CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early...

27
CEPHALOSPORINS CEPHALOSPORINS Semisynthetic antimicrobial Semisynthetic antimicrobial agents closely related to the agents closely related to the penicillins. penicillins. Commercially available Commercially available cephalosporins contain the 7- cephalosporins contain the 7- amino cephalosporanic acid amino cephalosporanic acid nucleus. nucleus.

TAGS:

Transcript of CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early...

Page 1: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

CEPHALOSPORINSCEPHALOSPORINS

Semisynthetic antimicrobial agents Semisynthetic antimicrobial agents closely related to the penicillins.closely related to the penicillins.

Commercially available Commercially available cephalosporins contain the 7-amino cephalosporins contain the 7-amino cephalosporanic acid nucleus.cephalosporanic acid nucleus.

Page 2: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.
Page 3: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.
Page 4: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

CLASSIFICATION BY CLASSIFICATION BY GENERATIONGENERATION

First Generation Cephalosporins.First Generation Cephalosporins.

Second Generation Cephalosporins.Second Generation Cephalosporins.

Third Generation Cephalosporins.Third Generation Cephalosporins.

Fourth Generation Cephalosporins.Fourth Generation Cephalosporins.

Page 5: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

FIRST GENERATION -FIRST GENERATION -(CEFAZOLIN)(CEFAZOLIN)

Very active vs gram positive cocci.Very active vs gram positive cocci.

Moderate activity against gram Moderate activity against gram negative bacteria.negative bacteria.

Page 6: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

PHARMACOKINETICSPHARMACOKINETICS

Do not penetrate the CNS. Do not penetrate the CNS.

Excretion is via the kidney and dose Excretion is via the kidney and dose adjustments must be made for adjustments must be made for impaired renal function.impaired renal function.

Page 7: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

THERAPEUTIC USESTHERAPEUTIC USES

Parenteral agents are used primarily Parenteral agents are used primarily for prophylaxis in various surgical for prophylaxis in various surgical procedures.procedures.

Oral drugs used for minor staph Oral drugs used for minor staph infections or some polymicrobial infections or some polymicrobial infections.infections.

Page 8: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

THERAPEUTIC USESTHERAPEUTIC USES

Occasionally for gram negative Occasionally for gram negative infections.infections.

Page 9: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

SECOND GENERATION-SECOND GENERATION-(CEFOXITIN)(CEFOXITIN)

Extended gram negative coverage Extended gram negative coverage (less active vs gram positive (less active vs gram positive organisms).organisms).

Page 10: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

PHARMACOKINETICSPHARMACOKINETICS

Several orally and parenterally Several orally and parenterally available (cefoxitin-IV).available (cefoxitin-IV).

Poor penetration into the CNS.Poor penetration into the CNS.

Dosage adjustments must be made Dosage adjustments must be made in renal failure.in renal failure.

Page 11: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

THERAPEUTIC USESTHERAPEUTIC USES

Variety of gram negative infections.Variety of gram negative infections.

Page 12: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

THIRD GENERATION –THIRD GENERATION –Ceftriaxone and ceftazidimeCeftriaxone and ceftazidime

Expanded gram-negative coverage. Expanded gram-negative coverage.

CefoperazoneCefoperazone and and ceftazidime ceftazidime have have excellent activity vs excellent activity vs Pseudomonas.Pseudomonas.

Page 13: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

PHARMACOKINETICSPHARMACOKINETICS

Cross the blood brain barrier well.Cross the blood brain barrier well.

Half-lives and the necessary dosing Half-lives and the necessary dosing intervals vary greatly (ceftriaxone once intervals vary greatly (ceftriaxone once every 24h).every 24h).

Most are excreted by the kidney and Most are excreted by the kidney and require dosage adjustment (cefoperazone require dosage adjustment (cefoperazone and ceftriaxone are exceptions). and ceftriaxone are exceptions).

