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Cephalosporins 2


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What type of antibiotics are cephalosporins ?
beta lactam antibiotics
Are cephalosporins bactericidal or static ?
How do they work ?
disrupt cell synthesis and activate autolysins
Describe cephalosporin characteristics as you move from first generation to fourth generation ?
1.)increasing effect against gram negative
2.)increasing ability to penetrate the CSF
3.)icreased resistance to beta lactamase
First generation cephs are useful for ....
are highly active against gram positive bacteria and are the most active of ALL cephs against staphylococci and nonenterococcal strep
List some of the first generation cephs, especially the prototype ?
Cephalexin (Keflex)
Cefadroxil (Duricef)
Cefazolin (Ancef)
List the second generation cephalosporins.
What are indications for use for the second generations ?
They have an increased activity against some gram negative such as H. flu
-useful in respiratory infections, otitis media, sinusitis and bronchitis
What makes the third generation Cephs unique ?
Even more activity against gram negative like salmonalla, enterobacter, n. gonorrhea and anaerobes

PLUS....will penetrate the CNS
What generation ceph is Rocephin ?
THIRD generation
Other 3rds are Ceftriaxone
Vantin (Cefpodozime)
Claforan (Cefotaxime)
Fourth generations cephs can be given po or IV...TRUE OR FALSE?

Two main points for the 4the generation Cephs are:
1.can penetrate the CNS
2. effective against psuedemonas
If you had a patient with a psuedemonas infection, what are some of the options ?
The anti-psuedemonas drugs (aka extended spectrums) like piperacillin, ticarcillin, mezlocillin or carbenicilin) OR a 4th generation ceph like Cefepime or Maxipime.

-also a good alternative if they are pen allergic
Practically all cephalosporins are excreted by this route ?
What are the clinical implications of this ?
Almost all are renal excretion
LOWER the dose for renally impaired patients OR prescribe cefoperazone and ceftriaxone...both of which are not excreted renally and are therefore safe in renal impairment
What is the most common side effect cephalosporin Rx ?
maculopapular rash that develops several days after the onset of treatment
-anaphylaxis is rare

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