Anaerobic Gram-positive nonspore-forming bacilli:
>Actinomyces,
>Bifidobacterium species
>Eubacterium
>Lactobacillus
>Propionibacterium 
Propionibacterium:
- Gram-positive, rod shaped, slow-growing, nonsporeforming, anaerobic bacteria.
- Unique metabolism: able to synthesize propionic acid by using unusual transcarboxylase enzymes.
- Flora: primarily facultative parasites and commensals of humans and other animals, living in and around the sweat glands, sebaceous glands, and other areas of the skin.
- Usually innocuous, however, have been implicated in acne and other skin conditions.
- Species include:
- P. acnes;
- P. avidum;
- P. cyclohexanicum;
- P. freudenreichii;
- P. granulosum;
- P. jensenii;
- P. microaerophilum;
- P. propionicum
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Important considerations: The choice of an agent should be based on local antimicrobial sensitivities, site of infection, cost, and comorbid conditions. Generally, the most common agents/regimens are listed first. Listed dosages may need to be adjusted for renal dysfunction. Propionibacterium strains are usually highly susceptible to penicillins, clindamycin, cephalosporins, and carbapenems .
- Penicillin G 2-4 million units IV q4-6h
- Clindamycin 600mg IV every 6 or 8 hours or 300mg orally four times daily (~15% of strains are resistant)
- Ceftriaxone 1-2 grams IV q24h (range: 1-2 grams q12-24h)
- Cefazolin 1 to 2 g IV every eight hours
- Vancomycin 1 gram ivpb q12h (patient-specific dosing required)
- Linezolid 600 mg orally or IV q 12h
- Daptomycin 4 – 6 mg/kg IV once daily. – NOT FOR PNEUMONIA
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