cephalosporin

Introduction

Contain a 6-member dihyrothiazine ring rather than a five member thiazolidine ring of penicillins. Allergic cross reactivity between penicillins & 1st generation cephalosporins is reported to be 3-7%; however, this may largely represent mislabeling of patients not truely allergic to penicillin. (see drug allergy)

Indications

• treatment of bacterial infections due to susceptible organisms
  • skin or soft tissue infection
    • impetigo
    • cellulitis
    • ecthyma gangrenosum
    • diabetic foot infection
  • lower respiratory tract infection
    • bronchitis
    • pneumonia
      • ventilator-associated pneumonia
    • pulmonary abscess
  • upper respiratory tract infection
    • pharyngitis
    • tonsillitis
  • acute otitis media
  • intra-abdominal infection
    • abdominal abscess
    • cholangitis
    • bacterial peritonitis
  • CNS infection
    • bacterial meningitis
  • sepsis
  • endocarditis
  • urogenital infection
    • urinary tract infection
      • chronic pyelonephritis
    • cervicitis
    • pelvic inflammatory disease
    • chancroid
  • infectious arthritis, osteomyelitis
  • Lyme disease
  • proctitis
  • ophthalmia neonatorum
  • meliodosis
  • infection in patients with cystic fibrosis
• prophylaxis for perioperative infection
  • gastrointestinal surgery
  • prosthetic arthroplasty
  • transurethral resection of the prostate
  • hysterectomy
  • cesarean section
  • open heart surgery
• prophylaxis for bacterial endocarditis
• empiric treatment for febrile neutropenia
• empiric treatment for fever of unknown origin

Antimicrobial activity

Gram postivie

• Streptococcus
• Staphylococcus aureus (methicillin-sensitive)
• no activity against methicillin-resistant Staphylococcus

gram-negative

• Haemophilus
  • Haemophilus parainfluenzae
  • Haemophilus parainfluenzae
  • Haemophilus parahemolyticus
• Salmonella
• Providencia
• Morganella morganii
• Moraxella catarrhalis
• Neisseria meningitidis
• Neisseria gonorrhoeae
• Pseudomonas aeruginosa
• Proteus mirabilis
• Yersinia enterocolita
• Yersinia pseudotuberculosis
• Citrobacter
• Klebsiella
  • Klebsiella pneumoniae
• Enterobacter
• Escherichia coli
• Proteus
• Serratia

Anaerobes

• Bacteroides fragilis
• Peptococcus
• Peptostreptococcus
• Clostridium
• Bacteroides
• Fusobacterium Enterococcus

Adverse effects

• Stevens-Johnson syndrome
• erythema multiforme
• toxic epidermal necrolysis
• renal dysfunction
• toxic nephropathy
• aplastic anemia
• hemolytic anemia
• hemorrhage
• cholestasis
• pancytopenia
• seizures

• drug adverse effects of cephalosporins

More general terms

• beta-lactam antibiotic

More specific terms

• cefiderocol (Fetroja)
• cefovecin (Convenia)
• cephalosporin, 1st generation
• cephalosporin, 2nd generation
• cephalosporin, 3rd generation
• cephalosporin, 4th generation
• cephalosporin, 5th generation

Additional terms

• type B drug reaction; drug-induced hypersensitivity syndrome; drug rash with eosinophilia & systemic symptoms (DIHS, DRESS)

Database

• Kegg: http://www.genome.jp/dbget-bin/www_bget?