Increased resistance to gram positives and anaerobes, avoid empirically first line
Gram positive
- Arcanobacter sp.
- C. diphtheriae
- coag-negative Staphylococcus
- MSSA
- Susceptible MRSA (CA-MRSA usually covered)
- Staph. epidermidis, lugdunensis, saprophyticus & anginosus group
- Group A,B,C, F,G Streptococci (but increasing resistance)
- Strep. pneumoniae
Gram negatives
- Essentially no aerobic gram negative coverage
- Capnocytophaga
Anaerobes
- Actinomyces sp.
- Increasing resistance in Bacteroides fragilis
- Clostridium sp. (non-difficile)
- F. necrophorum
- P. melaninogenica
- Peptostreptococci
- Covers many oral anaerobes
Other
- Pneumocyctis jiroveci
- Malaria
- Toxoplasma
Does not cover
- Almost all aerobic gram negatives
- Enterococci