CEPHALOSPORINSIndications | Respiratory, UTI, skin/bone infections, septicemia, gonorrhea, bacterial meningitis | AE | Hypersensitivity, NVD, pain at IM injection site |
1st GENERATION CEPHALOSPORINSCEPHALEXIN | CEFAZOLIN | Only 1st gen parenteral still used Long T½ Surgical prophylaxis, UTI, SSTI |
Act as penicillin G substitutes and have activity against Proteus mirabilis, E. coli, and Klebsiella pneumoniae (PEcK)
2ND GENENRATION CEPHALOSPORINSCEFUROXIME | CEFOXITIN | CEFOTETAN | AE: hypoprothrominemia, disulfiram-like rxns with ethanol | CEFONICID | CEFAMANDOLE | AE: hypoprothrominemia, disulfiram-like rxns with ethanol |
Indication: community-acquired infections of the respiratory tract (H. influenzae, Moraxella catarrhalis, S. pneumoniae) and UTI (Escherichia coli)
3RD GENERATION CEPHALOSPORINICEFIXIME | Useful activity against B. fragilis | CEFDINIR | Useful activity against B. fragilis | CEFTAZIDIME | CEFOXATIME | CEFTRIAXONE | Penetrate CNS and used to treat meningitis caused by gram-negative rods except L. monocytogenes Indication: Useful activity genital, anal, and pharyngeal penicillin-resistant N. gonorrhoeae | CEFOTAXIME | Penetrate CNS and used to treat meningitis caused by gram-negative rods except L. monocytogenes | CEFOPERAZONE | AE: hypoprothrominemia, disulfiram-like rxns with ethanol |
Indications: Hospital-acquired gram-negative bacteremia
| | 4TH GENERATION CEPHALOSPORINCEFIPIME | Only one in the US, penetrates CNS |
5TH GENERATION CEPHALOSPORINCEFTAROLINE | CEFTOBIPROLE | metabolized in plasma, majority excreted in urine |
CARBAPENEMSDORIPENEM | IMIPINEM-CILASTIN | Inactivated by dehydropeptidases in renal tubes | MEROPENEM | Greater activity against gram negative aerobes and less activity against gram positives compared to imipenem | ERTAPENEM |
Indications : infections resistant to other drugs, enterbacter infections, extended spectrum B lactam producing gram negatives
PK: penetrates CNS, cleared by kidney
MONOBACTAMSAZTREONAM | Indications: pts allergic to penicillins and/or cephalosporins to treat pneumonia, meningitis, and sepsis, penetrates CNS |
No activity against gram-positive organisms
BACITRACIN (topical)MOA | Inhibits cell wall formation by interference with the dephosphorylation of the C55-isoprenyl pyrophosphate, a molecule that carries the building-blocks of the peptidoglycan bacterial cell wall | Indications | Highly nephrotoxic when administered systemically and is thus used topically for gram positive cocci and bacilli skin infections |
CYCLOSERINEMOA | Structural analog of D-alanine and inhibits the incorporation of D-alanine into peptidoglycan pentapeptide chain | Indications | Treats tuberculosis | Toxicity | Serious dose-related CNS toxicity |
GLYCOPEPTIDESVANCOMYCIN | Resistance in enterococci develops due to modification in binding site (D-ala-D-ala D-lactate) and increased numbers of D-ala-D-ala residues (S. aureus) Effective against gram positive producing lactamases and those resistant to nafcillin and methacillin (MRSA, MRSE) or allergic to penicillin or cephalosporin Indications: infections caused by MRSA (sepsis, endocarditis), penicillin-resistant enterococci, individuals with prosthetic heart valve, oral administration of antibiotic induced colitis due to C. diff SE: fever, chills, phlebitis | VANCO + GENT | Use: enterococcal endocarditis (penicillin allergy) | VANCO + CEFTRIAXONE VANCO + CEFOTAXIME VANCO + RIFAMPIN | Use: meningitis (penicillin-resistant strain of pneuomococcus | TELAVANCIN | Two mechanisms of action; first is the same as vancomycin and the second is it disrupts the bacterial cell membrane potential and increases membrane permeability t1/2 is 8 hours allowing for daily dosing Teratogenic | DAPTOMYCIN | Long half life of 6-11 days allows for weekly dosing Methicillin-susceptible and methicillin-resistant Streptococcus pneumoniae, Streptococcus pyogenes, Corynebacterium jeikeium, E. faecalis and E. faecium (including VRE) Indications: skin infections and bacteremia caused by S. aureus AE: constipation, nausea, HA, insomnia | FOSFOMYCIN | MOA: inhibits UDP-N acetylglucosamine 3-Enolpyruvte transferase Indications: UTI |
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