classification of cephalosporin

1. Cephalosporin Classification
Cephalosporins may be classified by
their antimicrobial spectrum into four
generations
or
Some divide cephalosporins in seven
groups
ACTA FAC. MED. NAISS. 2003; 20 (2): 131-136

2. Cephalosporin Classification
• The first generation cephalosporins have good activity against
gram-positive bacteria and relatively modest activity against
gram-negative bacteria. Streptococci and pneumococci are
susceptible. Some species of Staphylococci are sensitive to this
generation, but not methicillin-resistant S. aureus and S.
epidermidis. Enterococci are resistant too. Activity against
Moraxella catarrhalis, E. coli, K. pneumoniae and P. mirabilis
is good. Most oral cavity anaerobes are sensitive.
• The second generation cephalosporins have increased activity
against gram-negative bacteria, but are less active than third-
generation agents. Cefoxitin, cefotetan and cefmetazole are
active as well against B. fragilis group.

3. Cephalosporin Classification
• The third generation cephalosporins are generally less active
than first-generation agents against gram-positive cocci, but
they are much more active against Enterobacteriaceae,
including b-lactamase-producing strains
• Ceftazidime and cefoperazone are active against P. aeruginosa,
but less active than the rest third-generation agents against
gram-positive cocci.
• The fourth generation cephalosporins such as cefepime and
cefpirom have an extended spectrum of activity compared to
the third-generation and have increased stability to b-
lactamase-producing bacteria

4. Cephalosporin Classification
Generation Oral Parenteral
I cephalexin cefamezin
II cefaclor cefamandole
III ceftibuten
cefpodoxime
cefixime
cefotaxime
cefoperazone
ceftriaxone
ceftazidime
IV cefepime
cefpirome

5. Cephalosporin Classification
Group 1
(I-P)
Group 2
(I-O)
Group 3
(II-P)
Group 4
(III-P)
Cephaloridine
Cephalothin
Cephapirin
Cefazolin
Ceforanide
Cefadroxil
Cefaclor
Cephalexin
Cephradine
Loracarbef
Cefamandole
Cefoxitin
Cefonicid
Cefotetan
Cefuroxime
Cefotaxime
Ceftizoxime
Ceftriaxone

6. Cephalosporin Classification
Group 5
(III-O)
Group 6
(III-P)
Group 7
(IV-P)
Cefixime
Cefpodoxime
Cefprozil
Ceftibuten
Cephoperazone
Cefsulodin
Ceftazidime
Cefepime
Cefpirome

7. Cephalosporin Classification
• First generation:
– Group 1: cephalosporins for parenteral administration with
moderate antibacterial activity and resistance to
Staphylococci b-lactamases; hydrolyzed by a large number
of Enterobacterial b-lactamases.
– Group 2: cephalosporins for oral administration with
moderate antibacterial activity and resistance to
Staphylococci b-lactamases; moderately resistant to some
Enterobacterial b-lactamases.
• Second generation:
– Group 3: cephalosporins for parenteral administration with
moderate antibacterial activity and resistant to most b-
lactamases.

8. Cephalosporin Classification
• Third generation:
– Group 4: cephalosporins for parenteral
administration with increased antibacterial activity
and resistant to most b-lactamases.
– Group 5: cephalosporins for oral administration
with increased antibacterial activity and resistant to
most b-lactamases.
– Group 6: cephalosporins for parenteral
administration active against Pseudomonas
aeruginosa and resistant to most b-lactamases.

9. Cephalosporin Classification
• Fourth generation:
– Group 7: cephalosporins for parenteral
administration with increased antibacterial activity
against Enterobacteria, moderate activity against
Pseudomonas aeruginosa, stable to hydrolysis by
most b-lactamases and with enhanced anti
staphylococcal activity.