Cephalosporins Flashcards
What class of antibiotics are cephalosporins?
Broad spectrum
gram positive, negative, anaerobes
Which 2 cephalosporins are suitable for infections of the CNS e.g. meningitis?
Cefotaxime and Cetriaxone
What are the 1st generation cephalosporins? (2)
Cefazolin IV and Cephalexin PO
What are the 2nd generation cephalosporins? (5)
Cefotetan
Cefoxitin
Cefuroxime
Cefuroxime axetil PO
Cefaclor PO
What are the 3rd generation cephalosporins? (5)
Cefotaxime, Ceftazidime,
Ceftriaxone,
Cefixime PO
Cefdinir PO
What is the 4th generation cephalosporin?
Cefepime
What is the 5th generation cephalosporin?
Ceftaroline
What does 1st generation Cephalosporins cover? (8)
- MSSA
- Streptococci group A, B, C, G
- Strep viridans
- S. pneumoniae
- H. influenzae
- E. coli
- Klebsiella pneumonie
- Proteus mirabilis
What is the trade name for Cephalexin (1st gen cephalosporin)
Keflex
What is the trade name for Cefazolin (1st gen cephazolin)?
Kefzol, Ancef
What does 2nd generation Cephalosporins cover? (16)
Same as 1st Gen:
- MSSA
- Streptococci group A, B, C, G
- Strep viridans
- S. pneumoniae
- H. influenzae
- E. coli
- Klebsiella pneumonie
- Proteus mirabilis
Plus:
- β-lactamase positive H. influenzae
- Moraxella catarrhalis
- Neisseria meningitidis
- E. coli
- Klebsiella pneumoniae
- Proteus
- Oral anaerobes
- Cefoxitin & Cefotetan cover B. fragilis
What are the major gaps in 2nd generation cephalosporin bacterial cover?
- No CNS penetration
- Cefuroxime does not have good coverage of gut anaerobes
What are the common uses for 2nd generation cephalosporins? (6)
- Community acquired pneumonia
- Bronchitis, sinusitis, otitis
- Skin and soft tissue infections
- MSSA
- Abdominal surgical prophylaxis
- Cefoxitin or Cefotetan can be used for mild intra-abdominal and pelvic infections
What are the names of the 3rd generation cephalosporins? (5)
- Cefotaxime IV
- Ceftazidime IV
- Ceftriaxone IV
- Cefixime PO
- Cefdinir PO
Why should you not prescribe Ceftriaxone with calcium containing solutions?
It can cause potentially fatal calcium precipitates to form in the lungs and kidney
What bacterias do 3rd generation cephalosporins cover?
- Same as 1st gen
- Expanded gram-negative coverage
- Oral anaerobes
- S. aureus (OSSA)
- Strep pneumoniae
- Strep group A, B, C, G
- Strep viridans
- Gram negative rods
- N. gonorrhoea
- All cover B. fragilis EXCEPT cefotaxime and ceftazidime
- P aeruginosa is ceftazidine ONLY
What are the common uses for 3rd generation cephalosporins? (8)
- Community acquired pneumonia
- Bacterial meningitis (EXCEPT Listeria) (3rd & 4th gen cross BBB to enter the CSF)
- UTIs (3rd and 4th)
- Anogenital gonorrhoea: ceftriaxone or cefixime
- Lyme disease
- Viridans strep endocarditis
- Intra-abdominal and pelvic infections: Ceftriaxone + metronidazole
- Hospital acquired pneumonia: ceftazidime only
What is the name for the 4th generation cephalosporin?
Cefepime (adds pseudomonas coverage)
What bacterias does the 4th generation cephalosporin cover?
- Good gram positive and gram negative coverage
- Anti-Pseudomonal (incl ceftazidime resistant isolates)
- Penetrates CSF
- Limited anaerobic coverage
What is the name for the 5th generation cephalosporin drug?
Ceftaroline: very broad spectrum
Rarely used
General MoA of cephalosporins?
Disrupt the synthesis of the peptidoglycan layer forming the bacterial cell wall
If a patient is taking (?) and/or (?), you should not prescribe any cephalosporins
- Penicillin
- Other beta-lactams
Cephalosporins should be used with caution in patients sensitivity to penicillin and other beta-lactams
