Cephalosporins, Carbapenems, Monobactam Flashcards
Name the Ceph-gen 1 drugs (2)
Cefalozin
Cephalexin
Cephalosporin Gen 1: Spectrum of Activity
Gram + aerobes:
MSSA
Gram - aerobes: PEK
Proteus Mirabilis
E. Coli
Kleb Pneumo
Cephalosporin Gen 1: Clinical Use
Surgical prophylaxis
SSSI Septic Arthritis Osteomyelitis Endocarditis UTIs Bacteremia
Cephalosporin Gen 2 Drugs Classes (3)
Cephalosporins
Cephamycin
Carbecephems
Cephalosporin Gen 2: Spectrum of Activity
Gram + aerobes:
MSSA
Gram - aerobes: HENPEK + M H. influ Enterobacter group Neisseria group Proteus Mirabilis E. Coli Kleb pneumo
M. cattrhalis
gram - anaerobe
bacteroide fragilis
Cephalosporin Gen 2: clinical use
** surgical prophylaxis for abdominal surgery**
Sinusitis
Otitis Media
Upper and lower respiratory tract
What is special about generation 2 of cephalosporins?
Cephamycin and carbcephems have ANAEROBIC activity
Cephalosporin gen 3 drugs
Ceftriaxone
ceftazidime
cefpodoxime
Cephalosporin gen 3: spectrum of activity
gram + aerobes
inc gram - aerobes:
HENPECKSSS + MP
INCLUDES PSEUDOMONAS ACTIVITY (ceftaz, cefpodo)
Cephalosporin gen 3: clinical uses
- Complicated UTI*
- Meningitis esp if PSEUDO is suspected **
- Uncomplicated gonorrhea*
- CA-penumo*
- Endocarditis (S. viridian)
Cephalosporin gen 3 downfall??
Induces B-lactamase producing bacteria (Neisseria)
Ceph gen 4 drugs:
Cefepime
Ceph gen 4 spectrum of activity:
gram + aerobes
Gram - aerobes:
HENPECKSSS + MP
INC PSEUDO coverage
ceph gen 4 clinical use:
GRAM NEG meningitis
Febrile neutropenia
**PSEUDO INFECTIONS **
Good thing about ceph gen 4:
More stable against resistance
includes coverage for B-lactamase producing enterobacter
LESS likely to induce extended spectrum B-lactamase (ESBL)
Ceph Gen 5 drug:
ceftaroline
Ceph Gen 5: spectrum of activity
gram + aerobes:
MRSA
PSSP
Gram - aerobes:
increased H. influ and M. catarrhalis activity
Ceph Gen 5: clinical use
CA- Bacterial Pneumo
SSSI
Improvement of Ceph with Gen 5?
Increase activity against respiratory infections
increase activity agasint SSSI
MRSA activity!!
Cephalosporins do not cover against??
LAME infections!! Listeria Atypicals - mycoplasma, chlamydia, legionella, S. Malt, Cdiff MRSA (except gen 5 ceftaroline!) Enterococcus spp
Which Cephs are able to penetrate the CSF, if any?
THREE AND FOUR parenteral cefuoxime (gen 2)
How are cephs eliminated?
RENALLY
**EXCEPT: Ceftriaxone (billiary) and Cefoperazone (hepatic)
What is the half life ?
Short, increase dose req.
EXCEPT: Ceftriaxone - 8 hours
Can I drink some alchy-hol if I’m taking Cephs??
NO!
Ethanol-intolerance is one of the side effects of those drugs containing MTT side chains
