Cephalosporins

1,085 views

Published on

Published in: Health & Medicine
0 Comments
2 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
1,085
On SlideShare
0
From Embeds
0
Number of Embeds
3
Actions
Shares
0
Downloads
32
Comments
0
Likes
2
Embeds 0
No embeds

No notes for slide

Cephalosporins

  1. 1. CephalosporinsCephalosporins B-Lactam antibiotics ( similar to penicillinsB-Lactam antibiotics ( similar to penicillins(( Broad spectrumBroad spectrum Act by inhibition of cell wall synthesisAct by inhibition of cell wall synthesis BactericidalBactericidal Inactive against : enterococci, MRSA,Inactive against : enterococci, MRSA, legionella , mycoplasma, chlamydia spplegionella , mycoplasma, chlamydia spp.. Widely used in surgical procedures toWidely used in surgical procedures to reduce the risk of post operative infectionsreduce the risk of post operative infections
  2. 2. Classifications of cephalosporinsClassifications of cephalosporins FIRST GENERATIONFIRST GENERATION Cephalexin , poCephalexin , po CefazolinCefazolin CephalothinCephalothin Cephradine , poCephradine , po Active against G+ cocci ( except.enterococci & MRSAActive against G+ cocci ( except.enterococci & MRSA(:(: s.pneumoniae, s.pyogenes,s. aureus, s.s.pneumoniae, s.pyogenes,s. aureus, s. epidermidisepidermidis Indicated for streptococcal pharyngitis ( e.g. cephalexinIndicated for streptococcal pharyngitis ( e.g. cephalexin(( Commonly used ( eg. Cefazolin( as prophylacic forCommonly used ( eg. Cefazolin( as prophylacic for surgical proceduressurgical procedures.. Modest activity against G- bacteriaModest activity against G- bacteria
  3. 3. SECOND GENERATIONSECOND GENERATION Cefoxitin ( mefoxinCefoxitin ( mefoxin(( Cefuroxime ( zinacef ( Cef. axetil ( zinnatCefuroxime ( zinacef ( Cef. axetil ( zinnat(( Cefaclor ( ceclor ( Cefprozil ( cefzilCefaclor ( ceclor ( Cefprozil ( cefzil(( Mainly effective against G- bacteriaMainly effective against G- bacteria Modest activity against G+ bacteriaModest activity against G+ bacteria CefoxitinCefoxitin active against bowel anaerobes (B. fragilisactive against bowel anaerobes (B. fragilis(( CefuroximCefuroxim active against H. influenzae, M. catarrhalis, S. pneumoniaeactive against H. influenzae, M. catarrhalis, S. pneumoniae Cef. Axetil-Cef. Axetil- oral form of cefuroximoral form of cefuroxim CefaclorCefaclor active against H. influenzae, M. catarrhalis &E.coliactive against H. influenzae, M. catarrhalis &E.coli CefprozilCefprozil- similar to cefaclor, c. axetil and augmentin- Liked by children- similar to cefaclor, c. axetil and augmentin- Liked by children Second Generations are used primarily for URTIs ( acute otitis media,Second Generations are used primarily for URTIs ( acute otitis media, sinusitis ( and Lower RTIs ( acute exacerbation of chronicsinusitis ( and Lower RTIs ( acute exacerbation of chronic bronchitisbronchitis((
  4. 4. THIRD GENERATIONTHIRD GENERATION Ceftriaxone ( rocephinCeftriaxone ( rocephin(( Cefotaxime ( claforanCefotaxime ( claforan(( Cetazidime ( fortumCetazidime ( fortum(( Cefoperazone ( cefobidCefoperazone ( cefobid(( Cefixime ( supraxCefixime ( suprax(( They have enhanced G- activity, H. influenzae, N. meningitidis, N.gonorrhea,They have enhanced G- activity, H. influenzae, N. meningitidis, N.gonorrhea, P. aeruginosae, M. catarrhalis, E.coli, most KlebsiellaP. aeruginosae, M. catarrhalis, E.coli, most Klebsiella CeftriaxoneCeftriaxone has long half-life . Not advised in neonates (interferes with bilirubinhas long half-life . Not advised in neonates (interferes with bilirubin metabolismmetabolism(( CefotaximeCefotaxime preferred in neonate ( does not interfere with bilirubin metabolism (,preferred in neonate ( does not interfere with bilirubin metabolism (, as may ceftriaxoneas may ceftriaxone.. CeftazidimeCeftazidime && cefoperazonecefoperazone have excellent activity against p. aeruginosaehave excellent activity against p. aeruginosae.. CefiximeCefixime has similar activity to amoxicillin & cefaclor for actute otitis mediahas similar activity to amoxicillin & cefaclor for actute otitis media