Page 14: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

THERAPEUTIC USESTHERAPEUTIC USES

A wide variety of serious infections A wide variety of serious infections caused by organisms resistant to caused by organisms resistant to other drugs.other drugs.

• Gonorrhea.Gonorrhea.

• Meningitis.Meningitis.

Page 15: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

THERAPEUTIC USES-THERAPEUTIC USES-CeftazidimeCeftazidime

In neutropenic febrile In neutropenic febrile immunocompromised patients (with immunocompromised patients (with an aminoglycoside).an aminoglycoside).

Page 16: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

FOURTH GENERATION -FOURTH GENERATION -CefepimeCefepime

Similar to the 3Similar to the 3rdrdgen. cpds, but more gen. cpds, but more resistant to hydrolysis by some resistant to hydrolysis by some --lactamases.lactamases.

Page 17: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

PHARMACOKINETICSPHARMACOKINETICS

Good penetration into the CSF.Good penetration into the CSF.

Cleared mainly by the kidneys.Cleared mainly by the kidneys.

Page 18: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

THERAPEUTIC USESTHERAPEUTIC USES

Similar to the third generation Similar to the third generation cephalosporins.cephalosporins.

Page 19: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

DRUG INTERACTIONSDRUG INTERACTIONS

Alcohol- disulfiram effectAlcohol- disulfiram effect

Page 20: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

CEPHALOSPORICEPHALOSPORINN

ANTIBACTERIAL ANTIBACTERIAL ACTIVITYACTIVITY

THERAPEUTIC THERAPEUTIC USESUSES

Cefazolin (1)Cefazolin (1) Streptococci, StaphStreptococci, Staph Gram + Infs.Gram + Infs.

Cefoxitin (2)Cefoxitin (2) Gram – orgs, some Gram – orgs, some Gram + orgs.Gram + orgs.

Variety of Gram – Variety of Gram – infs, mixed infs, mixed aerobic/anaerobic aerobic/anaerobic infs.infs.

CeftriaxoneCeftriaxone

(3a)(3a)

Expanded Gram - Expanded Gram - coveragecoverage

Meningitis, Meningitis, gonorrhea, serious gonorrhea, serious gram- infs.gram- infs.

Cefoperazone Cefoperazone (3b)(3b)

PseudomonasPseudomonas Pseudomonal Infs.Pseudomonal Infs.

Cefepime (4)Cefepime (4) Similar to 3Similar to 3rdrd. Gen. Gen Similar to 3Similar to 3rdrd Gen Gen

COMPARISON OF THE CEPHALOSPORINS.COMPARISON OF THE CEPHALOSPORINS.

Page 21: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

CARBAPENEMSCARBAPENEMS

IMIPENEMIMIPENEM

MeropenemMeropenem

ErtapenemErtapenem

Page 22: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.
Page 23: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

ANTIBACTERIAL SPECTRUMANTIBACTERIAL SPECTRUM

Broadest antimicrobial spectrum of Broadest antimicrobial spectrum of any any lactam antibiotic.lactam antibiotic.

Organisms resistant to other types of Organisms resistant to other types of antibiotics. antibiotics.

Page 24: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

MECHANISM OF ACTIONMECHANISM OF ACTION

Similar to other Similar to other lactams.lactams.

Resistant to hydrolysis by Resistant to hydrolysis by lactamases.lactamases.

Page 25: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

PHARMACOKINETICSPHARMACOKINETICS

Not absorbed orally; usually given IV.Not absorbed orally; usually given IV.

Predominantly excreted by the Predominantly excreted by the kidneys.kidneys.

Hydrolyzed by a renal tubular Hydrolyzed by a renal tubular enzyme (dehydropeptidaseenzyme (dehydropeptidase) ) so given so given combined with cilastatin.combined with cilastatin.

Page 26: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.
Page 27: CEPHALOSPORINS First used clinically in the early 1960’s. First used clinically in the early 1960’s. They have an important role in the modern treatment.

THERAPEUTIC USESTHERAPEUTIC USES

Infections caused by multi-drug Infections caused by multi-drug resistant organisms.resistant organisms.

