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Ceftriaxone (Rocephin)
Ceftazidime (Fortaz)
Ceftaxime (Claforan)
Cefdinir (Omnicef)
Cefditoren (Pivoxil)
Cefixime (Suprax)
Cefpodoxime (Vantin)
What are the 3rd generation cephalosporins?
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Ceftriaxone (Rocephin)
Cefotaxime (Claforan)
Ceftazidime (Fortaz)
What are the IV 3rd generation cephalosporins?
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Loose Staph activity
As you ascend the cephalosporin generations, what change in spectrum occurs?
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G-
Are G+ or G – the primary target for 3rd generation cephalosporins?
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G+: Group A strep, S. penumoniae, Peptostreptococci (4), S. aureus (4)
G-: H. flu, N. gon, e. coli, K. pneumonia (4)
What is the spectrum for 3rd generation cephalosporins (charts)?
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No
Do 3rd generation cephalosporins have good anaerobic activity?
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Less S. aureus and peptostreptococcus (4 vs 8)Better H. flu and N. gonSome pseudomonas (8)Some S. marcescenes (4)
Ceftazidime (3rd gen cephalosporin) compare to ceftriaxone in terms of spectrum in what ways?
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CefdinirCefditorenCefiximeCefpodoxime
What are the PO 3rd generation cephalosporins?
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Community and nosocomial infx (meningitis, pneumonia, cellulitis, sinusitis, otitis, STD)
What arethe common uses for 3rd generation cephalosporins?
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Ceftriaxone 1-2G IV q 12-24h
Cefotaxime 50-75mg/kg IV q6-12h
Cefdinir 300-600 mg q12-24
Cefditoren 400 mg q12
Cefixime 400 mg q24h
Cefpodoxime 100-200 q12h
What is a normal dose for 3rd generation cephalosporins?
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1-2G IV q 12-24h
What is a normal dose of Ceftriaxone (3rd gen)?
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50-75mg/kg IV q6-12h
What is a normal dose of Cefotaxime (3rd gen)?
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300-600 mg q12-24
What is a normal dose of Cefdinir (3rd gen)?
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400 mg q12
What is a normal dose of Cefditoren (3rd gen)?
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400 mg q24h
What is a normal dose of Cefixime (3rd gen)?
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100-200 q12h
What is a normal dose of Cefpodoxime (3rd gen)?
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175 ug/mL
What is the peak level of Ceftriaxone after 1 gram IV?
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1.6 ug/mL
What is the peak level of Cefdinir after 300 mg PO?
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8 hours
What is the T1/2 of Ceftriaxone?
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1.7 hours
16 with renal insufficiency
What is the T1/2 of Cefdinir?
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Meningitis
What are the 3rd generation cephalosporins used most for?
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Ceftriaxone
You should have to adjust dosing in renal insufficiency for PCNs and Cephalosporins with what exception?
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Biliary sludge formation(30% biliary excretion)
What are the SE for Ceftriaxone?
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Useful for adult meningitis
No adjustment for renal insufficiency
What are the benefits of Ceftriaxone?
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Would you use Ceftazidime for Pseudomonas?
Has been overused, so probably not
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Cefotaxime (3rd gen)
Which cephalosporin is useful for pediatric meningitis?
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Cefepime (Maxipime)
What are the 4th generation cephalosporins?
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G +: MSSA (4), Good Group A strep, S. pneumonia
G-: H. flu, N. gon, E. coli, K. pneumo, E. cloacae, S. marcescenesVery limited pseudomonas (16)
What is the coverage for Cefepime (Maxipime)?
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IV only
By what route is Cefepime (4th gen) given?
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Renaly
How is Cefepime (4th gen) eliminated?
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Neutropenic fever
Pseudomonas infx
Intra-abdominal infx
Meningitis
What are the major uses for Cefepime (4th gen)?
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1-2 grams Q8-12H IV
What is a normal dose for Cefepime (4th gen)?
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Ceftaroline (Tefaro)
What is the 5th generation/Advanced generation cephalospoirin?
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MRSA coverage
1st beta-lactam to have MRSA coverage
Use when patients do not respond well to Vanco
What is the main advantage of Ceftaroline over other cephalosporins?
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MRSA
What is the primary use of Ceftaroline (5th)?
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No, because it is to broad, choose a more narrow spectrum if possible
Would you use Ceftaroline (Teflaro) for gram negative infections?
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G +: MSSA, MRSA, Coagulase negative staph, Group A strep, S. pneumonia
G -: H. flue, N. gon, E. coli, K. pneumon, E. cloacae, S. marcescenes
What is the spectrum (chart) fo ceftaroline?
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IV only
What is the route of administration for ceftaroline (Teflaro)?
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Renally
How is ceftaroline (Teflaro, 5th) eliminated?
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Skin/skin structure infectionsCommunity acquired pnseumonia
What are the FDA approvals for Ceftaroline (Teflaro, 5th)?
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600 mg Q12H IV
What is a normal dose of ceftaroline (Teflaro, 5th)?
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21.3 ug/mL after 600 mg IV
What is the peak level of Ceftaroline?
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2.7
No data for ESRD
What is the T1/2 for ceftaroline?
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Imipenem/Cilastatin (Primaxin)
Meropenem (Merrem)
Doripenem (Doribax)
Ertapenem (Invanz)
What are the carbepenems?
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