In this episode, I’ll discuss alternatives to ampicillin for empiric listeria coverage.
Shout out to “Pharmacy Alex” for inspiring this episode.
But what if the patient has an allergy to penicillin?
Cephalosporins are not an option as listeria is inherently resistant to them.
Two possible alternatives are meropenem and sulfamethoxazole/trimethoprim.
When meropenem is used to provide listeria coverage, giving a cephalosporin such as cefotaxime or ceftriaxone is no longer necessary because meropenem also has activity against strep and gram-negative pathogens. A case matching study of a Swedish registry found that mortality was similar between regimens that used meropenem or a combination of cefotaxime and ampicillin.
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