DRUGS OF CHOICE FOR nalidixic acid for information concerning the use SPECIFIC BACTERIA of these agents in urinary tract infections. All the drugs effective against a given organism SYDNEY M. FINEGOLD, M.D., AND ALVIN DAVIS, M.D. are not necessarily listed. Drugs listed first are The choices below are not necessarily appropri- usually the most effective or least toxic, or both. ate for urinary tract infection. See sections on sul- Italicized drugs are outstanding in effectiveness fonamides, oral penicillin G, nitrofurantoin and against the particular organism. GRAM-NEGATIVE BACILLI Organism Drag of Choice Achromobacter anitratus ...... Kanamycin, polymyxin or colistin, tetracycline, erythro- mycin Achromobacter lwoffii ...... Tetracycline, kanamycin, polymyxin or colistin, erythro- mycin, chloramphenicol Achromobacter-other species ... Polymyxin or colistin, kanamycin, tetracycline, chloram- phenicol Actinobacillus actinomycetemcomitans ..... Tetracycline, streptomycin, chloramphenicol, ? ampicil- lin, ? penicillin Actinobacillus lignieresii ...... Kanamycin, ? polymyxin or colistin Aeromonas hydrophila ...... Tetracycline, kanamycin, chloramphenicol Arizona ...... Ampicillin, cephalothin, tetracycline, chloramphenicol Bacteroides fragilis ...... Tetracycline, chloramphenicol, erythromycin, lincomy- cin, penicillin Bacteroides melaninogenicus ...... Penicillin, linomycin, tetracycline, chloramphenicol Bartonella bacilliformis ...... Penicillin C, chloramphenicol, streptomycin, tetracy- cline Bordetella pertussis ...... Ampicillin, tetracycline Brucella...... Tetracycline, chloramphenicol Calymmatobacterium granulomatis ...... Tetracycline, streptomycin, chloramphenicol Chromobacterium ...... Streptomycin, tetracycline, chloramphenicol Citrobacter ...... Polymyxin or colistin, kanamycin, chloramphenicol, tetracycline E. coli ...... Chloramphenicol, tetracycline, kanamycin, gentamicin, ampicillin, cephalothin, polymyxin SEdwardsiella ...... Tetracycline, chloramphenicol, polymyxin or colistin, ampicillin .Enterobacter -Subgroup A (Aerobacter cloacae) B Enterobacter - Subgroup (Aerobacter kanamycin, polymyxin or colistin aerogenes) Gentamicin, Enterobacter - Subgroup C (Aerobacter liquefaciens) flavobacterium. Chloramphenicol, sulfadiazine Fusobacterium (fusiform bacilli) ...... Penicillin, lincomycin, tetracycline, chloramphenicol Hafnia ...... Tetracycline, chloramphenicol, kanamycin Hemophilus aphrophilus. Ampicillin, tetracycline, chloramphenicol, streptomycin -Hemophilus ducreyi ...... Tetracycline, sulfonamides, chloramphenicol, strepto- mycin Hemophilus influenzae ...... Tetracycline, chloramphenicol, streptomycin, kanamy- cin, penicillin Klebsiella pneumoniae ...... Gentamicin, kanamycin, polymyxin or colistin Klebsiella rhinoscleromatis ...... Streptomycin, tetracycline, chloramphenicol Moraxella liquefaciens ...... Penicillin, ampicillin, chloramphenicol, tetracycline Moraxella duplex, var. nonliquefaciens ...... Penicillin, tetracycline, kanamycin Pasteurella multocida (septica) ...... Penicillin, tetracycline, chloramphenicol Pasteurella pestis ...... Streptomycin plus either tetracycline or chloramphenicol Pasteurella pseudotuberculosis ...... Tetracycline, ? chloramphenicol, ? streptomycin Pasteurella (Franciscella) tularensis ...... Streptomycin plus either tetracycline or