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B-lactams part 2 Cephalosporins
Cephalosporins
80
Medical
Professional
07/13/2012

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Term
broader range of activity due to
Definition
increased resistance to b lactamases
Term
active vs Proteus, E. coli, Klebsiella
Definition
Cephalosporins (all generations)
Term
drug of choice in treatment of pneumonia and urinary tract infections causes by Klebsiella pneumoniae
Definition
Cephalosporins (all generations)
Term
Parenterally used in treatment of gonococcal disease and bacterial meningitis
Definition
Cephalosporins (3rd gen)
Term
inactrive vs
MRSA
Listeria monocytogenes
C diff
enterococci
Definition
Cephalosporins (1st-4th)
Term
active vs. MRSA, VRSA, VISA, Enterococcus faecalis
Definition
ceftaroline fosamil
Term
Cephalexin, Cefazolin, Cefadroxil
Definition
First generation
Term
Penicillin G substitutes resistant to inactivation by staphylococcal penicilinase
Definition
First generation
Term
Staphylococci, Streptococci, Pneumococi
Very active vs gram pos cocci

RTI (pharyngitis, tonsillitis, pneumonia) bone infections, skin and soft tissue, otitis media
Definition
First generation
Term
Active vs. gram negative bacilli:
Proteus mirabilis, E. Coli, Klebsiella pneumonia

PEcK
Definition
First generation
Term
UTIs and acute prostatitis

Pneumonia (Klebsiella)
Definition
First generation
Term
most widely prescribed cephalosporin
Definition
Cephalexin
Term
DOC for surgical prophylaxis due to longer half life
Definition
Cefazolin
Term
Alternative to antistaphyloccoccal penicillins in penicillin allergic patients

-susceptible bacterial endocarditis
Definition
Cephazolin
Term
Cefprozil, Cefuroxime axetil, Cefuroxime, Cefaclor
Definition
Second generation
Term
Increased activity against some gram negatives: Haemophilus influenzae, Moraxella catarrhalis

PeCKS + HiM
Definition
Second generation
Term
Less activity vs gram positive organisms
Definition
Second generations
Term
Widely prescribed 2nd gen cephalosporin
Definition
Cefprozil
Term
Otitis media/acute sinusitis, pharyngitis, tonsillitis, and LOWER RTIs (strep pneumo, strep pyo, Haemophilus influenze, Moraxella catarrhalis)
Definition
Cefprozil
Term
Skin and soft tissue infections (staph aureus, Strep pyogenes)
Definition
Cefprozil, Cefuroxime axetil
Term
most widely prescribed 2nd generation cephalosporin
Definition
Cefuroxime axetil
Term
Otitis media/acute sinusitis, pharyngitis, tonsillitis, *bronchitis*, *community acquired pneumonia*

(Strep pneumo, Strep pyo, Haemophilus influenze, Moraxella catarrhalis)
Definition
Cefuroxime axetil
Term
UTIs (E. Coli, Klebsiella)
Definition
Cefuroxime axetil
Term
Cephamyycins
Definition
Cefoxitin, Cefotetan
Term
Cephamycins are subclass of
Definition
Second generation
Term
Similar spectrum of activity as 2nd generations (Skin and soft tissue infections, RTIs, UTIs)
Definition
Cephamycins
Term
very active vs bacteroides fragilis and Clostridum perfringens (anaerobes)
Definition
Cephamycins
Term
Intra-abdominal infections
Definition
Cephamycins
Term
most active cephamycin
Definition
Cefoxitin
Term
First line for Bacteroides
Definition
Cefoxitin
Term
First line for mixed aerobic infections (diverticulitis, peritonitis)
Definition
Cefoxitin
Term
Indicated for Neisseria gonorrhoeae, Clostridum perfringens, Serratia
Definition
Cefoxitin
Term
widely used in treatment of bacterial meningitis
Definition
Ceftriaxone, Cefotaxime
Term
Crosses blood brain barrier entering CSF to treat bacterial meningitis
Definition
Ceftriaxone, Cefotaxime, Ceftazidime, Ceftizoxime
Term
Increased coverage against gram negative bacilli

adds Neisseria, Serratia marcescens, Citrobacter, and Providencia

HiM PECKS + NSCP
Definition
Third generation
Term
First line agent ofr treatment of Neisseria gonorrhoeae
Definition
Ceftriaxone, Cefixime
Term
First line agent for meningitis due to Haemophilus influenzae
Definition
Ceftriaxone, Ceftaxime
Term
First line agent for infections due to pen-resistant Streptococcus pneumoniae
Definition
Ceftriaxone, Ceftaxime
Term
First line agent for typhoid fever due to Salmonella
Definition
Ceftriaxone
Term
Other indications: meningitis (strep pneumo, Neisseria meningtidis, Strep agalactiae, campylobacter fetus, pasteurella))
Definition
Ceftriaxone
Term
otitis media, chancroid, bacterial endocarditis, UTIs, pneumonia, bacteremia, bone infections, skin and soft tissue infections
Definition
Ceftriaxone
Term
Meningitis (streptococcus pneumo, Neisseria meningitidis, and stre aglactae)
Definition
Cefotaxime
Term
Active for meningitis same as Cefotaxime with additional vs. Campylobacter fetus and Pasteurella
Definition
Ceftriaxone
Term
First line agent for infections due to Pseudomonas aeruginosa
-UTIs, pneumonia, bacteremia, meningitis
Definition
Ceftazidime (3rd), Cefepime (4th)
Term
Most widely prescribed 3rd gen
Definition
Cefdinir
Term
Community -aquired pneumonia, chronic bronchitis, sinusitis
(Streptococcus pneumo, Haemophilus influenze, moraxella catarrhalis)

