gut | schlecht | ||
ß-Laktame | MRSA, intrazelluläre Bakterien, Mykoplasmen | ||
Penicilline | |||
Penicillin G | Streptokokken, Treponema pallidum, Neisseria meningitidis, Anaerobier (50%) | Staphylokokken, gram-negative außer Neisseria meningitidis,Moraxella catarrhalis | |
Ampicillin | Enterobakterien, Enterokokken, Listerien | wie Penicillin | |
Piperacillin | Enterobakterien, Pseudomonas | Staphylokokken | |
Oxacillin | Staphylokokken | MRSA | |
Penicilline/ß-Laktamase-Inhibitoren | |||
Ampicillin/Sulbactam | wie Ampicillin, plus Moraxella, Haemophilus | ||
Amoxicillin/Clavulansäure | |||
Cephalosporine | Enterokokken, Listerien, Anaerobier | ||
Cefazolin | einige Enterobakterien, Staphylokokken, Streptokokken | Enterobakterien, Pseudomonas, Haemophilus | |
Cefuroxim | einige Enterobakterien, Staphylokokken, Streptokokken, Haemophilus | ||
Cefotaxim | Enterobacterien, Pneumonkokken | ||
Ceftazidim | wie Cefotaxim plus Enterobakterien minus Pneumokokken | ||
Carbapeneme | |||
Imipenem | Enterobakterien, Enterococcus faecalis, Pseudomonas | Enterococcus faecium, Stenotrophomonas maltophilia | |
Meropenem | Enterobacterien, Pseudomonas | Enterokokken |
rel. gut | rel. schlecht | ||
Makrolide | |||
Erythromycin | grampositive Bakterien | Enterobakterien, Haemophilus | |
Clarithromycin | grampositive Bakterien und MOTT | Enterobakterien, Haemophilus | |
Lincosamide | |||
Clindamycin | grampositive Bakterien, Anaerobier | Enterobakterien, Enterokokken | |
Tetracyclin | |||
Doxycyclin | Chlamydien, Rickettsien, Mykoplasmen,Brucella, Borrelia | alle anderen rel. schlecht | |
Oxazolidinone | |||
Linezolid | grampositive Bakterien auch MRSA VRE | gramnegative Bakterien | |
Aminogycoside | |||
Gentamicin | nur Kombinationspartner | Anaerobier | |
Tobramycin | |||
Amikacin |
Penicillin | Ampicillin | Oxacillin | Erythromycin | Clindamycin | Streptogramin | Gentamicin | ||
S. aureus | ||||||||
wild | S | S | S | S | S | S | S | |
ß-Laktamase | R | R | S | |||||
mecA | R | R | R | |||||
ermA/C | R | R | R/S | |||||
msrA | R | S | S | |||||
AAC-APH | R | |||||||
Streptokokken | ||||||||
wild | S | S | S | S | S | |||
mefA | R | S | ||||||
emrB | R | R | ||||||
S. pneumoniae | ||||||||
wild | S | S | S | S | S | |||
mut. PBP | R/S | R/S | ||||||
mefA | S | R | S | |||||
ermB | R | R | R | |||||
Enterokokken | ||||||||
E. faecalis | wild | S | S | R | R | R/S | ||
AAC-APH | R | |||||||
E. faecium | wild | S | R | R | S | R/S | ||
mecA | Methicillin-Resistenzgen | |||||||
ermA/B/C | Erythromycin ribosomale Methylase | |||||||
msrA | Makrolid-Exportergen | |||||||
AAC-APH | kombiniertes Aminoglycosid-Resistenzgen bei Staphylokokken und Enterokokken |
Resistenzmechanismus | ||||||
ermA/B/C | mefA | ß:lactamase | ESBL | MecA | AmpC | |
Resistenz-Phänotyp | ||||||
Erythromycin | R | R | ||||
Clarithromycin | R | R | ||||
Clindamycin | R | S | ||||
Streptomycin | R | S | ||||
ß-Laktame | ||||||
Penicillin | R | R | ||||
Ampicillin | R | R | R | R | ||
Piperacillin | R | R | R | R | ||
Oxacillin | S | R | ||||
Cefazolin | S | R | R | R | ||
Cefotaxim | S | R | R | R | ||
Ceftazidim | S | R | R | R | ||
Imipenem | S | S | R | S |