Gram negative organisms

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Gram-negative organisms

Include the Coliform bacilli eg E. Coli, Klebsiella sp, Enterobacter sp, Salmonella sp and the Pseudomonas, Acinetobacters, Neisseria sp. and Bacteroides.

Main clinical infections:

Abdominal and urinary tract infections.
Coliforms and Pseudomonas can be responsible for hospital-acquired pneumonia particularly ventilator-associated.

Usually sensitive to:

Quinolones (ciprofloxacin, levofloxacin) (except Bacteroides)
Aminoglycosides (gentamicin, tobramycin, amikacin) (except Neisseria sp).
The 2^nd and 3^rd generation cephalosporins (Pseudomonas and Acinetobacter only sensitive to the 3^rd generation cephalosporin ceftazidime.)
Piperacillin/tazobactam
Carbapenems (imipenem, meropenem)

Usually resistant to:

Vancomycin,
Teicoplanin
Metronidazole.
Over 50% of coliform bacilli are now resistant to amoxicillin, therefore only indicated for treatment if known sensitive strain.
Pseudomonas and Acinetobacters are resistant to amoxicillin, trimethoprim and co-amoxiclav.

Page last edited: 16/01/2009

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.