1. Bactericidal antibiotics
- Cell wall synthesis inhibitors (b-lactams, glycopeptides like vanc, lipopetides like dapto)
- Cell membrane integrating agents (polymyxin, colistin)
- DNA synthesis inhibitors (fluroquinolones, metronidazole, rifampin)
- Aminoglycosides
2. All other agents are bacterostatic
- All protein synthesis inhibitors other than aminoglycosides (tetracyclines, clinda, linezolid, macrolides, chloramphenicol, dalfo/quino)
- Folic acid synth inh (like bactrim)
3. Protein synthesis inhibitors (30s)
- Aminoglycosides: tobra typically has better coverage of psuedomonas than gent. Never use AG as single-agent therapy against pseudomonas, they rapidly develop resistance.
- Tetracyclines
4. Protein synthesis inhibitors (50s)
- Supposedly the large subunit ribosomes of eukaryotes and prokaryotes bear more resemblance than the smaller subunits, so theoretically these guys have more cross-interaction with human ribosomes and thus more side effects.
- Clinda - MRSA coverage, but crappy MRSA coverage... pick another agent if you're really worried.
- Macrolides - all lengthen QT, including azithro. Erythro is not used as an antibiotic anymore, its used more as a pro-motility agent in GI studies like EGD. It lengthens your QT, has tons of interactions, and (obvi) causes bad diarrhea.
- Linezolid: since its bacteriostatic, don't use it as the main treatment for sepsis, particularly in people who are immunocompromised, neutropenic. Static agents are only good in people with good enough immune systems to mop up the paralyzed bacteria. Linezolid has excellent CNS penetration, one of the few PO treatments vs MRSA (along with doxy, bactrim, clinda)
- Chloramphenicol - great drug, terrible side effects. aplastic anemia
- Synercid (dalfopristin/quinopristin) - last resort agent for VRE (e. faeciUM, fecalIS is often susceptible to amp). 50% of those who use this drug will report peripheral neuropathy, really bad pain. Seriously this is a last-resort drug, after you've tried ceftaroline/dapto
5. Cell wall synthesis inhibitors- B-lactams 
- Penicillins, aminopenicillins, antipsuedomonal penicillins: cross-reactivity between these agents are high because they have very similar structures (i.e. aminopen = pen + animo group, etc). Empiric addition of amp to meningitis tx to cover for listeria is indicated in those <1-2 months and > 50 years
- Cephalosporins: 1st gen have 5% cross-reactivity with penicillin allergies, 4th gen have 1% cross-reactivity. So in someone who is pen-allergic, pick a higher-generation cef.
- Carbapenems: up to 40% reported cross-reactivity with penicillins. In clinical practice, its closer to 10%
- Monobactams (aztreonam): No cas reports of cross-reactivity, very different structure.
6. Cell wall synthesis inhibitors- Glycopeptides
- Vanc: can be used to cover resistant strep in meningitis. Even when taken PO, there is some measured systemic absorption (diffuse colitis, compromised barrier). The liquid formulation = IV formulation in a cup, tastes really bad. You can get the IV formulation in capsules but they cost a few thousand dollars. Add cherry syrup if you're nice.
- Televancin: new, supposedly better than vanc, butits the same as vanc.
7. Cell wall synthesis inhibitors- Lipopeptides. 
- Daptomycin: pokes holes in cell walls, they leak K and die
- Dapto has TERRIBLE CNS and lung penetration (can't get through surfactant). To get through, you have to push the dose really high.
8. On cephalosporins
- Ceftaroline is the only "5th gen" cephalosporin, has MRSA coverage but no pseudomonal coverage. Used in endocarditis bacteremia, skin+soft tissue infections.
- Ceftriaxone dosing: generally 1-2 g, depending on weight. >80 kg usually needs 2g dose. Meningitis dosing-- 2g q12, always; less for skin and soft tissue infections.
9. Folic Acid synthesis inhibitors: 
- TMP & SMX are bacteriostatic individually but bacteriocidal together in bactrim.
- Notorious for horrible interactions with warfarin (way worse than cipro): If you're giving someone on coumadin bactrim, plan on halving the dose of your coumadin.
- Bactrim can also cause hyperkalemia through a pseduo-RTA, and it can cause a creatinine bump as it inhibits creatine secretion in the tubule without impacting renal filtration.
- Bactrim can also cause aplastic anemia.
10. In someone with febrile neutropenia or someone with sepsis, you always want empiric double coverage of pseudomonas. Nothing kills people faster than GNR bacteremia- e.coli and pseudomonas.
- Zosyn, tobra, cefepime, Imipenem (all bactericidal)
- Add vanc if you're worried about MRSA
- Add anaerobic coverage if someone has bad mucositis and you think it may be the source.