Cephalosporins: Generations and Indications
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Questions and Answers

What is a specific indication for the use of Amidinopenicillins?

  • Pseudomonas infections
  • MRSA infections
  • Pneumonia
  • Urinary Tract Infections (UTI) (correct)

    • Which bacterium is not affected by Cephalosporins?

  • Enterococci (correct)
  • E. coli
  • Klebsiella
  • Moraxella

    • Which adverse reaction to antibiotics can cause fever, myalgias, and flushing?

  • Tubulointerstitial nephritis
  • Anaphylaxis
  • Herxheimer reaction (correct)
  • Seizures

    • Which Cephalosporin is effective against Pseudomonas?

    <p>Ceftazidime</p> Signup and view all the answers

    What is a common adverse reaction to Amoxicillin-Clavulanic acid?

    <p>Cholestatic jaundice</p> Signup and view all the answers

    Which generation of Cephalosporins includes Ceftriaxone?

    <p>3rd generation</p> Signup and view all the answers

    What is Cefazolin IV commonly used for?

    <p>Surgical prophylaxis</p> Signup and view all the answers

    Which of the following is a side effect of prolonged treatment with Ceftriaxone?

    <p>Biliary sludge</p> Signup and view all the answers

    What percentage of patients that developed an allergic reaction to a Penicillin are also allergic to Cephalosporins?

    <p>10%</p> Signup and view all the answers

    What is Cefuroxime IV/PO commonly used for?

    <p>Meningitis and respiratory infections</p> Signup and view all the answers

    What is Cephalexin commonly used for?

    <p>Urinary infections in penicillin-allergic patients</p> Signup and view all the answers

    Which of the following is a contraindication for Cephalosporins?

    <p>Penicillin allergy</p> Signup and view all the answers

    What is Ceftriaxone commonly used for?

    <p>Severe intraabdominal and urinary infections</p> Signup and view all the answers

    Which generation of Cephalosporins includes Cefepime?

    <p>4th generation</p> Signup and view all the answers

    What is a common indication for the use of Carbapenems?

    <p>Severe ESBL-producing GNB infections</p> Signup and view all the answers

    Which of the following is NOT a mechanism of action of Carbapenems?

    <p>Binds to PBP3</p> Signup and view all the answers

    What is a common adverse reaction of Carbapenems?

    <p>Nausea, vomiting, diarrhea</p> Signup and view all the answers

    Which of the following is a Cephalosporin + Beta-lactamase inhibitor combination?

    <p>Ceftazidime + Avibactam</p> Signup and view all the answers

    What is the mechanism of action of Monobactams?

    <p>Binds to PBP3</p> Signup and view all the answers

    Which of the following is a Glycopeptide?

    <p>Teicoplanin</p> Signup and view all the answers

    What is the mechanism of action of Glycopeptides?

    <p>Binds to cell wall peptides</p> Signup and view all the answers

    Which of the following is an indication for the use of Aztreonam?

    <p>Inhalations in patients with bronchiectases colonized by Pseudomonas aeruginosa</p> Signup and view all the answers

    What is the spectrum of activity of Carbapenems?

    <p>Ultralarge spectrum, active against most Gram-positive and Gram-negative bacteria</p> Signup and view all the answers

    What is a common adverse reaction of Imipenem and Ertapenem?

    <p>Seizures</p> Signup and view all the answers

    Study Notes

    Cephalosporins

    • Cephalosporins are classified into five generations: 1st, 2nd, 3rd, 4th, and 5th.
    • Each generation has its specific spectrum and indications.
    • Examples of cephalosporins include Cefazolin, Cephalexin, Cefadroxil, Cefuroxime, Ceftriaxone, and Ceftobiprole.

    Indications

    • Cephalosporins are used for surgical prophylaxis, intraabdominal infections, urinary infections, respiratory infections, and meningitis.
    • 1st generation cephalosporins are used for surgical prophylaxis and ENT infections.
    • 2nd generation cephalosporins are used for intraabdominal infections and urinary infections.
    • 3rd generation cephalosporins are used for meningitis, respiratory infections, and urinary infections.
    • 4th generation cephalosporins are used for severe intraabdominal infections, CNS infections, and urinary infections.
    • 5th generation cephalosporins are used for community-acquired pneumonia and severe MRSA infections.

    Adverse Reactions

    • Cephalosporins have similar adverse reactions to penicillins.
    • High risk of C. difficile infection.
    • Biliary sludge can occur with prolonged treatment with ceftriaxone.
    • Only 10% of patients with a penicillin allergy are also allergic to cephalosporins.

    Penicillins

    • Adverse reactions include hypersensitivity, seizures, tubulointerstitial nephritis, cholestatic jaundice, and Herxheimer reaction.
    • Herxheimer reaction occurs within the first 2 hours of antibiotic therapy and resolves after 24-36 hours.

    Cephalosporins - Black Sheep

    • Enterococci, Listeria, Clostridioides difficile, and atypical bacteria are not covered by cephalosporins.
    • MRSA is not covered by cephalosporins except for the 5th generation.

    Carbapenems

    • Representatives include Imipenem, Meropenem, Ertapenem, and Doripenem.
    • Ultralarge spectrum, but do not cover MRSA, Ampicillin-Resistant Enterococci, Cl. difficile, and Stenotrophomonas maltophilia.
    • Indications include severe ESBL-producing GNB infections, hospital-acquired infections, and empirical treatment of febrile neutropenia and immunocompromised patients.
    • Adverse reactions include seizures, nausea, vomiting, diarrhea, hepatic cytolysis, and C. difficile infection.

    Beta-Lactam + Beta-Lactamase Inhibitor

    • Representatives include Amoxicillin + Clavulanic acid, Ceftolozane + Tazobactam, and Ceftazidime + Avibactam.
    • Indications include ABP, UTI, ENT and respiratory infections, and intraabdominal infections with KPC/OXA-48-producing bacteria.

    Monobactams

    • Representative: Aztreonam.
    • Mechanism of action: binds to PBP3.
    • Spectrum: MDR GNB (even MBL-producing bacteria).
    • Indications: severe infections with MDR GNB sensitive to Aztreonam and inhalations in patients with bronchiectases colonized by Pseudomonas aeruginosa.

    Glycopeptides

    • Representatives: Vancomycin and Teicoplanin.
    • Mechanism of action: binds to cell wall peptides D-ala termination preventing their cross-linking into the peptidoglycan form.
    • FDA pregnancy category: B for Vancomycin PO and C for Vancomycin IV.

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    Description

    This quiz covers the different generations of cephalosporins, their indications, and administration routes. Learn about the various types of cephalosporins and their uses.

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