Sketchy - Cephalosporins

Question 1

Class: Cephalosporins

Answer 1

Beta-lactams - binds PBPs halting peptidoglycan wall synthesis

Question 2

Class: Cephalexin

Answer 2

1st gen cephalosporin

Question 3

Class: Cefazolin

Answer 3

1st gen cephalosporin

Question 4

Most common uses for 1st generation cephalosporins such as Cefazolin, Cephalexin

Answer 4

Gram pos bacteria - ie Staph and Strep

Second line for strep pharyngitis and cellulitis

Question 5

Can Cefazolin and Cephalexin be used against gram negative bacteria?

Answer 5

Yes, some: Proteus, Klebsiella and E. Coli, ie uncomplicated UTI
“PEK”

Question 6

Why is Cefazolin a first drug of choice for surgery prophylaxis?

Answer 6

It penetrates well into tissues

Cefazolin is a 1st gen cephalosporin

Question 7

Class: Cefuroxime

Answer 7

2nd gen Cephalosporin

Question 8

Class: Cefotetan

Answer 8

2nd gen Cephalosporin

Question 9

Class: Cefoxitin

Answer 9

2nd gen Cephalosporin

Question 10

Spectrum: 2nd gen Cephalosporins
Cefoxitin
Cefotetan
Cefuroxime

Answer 10

The same coverage as 1st generation (PEK + Staph/Strep)

with extended gram negative coverage: Haemophilus influenzae, Neisseria, Serratia (HENS)

Question 11

T/F: 2nd generation Cephalosporins are first-line agents.

Answer 11

FALSE, they are not used much anymore, but they CAN be used for:
Sinusitis
Otitis media
Mixed aerobe anaerobe infections
Lower RTIs ie from strep pneumo
Peritonitis

Question 12

Class: Ceftriaxone

Answer 12

3rd gen cephalosporins

Question 13

Class: Cefotaxime

Answer 13

3rd gen cephalosporins

Question 14

Class: Ceftazidime

Answer 14

3rd gen cephalosporins

Question 15

Take homes about 3rd gen cephalosporin spectrum

Answer 15

Extended gram negative coverage AND some can cross BBB

Question 16

Which 3rd gen cephalosporins can cross the BBB?

Answer 16

Ceftriaxone
Cefotaxime

**Used to treat meningitis as first-line - usual culprits for meningitis are Strep pneumo, H. influenzae, Neisseria meningitidis

Question 17

When treating meningitis, what antibiotic is often used in addition to Ceftriaxone to cover resistant strains of Strep pneumo?

Answer 17

Vancomycin

Question 18

For young and old patients, what drug is added to Ceftriaxone to cover Listeria meningitis?

Answer 18

Ampicillin

Question 19

Kinds of infections covered by 3rd gen cephalosporins:

Answer 19

CA and HA pneumonia (coverage of pseudomonas for hospital or ventilator acquired pneumonia);
Endocarditis (Strep viridans);
Gram neg GI bugs

Question 20

Which 3rd gen cephalosporin is best used to treat Pseudomonas infection?

Answer 20

Ceftazidime

Ceftazz treats Pseudomonazz

Question 21

Do 3rd gen cephalosporins cover MRSA?

Answer 21

No!!

Cefepime, a 4th generation cephalosporin, also has no MRSA coverage.

Question 22

What is the first line treatment for gonorrhea?

Answer 22

A single IM dose of Ceftriaxone

Question 23

What is highly recommended in the treatment of Lyme disease, especially when it involved arthritis or neurologic symptoms?

Answer 23

Ceftriaxone

Question 24

What are the only things you need to know about Cefepime?

Answer 24

1. 4th gen cephalosporin
2. Active against Pseudomonas
3. Penetrates BBB
4. Broad spectrum

A big gun used in the treatment of patients with drug resistant systemic situations

Question 25

Class: Ceftaroline

Answer 25

5th gen cephalosporin

Broad spectrum

Question 26

Does Ceftaroline have MRSA coverage?

Answer 26

Yes!

Question 27

What are the common modes of resistance acquired by bacteria against cephalosporins?

Answer 27

Altered PBPs

Extended spectrum beta-lactamases