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Infectious Disease > Cephalosporins > Flashcards

Cephalosporins Flashcards

1
Q

1st generation cephalosporins have a good spectrum in which bacteria?

A
  • MSSA

- Streptococci

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2
Q

(T/F) - 1st generation cephalosporins are a good alternative to anti-staphylococcal. If so, why?

A

TRUE - cause less phlebitis and given less frequently

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3
Q

(T/F) - 1st generation cephalosporins cross CNS, so they can be given for CNS infections

A

FALSE - do not cross CNS and should not be given for CNS infections

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4
Q

1st generation cephalosporins are mainly utilized for?

A
  • MSSA infections (endocarditis)
  • Skin and soft tissue infections
  • Surgical prophylaxis
  • Staph bloodstream infections
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5
Q

What is the most common indication for 1st generation cephalosporins in hospitals?

A

Surgical prophylaxis

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6
Q

What is important to limit for 1st generation cephalosporins when given for surgical prophylaxis?

A

Duration of therapy - more than 24 hrs is rarely justified

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7
Q

Do 1st generation cephalosporins lower post-op infections?

A

It does not

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8
Q

2nd generation cephalosporins have a good spectrum in which bacteria?

A
  • Some enteric GNRs
  • Haemophilus influenzae
  • Neisseria
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9
Q

Which 2nd generation cephalosporins consist of the N-methylthiotetrazole (MTT) side chain?

A
  • Cefamandole

- Cefotetan

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10
Q

What type of adverse events could happen with cephalosporins containing N-MTT side chains?

A
  • Prolong bleeding by inhibiting the vitamin K production

- Disulfuram-like reactions when alcohol is being consumed

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11
Q

Which 2nd generation cephalosporins can be used for surgical prophylaxis in abdominal surgery?

A
  • Cefoxitin

- Cefotetan

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12
Q

Which 2nd generation cephalosporins do not need to be renally adjusted?

A
  • Cefoxitin

- Cefotetan

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13
Q

2nd generation cephalosporins are mainly utilized for?

A
  • URTI
  • CAP
  • Gonorrhea
  • Surgical prophylaxis (only 2 drugs)
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14
Q

If 2nd generation cephalosporins are used for surgical prophylaxis, what should be done?

A

Limit duration of therapy after surgery

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15
Q

What should be done if a patient develops an infection while on 2nd generation cephalosporins?

A

Switch to an alternative agent

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16
Q

3rd generation cephalosporins have a good spectrum in which bacteria?

A
  • Enteric GNRs

- Streptococcus

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17
Q

Which 3rd generation has a good spectrum over pseudomonas?

A

Ceftazidime

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18
Q

Which 3rd generation cannot be given for streptococcus infections?

A

Ceftazidime

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19
Q

Which 3rd generation cephalosporins consist of the N-MTT side chain?

A

Cefpodoxime

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20
Q

Which 3rd generation cephalosporin causes hyperbilirubinemia and biliary sludging in neonates?

A

Ceftriaxone

21
Q

Which 3rd generation cephalosporin should be used in neonates instead of ceftriaxone?

A

Cefotaxime

22
Q

Ceftazidime lacks activity against which bacteria?

A

Gram (+)

23
Q

Ceftriaxone and cefotaxime can be useful in?

A

Meningitis - excellent CNS penetration

24
Q

Which 3rd generation does not need to be renally adjusted because it is eliminated by dual modes (renal and biliary)?

A

Ceftriaxone

25
Q

3rd generation cephalosporins are mainly utilized for?

A
  • LRTIs
  • Pyelonephritis
  • Nosocomial infections
  • Lyme disease
  • Meningitis
  • Skin/soft tissue infections
  • Febrile neutropenia
  • Gonorrhea
26
Q

Which 3rd gen cephalosporin should be given for nosocomial infections?

A

Ceftazidime

27
Q

Which 3rd gen cephalosporin should be given for Lyme disease?

A

Ceftriaxone

28
Q

Which 3rd gen cephalosporin should be given for febrile neutropenia and nosocomial infections?

A

Ceftazidime

29
Q

(T/F) - Ceftriaxone is a once-daily drug for every indication

A

FALSE - not for meningitis

30
Q

Ceftriaxone dose for meningitis is?

A

2 g IV q 12 h dose

31
Q

4th generation cephalosporins have a good spectrum in which bacteria?

A
  • Pseudomonas
  • Streptococci
  • Enteric GNRs
  • MSSA
32
Q

4th generation cephalosporins are a good empiric choice for which indication(s)?

A

Nosocomial infections

33
Q

What’s nonbeneficial of giving 4th generation cephalosporins for nosocomial infections? How could it be prevented?

A

They can overkill community acquired infections. Deescalate if possible

34
Q

4th generation cephalosporins are mainly utilized for?

A
  • Febrile neutropenia

- Nosocomial infections

35
Q

What is the primary use for 4th generation cephalosporins?

A

Nosocomial infections

36
Q

5th generation cephalosporins have a good spectrum in which bacteria?

A
  • MRSA
  • MSSA
  • Streptococci
  • Enteric GNRs
37
Q

What are the main utilizations for 5th generation cephalosporins?

A
  • CAP

- Skin/soft tissue infections

38
Q

(T/F) - Ceftaroline (5th gen) has a greater activity against Gram (-) compared to cefepime (4th gen)

A

FALSE - 4th gen has greater activity than 5th gen especially in pseudomonas

39
Q

6th generation cephalosporins have a good spectrum in which bacteria?

A
  • GNRs
  • Pseudomonas
  • Acinetobacter
  • Stenotrophomonas
  • Enterobacteriaceae
40
Q

(T/F) - 6th generation cephalosporins are stable to all classes of the carbapenemase hydrolyzing enzymes

A

TRUE

41
Q

6th generation cephalosporins are mainly utilized for?

A
  • Complicated UTIs in adults who have limited or no other Tx options
42
Q

(T/F) - 6th generation cephalosporins have a gram (-) coverage only, so it’s best to reserve in patients with no other options of MDR GNRs

A

TRUE

43
Q

Cephalosporin/beta-lactamase inhibitors have a good spectrum in which bacteria?

A
  • Pseudomonas

- Enteric GNRs

44
Q

Which cephalosporin/beta-lactamase inhibitor has greater activity for enteric GNRs?

A

Ceftazidime/avibactam

45
Q

Which cephalosporin/beta-lactamase inhibitor is active against carbapenem-resistant Klebsiella and other carbapenem-resistant enterobacteriaceae infections?

A

Ceftazidime/avibactam

46
Q

(T/F) - Both cephalosporin/beta-lactamase inhibitor are active against pseudomonas

A

TRUE

47
Q

What is the main utilization(s) for both cephalosporin/beta-lactamase inhibitor?

A
  • MDR pseudomonas infections
  • Mixed aerobic/anaerobic infections
  • Intra-abdominal infections
  • Infections caused by ESBL-producing organisms
48
Q

If a cephalosporin/beta-lactamase inhibitor is given for intra-abdominal infections, what should be done?

A

Add metronidazole due to limited anaerobic activity

Infectious Disease (41 decks)

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