Cephalosporins

First generation

Parenteral: Cephalothin,cefazolin
Oral: Cephalexin,cefadroxil,cefaridine
Acts on gram positive cocci

Second generation

Parenteral: Cefuroxime,cefoxitin
Oral: Cefaclor,Cefuroxime

Most active against gram negative organisms

cefuroxime higher CSF concentration

Third generation

Parenteral: Cefotaxime,ceftizoxime,ceftriaxone,ceftazidime,cefoperazone

Oral: Cefixime,Cefpodoxime,cefdinir

Highly active against gram negative enterobacteriacea

Ceftyazidime and cefoperazone antipseudomonal

ceftazidime+aminoglycoside-TOC for pseudomonas

Forth generation

Parenteral: cefepime,Cefpirome.
No oral agents.

General properties

  1. Cephalosporins excreted primarily by kidney require dose reduction in renal impairment
  2. Cefpiramide,ceftriaxone,cefoperazone excreted predominantly by bile.
  3. Cefotaxime,ceftriaxone,cefepime useful in meningitis(penetrate BBB)
  4. No cephalosporins active against Enterococcus fecalis,MRSA,listeria
  5. Cephaloridine-Most nephrotoxic cephalosporin
  6. Disulfuram like reaction- Cefamandole,cefotetan,cefoperazone.

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