chloramphenicol Proteus mirabilis ...... Kanamycin, ampicillin, cephalothin or cephaloridine, chloramphenicol, penicillin, gentamicin (Gram-Negative Bacilli, Continued from Page 374) Organism Drag of Cboice Proteus morganin ...... Kanamycin, chloramrphenicol, gentamicin Proteus rettgeri ...... Kanamycin, gentamicin Proteus vulgaris ...... Kanamycin, chloramphenicol, gentamicin Providence ...... Kanamycin, chloramphenicol, tetracycline, polymyxin or colistin Pseudomonas aeruginosa ...... Gentamicin, polymyxin or colistin, oxytetracycline, chloramphenicol Pseudomonas maltophilia ...... Polymyxin or colistin, chloramphenicol, kanamycin Pseudomonas pseudomallei ...... Chloramphenicol, kanamycin, sulfadiazine, tetracycline Pseudomonas stutzeri ...... Ampicillin, cephalothin, kanamycin, polymyxin or co- listin Salmonela typhi ...... Chloramphenicol, ampicillin Salmonella, other than S. typhi ...... Chloramphenicol, ampicillin, cephalothin Serratia marcescens ...... Gentamicin, kanamycin, chloramphenicol Shigela ...... Ampicillin, cephalothin, kanamycin, tetracycline, chlor- amphenicol Sphaerophorus necrophorus (Bacteroides funduliformis) ...... Tetracycline, chloramphenicol, penicillin, lincomycin Streptobacillus moniliformis ...... Penicillin Vibrio cholerae ...... Tetracycline, chloramphenicol Vibrio fetus ...... Tetracycline, chloramphenicol, ampicillin, streptomycin GRAM-NEGATIVE COCCI Gonococcus (Neisseria gonorrhoeae) ...... Penicillin, tetracycline, erythromycin Meningococcus (Neisseria meningitidis). .Penicillin, ampicillin, chloramphenicol, erythromycin, tetracycline, sulfadiazine GRAM-POSITIVE BACILLI Actinomyces israelii ...... Penicillin, tetracycline, chloramphenicol, cephalothin Bacillus anthracis ...... Penicillin, erythromycin, tetracycline Clostridium ...... Penicillin, tetracycline, chloramphenicol Corynebacterium acnes ...... Tetracycline, ? lincomycin Corynebacterium diphtheriae ...... Penicillin, erythromycin, cephalothin Corynebacterium, other ...... Vancomycin, penicillin, erythromycin Erysipelothrix rhusiopathiae ...... Penicillin, ? tetracycline Listeria monocytogenes ...... Tetracycline, ampicillin, penicillin, erythromycin Nocardia ...... Sulfonamides, cycloserine GRAM-POSITIVE COCCI Pneumococcus (Diplococcus pneumoniae) . Penicillin, erythromycin Staphylococcus. . Methicillin, cloxacillin or dicloxacillin, cephalothin or cephaloridine, nafcillin, vancomycin, lincomycin Streptococci Anerobic and microaerophilic strep. (and cocci) ...... Penicillin, lincomycin, erythromycin, chloramphenicol, vancomycin Enterococci ...... Penicillin plus streptomycin, chloramphenicol, vanco- mycin, penicillin plus kanamycin, ampicillin, (tetra- cycline for S. liquefaciens) Group A beta-hemolytic strep...... Penicillin, erythromycin, ampicillin, cephalothin Viridans group ...... Penicillin, vancomycin, cephalothin SPIROCHETES Borrelia recurrentis ...... Tetracycline, chloramphenicol, penicillin Spirillum minus ...... Penicillin, erythromycin Treponema palidum ...... Penicillin, erythromycin, tetracycline RICKETTSIAE, MYCOPLASMA, CHLAMYDIA (BEDSONIA) Rickettsia ...... Tetracycline, chloramphenicol Mycoplasma pneumomae ...... Tetracycline, erythromycin Psittacosis (ornithosis) ...... Tetracycline, chloramphenicol Lymphogranuloma venereum ...... Tetracycline, chloramphenicol, sulfonamides