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Cephalosporins (beta lactam antimicrobials) - Coggle Diagram
Cephalosporins (beta lactam antimicrobials)
Mechanism of Action
Bactericidal
4-member core beta-lactam ring + 6-member side ring
binds to transpeptidatse (PBP) and prevent cross-link formation ---> inhibits cell wall synthesis ---> cell death
Examples
1st generation (bad gram - cover; good strepp and staph cover)
Cephalexin
ADME
Oral
Cefazolin
2nd generation (better gram - cover)
Cefuroxime
ADME
Oral/IV (not usually oral)
Cefaclor
ADME
Oral
3rd generation (broad spectrum, better gram - cover; strap and staph cover not as good)
Cefotaxime
ADME
IV
Ceftriaxone
ADME
IV
Ceftazidime
ADME
IV/IM
4th generation (even broader)
Cefepime
5th generation (good MRSA cover, not good gram - cover)
Cetaroline
ADME
Absorption
Cephalexin > Cefaclor >> Cefuroxime
Distribution
Most tissues/fluids
Crosses placenta
Crosses BBB (except 1st and 2nd generation)
Excretion/Metabolism
Predominantly renal excretion
Dose reduction required in renal impairment
Some hepatic metabolism
Side Effects
GI
Nausea
Vomiting
Diarrhea
C. difficile
infection
Skin
Rash
Phlebitis
Haematological
Neutropenia
Platelet dysfunction
CNS
Seizures
Encephalopathy
Nephrotoxicity
Nephrotoxicity
Acute interstitial nephritis
Hepatic
Hypersensitivity type 1 and 4 reactions
Activity/Use
1st generation
Some gram - bacilli
Uncomplicated UTI
Streptococci
Staph. aureus
Skin/soft tissue infections
Pharyngitis
2nd generation
Streptococci
Respiratory tract infection
Staph.aureus
Gram - bacilli
UTI
Intra-abdominal infections
Haemophilus influenzae
Surgical prophylaxis
3rd generation
Cefotaxime/Ceftriaxone
Streptococci
Pneumonia
Staph. aureus
(less than 1st or 2nd generation)
Neisseria meningitidis
Meningitis
Gram - bacilli
Pyelonephritis
Ceftazidime
Pseudomonas aeruginosa
Much less
Staph. aureus
cover
Lyme disease
Gonorrhea
Neutropenic sepsis
4th generation
Similar to 3rd generation
5th generation
Enhanced gram + cover
MRSA
Enterococci
No pseudomonas cover
