C / 9 - cephalosporins

Question 1

How are cephalosporins mostly administered?

Answer 1

parenterally

Question 2

What are the 3 main changes from the 1st to the 3rd generations?

Answer 2

1. Gram (+) activity diminishes while gram (-) activity increases
2. Tissue penetration improves
3. CNS penetration improves

Question 3

Which bacteria are not covered by 1-4 generation cephalosporins?

Answer 3

<LAME>
- Listeria
- Atypical (chlamydia, mycoplasma)
- MRSA
- Enterococci
</LAME>

Question 4

Toxicity / side effects of cephalosporins (4)

Answer 4

• Hypersensitivity reaction
• Cross-allergenicity with penicillins
• Pain at intramuscular injection site
• Vitamin K deficiency

Question 5

1st generation cephalosporins
Names
Spectrum
ROA

Answer 5

• Cephalexin, cephazolin
• Gram (+) cocci, Gram (-) UTI causing organisms (staph and strep)
• Oral

Question 6

2nd generation cephalosporins
Names
Spectrum

Answer 6

• Cefuroxime, cefoxitine
• Same as 1st generation, with extended gram (-) coverage, like H. influenza

Question 7

What are the 3rd generation cephalosporins?

Answer 7

• Cefixime
• Ceftriaxone
• Cefotaxime
• Ceftazidime

Question 8

Cefixime, ceftriaxone, cefotaxime, ceftazidime
Generation
Spectrum

Answer 8

• 3rd gen
• Same as the others, along with S. pneumoniae, N. Gonorrhea, N. meningitidis

Question 9

Cefepime
Generation
Spectrum

Answer 9

• 4th generation
• Broad spectrum, resistant to most Beta lactamases : enterobacter, hemophilus, neisseria, pneumococci, pseudomonas

Question 10

5th generation cephalosporins
Names
Spectrum

Answer 10

• Ceftolozane + tazobactam / ceftarolin fosamil
• MRSA, complicated UTIs

Question 11

Cefiderocol
Spectrum

Answer 11

Enhanced stability to B lactams, even ESBLs