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CARBAPENENEMS
- Broadest spectrum of activity of all classes
- Imipenem has slightly better gm + activity; lowers seizure threshold
- Meropenem has slightly better gm - activity
- Ertapenem does not cover Pseudomonas
- Doripenem has the most activity against Pseudomonas
- May use in PCN allergic patients (cross reactivity lower than previously thought)
TIGECYCLINE
- Has broad coverage, but does not cover Pseudomonas
- Bacteriostatic; derivative of tetracycline
- Does NOT require renal dosing
- Higher mortality in VAP than other agents; do not use for intra-abdominal infections (poss higher risk of perforation)
AMIKACIN
- Has antipseudomonal activity
- Used in combination with other agents for MDR (multi-drug resistant) bacteria
- Causes nephrotoxicity and ototoxicity
COLISTIN
- Bacteriocidal against many MDR gram - bacteria
- Not active against Proteus, Provincia, Burkholderia, Neisseria, or Serratia
- Nephrotoxicity and ototoxicity reported