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Cephalosporins
| Question | Answer |
|---|---|
| Classification | 1 generation , 2 generation , 3 generation, 4 generation |
| 1 generation | IV-cegazolin,cefradine Oral- cephalexin,cefaclor,cefadroxil |
| Active against | Gram + cocci, Pneumococci, Streptococci, Staphylococci E.coli Klebsiella pneumoniae Proteus mirabilis |
| Not active against | P. Aeruginosa, Indole positive proteus, Enterobacter |
| Clinical uses | Oral drugs used for UTI, uncomplicated upper n lower RTI, minir staphylococcal lesions n minor infections such as cellulites, soft tissue abscess |
| 2 generation | Cefaclor, Cefamandole, Cefanocid, Cefuroxime, Cefprozil, Ceforanide, Cefoxitin, Cefmetazole, Cefotetan |
| Antimicrobial activity | 1. Extended gram negative coverage |
| 2. Active against organism affected by 1 generation drugs | 3. Cefoxitin,cefmetazole,cefotetan, have activity against anaerobes |
| Dosage | Oral-Cefaclor, cefuroxime, axetil Parentaral- cefoxitin,cefuroxime |
| Clinical uses | Treat sinusitis, otitis or lower RTI Cefoxitin- peritonitis,diverticulitis, PID Cefuroxime-community acquired pneumonia |
| 3 generation | Parentaral- cefotaxime, ceftazidime,ceftriaxone, Oral- cefixime,cefpodoxime proxetil |
| Antimicrobial activity | 1. Expanded gram - coverage, 2.effective against beta lactamase producing strains of Haemophilus and Neisseria, 3.ceftazidime active against p. Aeruginosa 4.not reliably active against enterobacter species 5.some cross BBb |
| Excretion | Ceftriaxone- biliary tract, others kidney |
| Clinical uses | Meningitis, Ceftriaxone, cefotaxime - most active cephalosporins against resistant strains of pneumococci used in empirical therapy of sepsis |
| 3 generation + aminoglycoside uses in netropenic, febrile, immunocompromised patients | Ceftriaxone , cefixime - 1 line treatment of gonorrhea |
| 4 generation | Cefepime, |
| Active against | P.aeruginosa, Enterobactericeae, S.aureus, S.pneumoniae, Hemophilus and neisseria |
| Excretion | Kidneys |
| Adverse effects | 1.Allergy, 2.Long term use- thrombocytopaenia, hemolytic anemia, neutropenia, interstitial nephritis, abnormal kiver function test, 3. Local irritation 4.opportunist infection |
| Interaction | Nephrotoxicity of the older cephalosporins was enhanced by frusemide, ethacrynic acid and aminoglycoside |
| Caution | Penicilins sensitivity, Renal impairment , False positive urinary glucose, False positive coombs test |
| Contraindications | Cephalosporin hypersensitivity, Acute intermittent porphyria |
| Individual agents | Cefuroxime, Cefotaxime, Ceftriaxone |
Created by:
Angel thili
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