Antibiotics: Cephalosporin Flashcards
Indications of cephalosporin?
Oral: 2nd & 3rd line options of:
- UTI
- Respiratory tract infections
Parenteral cephalosporins are reserved for infections that are:
- very severe or complicated
- Caused by antibiotic-resistant organisms
Spectrum of activity of cephalosporin?
Broad spectrum
Works against Gram-positive and Gram-negative bacteria.
More resistant to beta-lactamases than penicillins (due to fusion of the β-lactam ring with a dihydrothiazine ring (cephalosporins) or a unique hydroxyethyl side chain)
MOA of cephalosporin?
Inhibit the enzymes responsible for cross-linking peptidoglycans in bacterial cell walls.
→ This weakens cell walls and prevents them from maintaining an osmotic gradient.
→ Uncontrolled entry of water into bacteria causes:
- cell swelling
- lysis
- death
Contains beta-lactam ring
→responsible for bactericidal activity.
Adverse effects of cephalosporin?
GI upset:
- nausea
- diarrhoea
Antibiotic-associated colitis
Hypersensitivity
Neurological toxicity
- seizures
Warnings of cephalosporin?
Caution in:
- risk of C.diff infection
- epilepsy
Contraindicated in:
- penicillin allergy, anaphylactic reaction
Interactions of cephalosporin?
Enhance anticoagulant effect of warfarin by killing normal gut flora that synthesise vitamin K.
Increase nephrotoxicity of aminoglycosides.
Reduces plasma concentration.
Reduces efficacy of valporate.
Monitoring of cephalosporin?
Check improvement in symptoms/signs (e.g. resolution of pyrexia) and blood tests (e.g. falling CRP and WCC).
Pt education of cephalosporin?
Aims to get rid of infection and improve symptoms.
Check for penicillin allergy.
Seek medical advice if they develop a rash.
If allergy develops during treatment, give pt written and verbal advice NOT to take this abx class in future and make sure that the type of reaction (including its nature) is clearly documented in pt’s medical records.
