therapy Gastroenteritis, ocular infections, bacteremia Neutralizing exotoxin; penicillin or erythromycin to eliminate organism and terminate toxin production; immunization with diphtheria toxoid Septicemia, endocarditis; wound infections; foreign Vancomycin Urinary tract infections, including pyelonephritis with calculi; septicemia; endocarditis; wound infections Erysipeloid (painful, pruritic inflammatory skin Penicillin; cephalosporins, fluoroquinolones, erythromycin, or clindamycin as alternative therapy Early onset neonatal disease (granulomatosis Ampicillin (alone or in combination with gentamicin) infantiseptica); late-onset neonatal disease (meningitis with septicemia); flulike illness in adults; bacteremia or disseminated disease in pregnant women or patients with cell-mediated immune defects Localize pulmonary disease; disseminated disease Clarithromycin or azithromycin combined with and rifampicin for tuberculoid form; add clofazimine for lepromatous form Multidrug therapy with isoniazid, rifampin, Bronchopulmonary disease; primary or secondary Sulfonamides; amikacin, carbapenems, or broad- spectrum cephalosporins as alternative therapy if active Bronchopulmonary disease (lung abscesses); opportunistic infections in immunocompetent carbapenems, aminoglycosides, ciprofloxacin, Gonorrhoea, pelvic inflammatory disease, arthritis Ceftriaxone, ciprofloxacin; cefoxitin plus doxycycline Meningitis, bacteremia (meningococcemia) Ceftriaxone, penicillin, chloramphenicol Pneumonia, septicemia, opportunistic infections Imipenem or ceftazidime combined with aminoglycoside for serious infections Ciprofloxacin; trimethoprim-sulfamethoxazole, gentamicin, or amikacin as alternative therapy Bartonella henselae Bacillary angiomatosis; subacute endocarditis; cat Gentamicin alone or with erythromycin; broad- spectrum cephalosporins used as alternative therapy; CSD does not response to antibiotic therapy Bartonella quintana Trench fever (TF); bacillary angiomatosis (BA) Bordetella pertussis, Pertussis (whooping cough) Supportive therapy, erythromycin (or other macrolides) to decrease infectivity and prophylaxis Doxycycline plus rifampin or gentamicin; trimethoprim-sulfamethoxazole Burkholderia cepacia Pulmonary infections; opportunistic infections Trimethoprim-sulfamethoxazole; piperacillin, ceftazidime, or ciprofloxacin as alternative therapy if trimethoprim-sulfamethoxazole resistant Meliodosis (asymptomatic to severe pulmonary Trimethoprim-sulfamethoxazole combined with Self-limited; severe infections treated with erythromycin; tetracycline or fluoroquinolones used Campylobacter upsaliensis Camplyobacter fetus Septicemia; meningitis; gastroenteritis; Aminoglycosides, carbapenems, chloramphenicol hominis Eikenella corrodens Subacute endocarditis; wound infections Penicillin, cephalosporins, tetracycline, or fluoroquinolones Watery diarrhea, hemorrhagic colitis, hemolytic Ciprofloxacin shortens course (high level of Antibiotics reduce duration of disease and infectivity Trimethoprim-sulfamethoxazole, fluoroquinolones associated Francisella tularensis Tularemia: ulceroglandular, oculoglandular, Streptomycin, gentamicin; fluoroquinolones Encapsulated type b strains: meningitis, Broad-spectrum cephalosporin, azithromycin, or septicemia, cellulitis, epiglottitis; unencapsulated fluoroquinolone; many strains resistant to ampicillin strains: otitis media, sinusitis, bronchitis, pneumonia Gastritis, peptic, and duodenal ulcers; gastric Multidrug therapy: tetracycline, metronidazole, β-Lactam with β-lactamase inhibitor, cephalosporins, macrolides, tetracycline, fluoroquinolones Legionnaires' disease (pneumonia), Pontiac fever clarithromycin); fluoroquinolones (ciprofloxacin, levofloxacin) used as alternative therapy Moraxella catarrhalis Ear, eye, and respiratory infections Cephalosporins; amoxicillin/clavulanic acid Urinary tract infections, wound infections Amoxicillin, trimethoprim-sulfamethoxazole, cephalosporins, fluoroquinolones Pulmonary; primary skin infection; urinary tract Combination therapy generally required (e.g., infection; ear or eye infections; bacteremia aminoglycoside with extended-spectrum cephalosporins, piperacillin-tazobactam, or carbapenem) Salmonella enterica Diarrhea, enteric fever (serovar Typhi) May prolong carrier state in simple diarrhea treatment; fluoroquinolones for enteric fever Pneumonia, urinary tract infections, wound Ampicillin; trimethoprim-sulfamethoxazole; fluoroquinolones Wide variety of local and systemic infections Rehydration; doxycycline, trimethoprim-sulfamethoxazole, or furazolidone shortens course Minocycline combined with a fluoroquinolone or cefotaxime; débridement Actinomycosis: cervicofacial, thoracic, abdominal, Penicillin; alternative drugs include erythromycin, Bacteroides fragilis Polymicrobial infections of abdomen, female genital tract, cutaneous and soft tissues Ventilatory support; use of trivalent botulinum Clostridium difficile Antibiotic-associated diarrhea; Discontinue implicated antibiotic; metronidazole Soft-tissue infections: cellulitis, fasciitis, Tetanus: generalized, localized, neonatal Clean wound; passive immunization; vaccination with tetanus toxoid Acne; opportunistic infections (e.g., of prosthetic Acne treated with benzoyl peroxide plus clindamycin Anaplasma, Ehrlichia, Rickettsia, Coxiella, Mycoplasma, Chlamydia, and Chlamydophila Anaplasmosis (granulocytic ehrlichiosis) Doxycycline; rifampin used as alternative therapy Macrolides; fluoroquinolones; tetracyclines Trachoma; neonatal conjunctivitis and pneumonia; Tetracyclines; macrolides; fluoroquinolones urethritis; cervicitis; salpingitis; lymphogranuloma venereum Q fever: acute (fever, headache, chills, myalgias, granulomatous hepatitis) and chronic (endocarditis, sulfamethoxazole Ehrlichia chaffeensis Monocytic ehrlichiosis Doxycycline; rifampin used as alternative therapy Macrolides; tetracycline; fluoroquinolones pneumoniae Rickettsia rickettsii Rocky Mountain spotted fever Doxycycline; fluoroquinolones used as alternative therapy Borrelia burgdorferi Lyme disease: erythema migrans; cardiac, Oral penicillin; tetracyclines; ceftriaxone neurologic, or rheumatologic abnormalities Borrelia recurrentis Epidemic relapsing fever Tetracyclines; erythromycin; chloramphenicol; penicillin Tetracyclines; erythromycin; chloramphenicol; penicillin Leptospirosis: mild, viral-like illness to severe Penicillin; doxycycline; vaccination of pets and herds Treponema pallidum Syphilis: primary, secondary, tertiary, congenital Murray, Medical Microbiology. 5th Edition Table 48-1. Overview of Selected Bacterial Pathogens

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