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Cephalosporins Flashcards

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1
Q

1st generation cephalosporins have a good spectrum in which bacteria?

A
  • MSSA

- Streptococci

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2
Q

(T/F) - 1st generation cephalosporins are a good alternative to anti-staphylococcal. If so, why?

A

TRUE - cause less phlebitis and given less frequently

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3
Q

(T/F) - 1st generation cephalosporins cross CNS, so they can be given for CNS infections

A

FALSE - do not cross CNS and should not be given for CNS infections

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4
Q

1st generation cephalosporins are mainly utilized for?

A
  • MSSA infections (endocarditis)
  • Skin and soft tissue infections
  • Surgical prophylaxis
  • Staph bloodstream infections
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5
Q

What is the most common indication for 1st generation cephalosporins in hospitals?

A

Surgical prophylaxis

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6
Q

What is important to limit for 1st generation cephalosporins when given for surgical prophylaxis?

A

Duration of therapy - more than 24 hrs is rarely justified

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7
Q

Do 1st generation cephalosporins lower post-op infections?

A

It does not

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8
Q

2nd generation cephalosporins have a good spectrum in which bacteria?

A
  • Some enteric GNRs
  • Haemophilus influenzae
  • Neisseria
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9
Q

Which 2nd generation cephalosporins consist of the N-methylthiotetrazole (MTT) side chain?

A
  • Cefamandole

- Cefotetan

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10
Q

What type of adverse events could happen with cephalosporins containing N-MTT side chains?

A
  • Prolong bleeding by inhibiting the vitamin K production

- Disulfuram-like reactions when alcohol is being consumed

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11
Q

Which 2nd generation cephalosporins can be used for surgical prophylaxis in abdominal surgery?

A
  • Cefoxitin

- Cefotetan

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12
Q

Which 2nd generation cephalosporins do not need to be renally adjusted?

A
  • Cefoxitin

- Cefotetan

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13
Q

2nd generation cephalosporins are mainly utilized for?

A
  • URTI
  • CAP
  • Gonorrhea
  • Surgical prophylaxis (only 2 drugs)
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14
Q

If 2nd generation cephalosporins are used for surgical prophylaxis, what should be done?

A

Limit duration of therapy after surgery

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15
Q

What should be done if a patient develops an infection while on 2nd generation cephalosporins?

A

Switch to an alternative agent

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16
Q

3rd generation cephalosporins have a good spectrum in which bacteria?

A
  • Enteric GNRs

- Streptococcus

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17
Q

Which 3rd generation has a good spectrum over pseudomonas?

A

Ceftazidime

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18
Q

Which 3rd generation cannot be given for streptococcus infections?

A

Ceftazidime

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19
Q

Which 3rd generation cephalosporins consist of the N-MTT side chain?

A

Cefpodoxime

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20
Q

Which 3rd generation cephalosporin causes hyperbilirubinemia and biliary sludging in neonates?

21
Q

Which 3rd generation cephalosporin should be used in neonates instead of ceftriaxone?

22
Q

Ceftazidime lacks activity against which bacteria?

23
Q

Ceftriaxone and cefotaxime can be useful in?

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A

Meningitis - excellent CNS penetration

24
Q

Which 3rd generation does not need to be renally adjusted because it is eliminated by dual modes (renal and biliary)?

25
3rd generation cephalosporins are mainly utilized for?
- LRTIs - Pyelonephritis - Nosocomial infections - Lyme disease - Meningitis - Skin/soft tissue infections - Febrile neutropenia - Gonorrhea
26
Which 3rd gen cephalosporin should be given for nosocomial infections?
Ceftazidime
27
Which 3rd gen cephalosporin should be given for Lyme disease?
Ceftriaxone
28
Which 3rd gen cephalosporin should be given for febrile neutropenia and nosocomial infections?
Ceftazidime
29
(T/F) - Ceftriaxone is a once-daily drug for every indication
FALSE - not for meningitis
30
Ceftriaxone dose for meningitis is?
2 g IV q 12 h dose
31
4th generation cephalosporins have a good spectrum in which bacteria?
- Pseudomonas - Streptococci - Enteric GNRs - MSSA
32
4th generation cephalosporins are a good empiric choice for which indication(s)?
Nosocomial infections
33
What's nonbeneficial of giving 4th generation cephalosporins for nosocomial infections? How could it be prevented?
They can overkill community acquired infections. Deescalate if possible
34
4th generation cephalosporins are mainly utilized for?
- Febrile neutropenia | - Nosocomial infections
35
What is the primary use for 4th generation cephalosporins?
Nosocomial infections
36
5th generation cephalosporins have a good spectrum in which bacteria?
- MRSA - MSSA - Streptococci - Enteric GNRs
37
What are the main utilizations for 5th generation cephalosporins?
- CAP | - Skin/soft tissue infections
38
(T/F) - Ceftaroline (5th gen) has a greater activity against Gram (-) compared to cefepime (4th gen)
FALSE - 4th gen has greater activity than 5th gen especially in pseudomonas
39
6th generation cephalosporins have a good spectrum in which bacteria?
- GNRs - Pseudomonas - Acinetobacter - Stenotrophomonas - Enterobacteriaceae
40
(T/F) - 6th generation cephalosporins are stable to all classes of the carbapenemase hydrolyzing enzymes
TRUE
41
6th generation cephalosporins are mainly utilized for?
- Complicated UTIs in adults who have limited or no other Tx options
42
(T/F) - 6th generation cephalosporins have a gram (-) coverage only, so it's best to reserve in patients with no other options of MDR GNRs
TRUE
43
Cephalosporin/beta-lactamase inhibitors have a good spectrum in which bacteria?
- Pseudomonas | - Enteric GNRs
44
Which cephalosporin/beta-lactamase inhibitor has greater activity for enteric GNRs?
Ceftazidime/avibactam
45
Which cephalosporin/beta-lactamase inhibitor is active against carbapenem-resistant Klebsiella and other carbapenem-resistant enterobacteriaceae infections?
Ceftazidime/avibactam
46
(T/F) - Both cephalosporin/beta-lactamase inhibitor are active against pseudomonas
TRUE
47
What is the main utilization(s) for both cephalosporin/beta-lactamase inhibitor?
- MDR pseudomonas infections - Mixed aerobic/anaerobic infections - Intra-abdominal infections - Infections caused by ESBL-producing organisms
48
If a cephalosporin/beta-lactamase inhibitor is given for intra-abdominal infections, what should be done?
Add metronidazole due to limited anaerobic activity

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