skin and soft tissue infectoins (staphylococcus aureus, streptococcus pyogenes)
Definition
Cefdinir
Term
Pediatric patients
-skin and soft tissue (staph a, strep pyo)
-acute bacterial otitis media (strep pneumo, haemophilus influenze, moraxella catarrhalis)
Definition
Cefdinir
Term
Fourth generation
Definition
Cefepime
Term
most widely used fourth gen cephalosporin
requires parenteral administration
Definition
Cefepime
Term
Similar to last generation but more resistance to hydroylsis by chromosomal B lactamases by ENTEROBACTER
Definition
Cefepime
Term
Broad range of antibacterial activity:
staphylococci, streptococci, pneumococci

Aerobic Gram negative: Proteus mirabilis, E coli, Klebsiella pneumo, Haemophilus, Moraxella, Neisseria, Enterobacter, Pseudomonas aeruginosa, Serratia, Citrobacter)
Definition
Cefepime
Term
Also indicated for Enterobacter, Bacteroides, Serratia, Citrobacter

Intra abdominal infections
Definition
Cefepime
Term
First fifth gen on market
administered IV
Definition
Ceftaroline fosamil
Term
Broad spectrum vs. MRSA, VRSA, VISA, Enterococcus faecalis

streptococci, pneumococci
Definition
Ceftaroline fosamil
Term
Similar gram negative spectrum to second generation

plus Enterobacter and Citrobacter
-acute skin and soft tissue infections, community acquired pneumonia
Definition
Ceftaroline fosamil
Term
Gram negative spectrum:
Proteus mirabilis, E. coli, Klebsiella pneumonia
Definition
Second generation
Term
Gram negative spectrum:
Proteus mirabilis, E. coli, Klebsiella pneumonia , Haemophilus influenze, Moraxella catarrhalis
Definition
Second generation
Term
Cephalexin, cefadroxil, cefprozil, cefuroxime axetil, cefaclor, cefdinir, cefixime, ceftibuten, cefpodoime, cefditoren
Definition
oral administration
Term
only IV third generation
Definition
ceftriaxone, cefotaxime, ceftazidime, ceftizoxime
Term
only oral third generation
Definition
cefdinir, cefixime, ceftibuten, cefpodoxime, cefditoren
Term
only second generation not oral
Definition
Cefuroxime
Term
oral second generation
Definition
cefprozil, cefuroxime axetil, cefaclor
Term
oral first generation
Definition
cephalexin, cefadroxil
Term
IV only first generation
Definition
Cefazolin
Term
mechanisms of reistance indentical to penicillins
Definition
cephalosporins
Term
some third generations + this get into CSF
Definition
cefepime
Term
DOC in treatment of both NEONATAL and CHILDHOOD meningitis by Haemophilus influenze
Definition
Ceftriaxone, cefotaxime
Term
useful during orthopedic surgery since it concentrates in bone and is effective versus penicillinase-producing Staphyloccous aeurus
Definition
Cefazolin
Term
primarily excreted via renal tubular secretion
Definition
cephalosporins
Term
prolongs activity of cephalosporins eliminated by tubular secretion
Definition
Probenecid
Term
Probenecid would not work to prolong
Definition
Ceftriaxone
Term
excreted via bile and is commonly employed in patients with decreased renal function
Definition
Ceftriaxone
Term
bleeding disturbances
associated with hypoprothrombinemia
administer w/ vitamin K can remedy
Definition
Cefotetan
Term
may be associated w/ severe disulfiram like reactions
Definition
Cefotetan
Term
potential for nephrotoxicity when cephalosporins are combined w/
Definition
aminoglycosides
Term
You have unknown diagnosis of community acquired pneumonia. So you want to treat with something that covers the common culprits: Strep. Pneumo + HiB
Definition
Cefuroxime axetil
Term
You have an unknown sinusitis or otitis media infection by unknown organism and want to cover the bases of common culprits: HiB/moraxella
Definition
Cefuroxime axetil
Term
You want to work on intra-abdominal infection that covers anaerobic contaminants from GI tract, especially Bacteroides fragilis
Definition
Cefoxitin, Cefotetan (Cephamycins)
Term
Adding pseudomonas aeruginosa to spectrum took until the third generation and the drug: (first line agent)
Definition
Ceftazidime
Term
Cephalosporins that cover the anaerobes (including bacteroides fragilis)
Definition
Cefoxitin, Cefotetan
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