Natural Penicillins
PCN+Beta-Lactamase Inhibitors
Cephalosporins
Monobactams
Piperacillin
Penicillins
Natural Penicillins (strep, syphilis)
Ampicillin, Amoxicillin (strep, Enterococcus, Listeria)
Nafcillin, oxacillin (non MRSA staph)
Unasyn, Augmentin (mixed – no Pseudomonas)
Zosyn (mixed – including Pseudomonas)
Cephalosporins
Cefazolin, cephalexin (staph, strep, PECK)
Ceftriaxone (strep, gram-negatives, Not Pseudomonas)
Ceftazidime (gram-neg, including Pseudomonas)
Cefepime (gram-neg, including Pseudomonas)
Oral 2nd & 3rd generation (resp tract; some UTIs)
Monobactams
Aztreonam (gram-neg, PCN allergy, expensive)
Carbapenems
Imipenem & Meropenem (mixed, broad)
Ertapenem (mixed, but not as broad, no pseudomonas)
Beta-Lactams that hit Pseudomonas
Piperacillin/tazobactam
Ceftazidime
Cefepime
Aztreonam
Meropenem
Imipenem
Ceftolozane/tazobactam (Zerbaxa)
Ceftazidime/avibactam (Avycaz)
Meropenem/Vaborbactam
Adverse Effects
Hypersensitivity: rash & anaphylaxis
GI: diarrhea, nausea & vomiting; C. difficile infection
Seizures (especially carbapenems in high doses &/or risk factors)
This is probably the most common “dose-related” adverse effect of beta-lactams