Cephalosporins

Question 1

What are you 4 facts about cephalosporins?

Answer 1

1. well tolerated/associated with fewer allergic rxn compared to PCN
2. Time dependent killing
3. Most are renally excreted
4. not active against enterococci

Question 2

What are 4 facts about first gen: cefazolin(IV) and cephalexin (oral)?

Answer 2

1. gram + (staph and strep)
2. Gram - against E. coli, proteus spp, klebsiella
3. MSSA
4. good for cellulitis and surgical prophylaxis

Question 3

What are 4 facts about second gen: cefuroxime?

Answer 3

1. active against gram + S. pneumoniae)
2. Active against H. influ
3. Lose some gram + activity but gaining gram - activity
4. Good for respiratory infections and UTI

Question 4

What are 5 facts about 3rd gen Ceftriaxone?

Answer 4

1. less activity against S. aureus than 1st gen, but excellent activity against streptococci
2. no activity against pseudomonas
3. Good against P. pneumoniae, H influ, and other respiraotry bacteria
4. Can be used against N. meningitidis and N. gonorrhoeae.
5. Good CSF penetration for meningitis

Question 5

What are 5 facts about 4th gen: cefepime?

Answer 5

1. Active aginst gram + but not MRSA or S. epidermidis
2. Active against gram - including pseudomonas aeruginosa
3. no anaerobic activity
4. good empuric abx when worried about potential hospital acquired infection
5. report some neurotoxicity in patients with renal failure

Question 6

What are 4 facts about 5th gen: ceftaroline?

Answer 6

1. active against MRSA and S. pneumonia (affinity got PBP2a)
2. Active against gram - but not active against P. aueruginosa and anaerobes
3. Active against oral anaerobes
4. Approved for pneumonia and skin/soft tissue infections but not blood stream infections

Question 7

What is the 2nd 3rd gen: ceftrazidime?

Answer 7

1. poor gram + activity
2. no anaerobic activity
3. ONLY GRAM -
4. Special role in pseudomonas aeruginosa
5. good CNS penetration