  5. 5. Fourth GenerationFourth Generation CefipimeCefipime Active against G+ bacteria than cefazolinActive against G+ bacteria than cefazolin against s. pyogenes, s.pneumoniae butagainst s. pyogenes, s.pneumoniae but lower against s. aureus.lower against s. aureus. Similar to cefotaxime against E.coli & K.Similar to cefotaxime against E.coli & K. pneumoniae but for p. aeruginosapneumoniae but for p. aeruginosa..
  6. 6. PharmacokineticsPharmacokinetics Cephalosporins are given parenterally and orallyCephalosporins are given parenterally and orally.. Extent of binding to plasma protein vary from one to anotherExtent of binding to plasma protein vary from one to another.. e.g. Cefazolin is 80% protein bound ( hence, long t1/2e.g. Cefazolin is 80% protein bound ( hence, long t1/2(( Cephalexin is 10-15% protein boundCephalexin is 10-15% protein bound Relatively lipid insoluble ( like penicillinsRelatively lipid insoluble ( like penicillins(( Hence,do not penetrate cells or the CNS, except for third generationsHence,do not penetrate cells or the CNS, except for third generations.. Mostly excreted unchanged by the kidney (glomerular & tubularMostly excreted unchanged by the kidney (glomerular & tubular secretion (, except, ceftazidime & cefoperazone( glomerularsecretion (, except, ceftazidime & cefoperazone( glomerular(( Probenecid slows their elimination and prolong their half-live ( exceptProbenecid slows their elimination and prolong their half-live ( except Ceftazidime & cefoperazoneCeftazidime & cefoperazone(( Half-life 30-90 min; ceftriaxone 4-7 hrHalf-life 30-90 min; ceftriaxone 4-7 hr
  7. 7. Therapeutic usesTherapeutic uses 11..Alternative to penicillin in allergicAlternative to penicillin in allergic patientspatients 22..Upper respiratory tract infectionsUpper respiratory tract infections and otitis mediaand otitis media cefaclor cefuroxime axetilcefaclor cefuroxime axetil cefixime cefprozilcefixime cefprozil 33..Septicaemia caused by G- bacteriaSepticaemia caused by G- bacteria ( P.aeruginosae( P.aeruginosae(( A penicillin(eg.Piperacillin/A penicillin(eg.Piperacillin/ Ticarcillin( +aminoglycosideTicarcillin( +aminoglycoside OROR A cephalosporin(eg.A cephalosporin(eg. ceftazidime ( + AGceftazidime ( + AG 44..Urinary tract infectionsUrinary tract infections Cefuroxime, CefiximeCefuroxime, Cefixime ..55..Prophlaxis in surgeryProphlaxis in surgery Appendectomy ( bowelAppendectomy ( bowel anaerobes ( eg. Cefoxitinanaerobes ( eg. Cefoxitin Obstetrical &gynecological,Obstetrical &gynecological, urological, orthopedicurological, orthopedic procedures, etcprocedures, etc ((S. aureus & S. epidermidis (S. aureus & S. epidermidis ( eg. Cefazolineeg. Cefazoline 66..Meningitis- N. MeningitidisMeningitis- N. Meningitidis CeftriaxoneCeftriaxone Cefotaxime( pref. in neonateCefotaxime( pref. in neonate(( 77..Gonococcal infectionsGonococcal infections CeftriaxoneCeftriaxone
  8. 8. Adverse effectsAdverse effects 11..Hypersensitivity reactions- most commonHypersensitivity reactions- most common Anaphylaxis, bronchspasm, urticariaAnaphylaxis, bronchspasm, urticaria Maculopapular rash- more commonMaculopapular rash- more common 22..Nephrotoxicity ; esp. cephradineNephrotoxicity ; esp. cephradine 33..Thrombophlebitis ( i.v adminThrombophlebitis ( i.v admin. (. ( 44..SuperinfectionsSuperinfections 55..Diarrhea-oral cephalosporins, cefoperazone,Diarrhea-oral cephalosporins, cefoperazone, ceftriaxone & moxalactamceftriaxone & moxalactam.. 66..cefamandole, moxalactam & cefoperazone may causecefamandole, moxalactam & cefoperazone may cause:: a( bleeding disordersa( bleeding disorders b( Flushing, tachycardia, vomiting with alcohol intakeb( Flushing, tachycardia, vomiting with alcohol intake

×