LAB WORK
TREATMENT
CLINICAL NOTES
- Gram + cocci in chains/pairs, alpha-hemolytic (partial hemolysis)
TREATMENT
- Agents with very good activity
- Penicillins (Pen VK, ampicillin, amoxicillin)
- Fluoroquinolones (EXCEPT ciprofloxacin)
- 2nd, 3rd, 4th generation cephalosporins (EXCEPT ceftazidime), ceftaroline
- Clindamycin
- Vancomycin
- Linezolid
- Agents with VARIABLE activity (avoid, not as reliable, resistance concerns):
- Tetracyclines
- Macrolides (Azithromycin monotherapy should be reserved for mild community cases only, and even then our local resistance patterns show a trend toward significant macrolide resistance; see pneumonia guidelines and antibiograms)
- Bactrim
CLINICAL NOTES
- Most common cause of CAP (about 25% of cases)
- Most common cause of meningitis in adult and pediatric patients (possibly over half of cases)