What are first generation cephalosporins used for?
- Skin and soft tissue infections owing to S. pyogenes and methicillin-susceptible S.
- Surgical prophylaxis
: A single dose of cefazolin just before surgery is the preferred prophylaxis for procedures in which skin flora are the likely pathogens
What is the use of second generation cephalopsorins?
- For prophylaxis for intestinal anaerobes as in colorectal surgery. (Cefoxitin)
- For ORAL treatment of respiratory tract infections by penicillin resistant S. pneumoniae (e.g. pneumonia and otitis media) SUBOPTIMAL to ampicillin
- To cover facultative anaerobes and gram negative organisms (Cefoxitin and Cefotetan) as in:
- Intra-abdominal infections
- Diabetic foot
Why not use second generation cephalosporins for empirical treatment of pneumonia and meningitis?
Because of their inferior activity against penicillin-resistan Strept. pneumoniae when compared to Ampicillin and 3rd generation cephalosporins.
Based on Goodman and Gilman's