Serious mixed infections. Serious mixed infections.


Pharmatube antibiotics-3-cephalosporins and other cell wall inhibitors

Pharmatube antibiotics-3-cephalosporins and other cell wall inhibitors

Antibiotics Penicillins Cephalosporins Macrolides Aminoglycosides Sulfonamides Flouroquinolones.

Antibiotics Penicillins Cephalosporins Macrolides Aminoglycosides Sulfonamides Flouroquinolones.

Cephalosporins penems

Cephalosporins penems

SPECTROPHOTOMETRIC DETERMINATION OF CEPHALOSPORINS INPHARMACEUTICAL SAMPLES

SPECTROPHOTOMETRIC DETERMINATION OF CEPHALOSPORINS INPHARMACEUTICAL SAMPLES

PHARMACOECONOMIC ANALYSIS OF CEPHALOSPORINS …

PHARMACOECONOMIC ANALYSIS OF CEPHALOSPORINS …

Cephalosporins & other β lactam antibiotics

Cephalosporins & other β lactam antibiotics

Cephalosporins and Aminoglycosides

Cephalosporins and Aminoglycosides

Beta-lactam antibiotics - Cephalosporins · 1 Beta-lactam antibiotics - Cephalosporins Targets - PBP’s Activity - Cidal - growing organisms (like the penicillins) Principles of

Beta-lactam antibiotics - Cephalosporins · 1 Beta-lactam antibiotics - Cephalosporins Targets - PBP’s Activity - Cidal - growing organisms (like the penicillins) Principles of

Cephalosporins, Resistance in Gram Negative Bacteria

Cephalosporins, Resistance in Gram Negative Bacteria

B. CEPHALOSPORINS - University of Washington

B. CEPHALOSPORINS - University of Washington

Cephalosporins antibiotics

Cephalosporins antibiotics

CEPHALOSPORINS IN VETERINARY MEDICINE

CEPHALOSPORINS IN VETERINARY MEDICINE

Clinical Pharmacokinetics of Penicillins, Cephalosporins ...Clinical Pharmacokinetics of Penicillins, Cephalosporins and Aminoglycosides in the Neonate: A Review Gian Maria Pacifici

Clinical Pharmacokinetics of Penicillins, Cephalosporins ...Clinical Pharmacokinetics of Penicillins, Cephalosporins and Aminoglycosides in the Neonate: A Review Gian Maria Pacifici

Antibiotics(Cephalosporins • FluoroquinolonesTetracyclines)

Antibiotics(Cephalosporins • FluoroquinolonesTetracyclines)

Beta-lactam antibiotics - Cephalosporins · 10/15/2008 1 Beta-lactam antibiotics - Cephalosporins Targets - PBPPBPs’s Activity - Cidal - growing organisms (like the penicillins)

Beta-lactam antibiotics - Cephalosporins · 10/15/2008 1 Beta-lactam antibiotics - Cephalosporins Targets - PBPPBPs’s Activity - Cidal - growing organisms (like the penicillins)

Lecture 7 Chapter 25 Antibacterials: Penicillins & Cephalosporins.

Lecture 7 Chapter 25 Antibacterials: Penicillins & Cephalosporins.

Downstreamprocessing of Cephalosporins and Aspartic acid

Downstreamprocessing of Cephalosporins and Aspartic acid

Cephalosporins 5th generation

Cephalosporins 5th generation

Cephalosporins First Generation Cephalosporins Second Generation Cephalosporins Third Generation Cephalosporins Fourth Generation Cephalosporins.

Cephalosporins First Generation Cephalosporins Second Generation Cephalosporins Third Generation Cephalosporins Fourth Generation Cephalosporins.

Predicting resistance to third generation cephalosporins ... · Predicting resistance to third generation cephalosporins in patients with ... There are several potential risk factors

Predicting resistance to third generation cephalosporins ... · Predicting resistance to third generation cephalosporins in patients with ... There are several potential risk factors