Cephalosporins and carbapenems

Question 1

What is it indicated for?

Answer 1

Oral cephalosporins are second and third line options for treatment of UTI, pneumonia and other respiratory tract infections

Parenteral cephalosporins and carbapenems are reserved for infections that are very severe or complicated

Question 2

What is the spectrum of their activity?

Answer 2

They are broad spectrum of activity and they are more resistant to beta-lactamases than penicillin

Question 3

How do they work?

Answer 3

They have a beta-lactam ring and they inhibit enzymes responsible for bacterial cell wall cross-linking peptidoglycans

Question 4

What side effects occur with these drugs?

Answer 4

GI upset- nausea, diarrhoea
C-difficile overgrowth
Hypersensitivity reactions
Risk of cross-reactivity in ‘true’ penicillin allergies

Parenteral therapy can cause a seizure- rare

Question 5

What warnings are there for these drugs?

Answer 5

Caution in people at risk of C.difficile infections

Contraindicated in allergies to beta-lactam antibiotics

Dose reduction in renal impairment

Question 6

What interactions with other drugs occur with these drugs?

Answer 6

They can enhance the anticoagulant effect of warfarin

Carbapenems can also reduce plasma concentration and efficacy of valproate

Question 7

What are the names of drugs in the cephalosporin class?

Answer 7

cefuroxime, ceftriaxone, cefalexin

Question 8

What are the names of drugs in the carbapenems?

Answer 8

meropenem, ertapenem