Cefaclor
2nd gen cephalosporin, -AP (intermediate spectrum) Renal exc Less G+, more g- ( coli klieb proteus) No AP
Cefazolin
1st gen cephalosporin (narrow spectrum) Renal exc Good/most G+ Moderate G- Good b lactamase /penicillinase
Ceftriaxone
3rd gen cephalosporin (broad spectrum) Renal kidney exc Less g+, increased b lact/penicillinase producing Enterobacter Some w/amino = AP inc b lactamase resistance
cefepime
4th gen cephalosporin MSSA, enterobacter, pseudomonas +AP better. G+ Comparable to 3rd gen Higher res to some b lactameses Renal exc
DOC for surgery prophilaxis
Targets: MSSA
Moderate G- (E. Coli, Klebsiella, Proteus)
Most G+ cocci (streps, staph aureus, MSSA, EXCEPT enterococcus, MRSA, S.epidermis)
Cefazolin
1st gen cephalosporin
SE of all cephalosporins
Allergy
Superinfection (C.Diff, candida)
cross sensitivity with penicillin
Dose dependent renal tubular necrosis: synergistic NEPHROtoxicity with aminos
Avoid in neonates due to bilirubin displacement
Ceftriaxone
3rd gen cephalosporin
CNS penetration with
Ceftriaxone
3rd gen cephalosporin
DOC for N.Gonorrhea
Ceftriaxone
Targets:
G- (E.Coli, Klebsiella, Proteus), - AP
Moxarella Catarrhalis,
without antipsudomonal
Cefaclor
2nd gen cephalosporin
All resist B-lactamase/penicillinase (enzyme that doesn’t allow penicillin to bind to altering the binding site?)
Cephalosporins
Targets: G- :
Moxarella Catarr, salmonella
Enterobacter, +/- AP (w/amino)
Salmonella
N. Gonorrhea
some Pseudomonas Aeruginosa (w/amino)
Also: Pen. Resistant Strep pneumonia (G+)
Borrelia Burgdorferi (spirochete)Ceftriaxone
3rd gen cephalosporin
(broad spectrum)
Targets G- : Enterobacter, MSSA
Pseudomonas, + AP
MSSA (G+)
with antipseudomonal
Cefepime
4th gen cephalosporin
Like 3rd but more G+ coverage
Only B-lactam against MRSA
binds to mutated PBP2a
Unnamed gen of cephalosporin Ceftaroline fosamil (IV)
Aztreonam is part of 1) and targets only 2)
1) monobactam
2) G- rods only
Targets: G- only
Klebsiella
Proteus
Serratia
Aztreonam
monobactam
- good resistance to B-lactamase (penicillinase) (doesn’t allow penicillin to bind)
- no cross-sensitivity with penicillin (good for those who are allergic to penicillin)
AZtreonam
(monobactam)
only G- rods
Pseudomonas serratia klebsiella proteus
Parenteral only
SE of AZtreonam
Skin rash
phlebitis
abnormal liver
(not oral)
Imipinem and meropenem are
CARBapenems
broad spectrum
- good resistance to B-lactamase
- targets anaerobs, G+, G-
- add amino if pseudomonas resistant
Imipinem and Meropenem
CARBapenems
May become resistant to pseudomonas so add amino
Imipinem and Meropenem
CARBapenems
DOC for B-lactamase producing Enterobacter infections
Imipinem and Meropenem IV
CARBapenems
Targets: G+/G-
Pseudomonas (G-)
B-lactamase producing Enterobacter (G-)
{citrobacter, enterobacter, serratia??)
Imipinem and meropenem
CARBapenems
Must take with CILASTIN
Imipinem (carbopenem)
dihydropeptidase inhibitor bc Imipinem is inactivated by renal dihydropeptidase
Entrpenem is
CARBapenem
- strong B-lactamase resistance
- targets anaerobs, G+, G-
Entrapenem
CARBapenems
- Seizures at high dose
- caution with renal failure, brain lesions, head trauma, Hx of seizures
Imipinem
Target: Enterobacter (G-)
less against Pseudomonas
Entrapenem
CARBapenem
ototoxic
nephro
red man syndrome (skin flushing from histamine release)
Vancomycin
non B-lactam Inhibitor of Cell wall synthesis)
targets only G+
Vancomycin
non B-lactam Inhibitor of Cell wall synthesis)
SE of UTI
Fasfomycin
non B-lactam Inhibitor of Cell wall synthesis
Nephro SE (if parenteral)
Bacitracin
non B-lactam Inhibitor of Cell wall synthesis
Targets only G+
Vancomycin
Bacitracin
(non B-lactam Inhibitor of Cell wall synthesis)
topical application
Bacitracin
If want to use against G-, add neomycin/polymyxin to
Bacitracin
Inhibits Nag-Nam transport across membrane
Bacitracin
Prevents Nag-Nam reduction
Fosfomycin
- May have synergy with B-lactams, aminos, or fluoroquinolone
- G+ and G-
Fosfomycin
Prevents trans-peptidation of pentidoglycan (binds to D-ala site, if it’s mutated-» resistance)
Vancomycin
useful against penicillin (-) and (MRSA) infections
why is MRSA in brackets???
Vanco
First choice for C.Diff?
2nd choice for C. Diff?
Metronidazol
Vanco
Tx for superinfections caused by Staph and C Diff
1st DOC for c diff is
Vancomycin
Metronidazol doc c diff
Which targets MSSA?
Cefazolin 1st gen
Renal excretion
