(精选)头孢菌素类抗生素(英文课件)Cephalosporin Antibiotics教学课件.ppt

Cephalosporin Antibiotics;Transition from first generation to third generation agents reflects Broadening of the Gram (-) organism spectrum Loss of efficacy against Gram (+) organisms Greater efficacy against resistant organisms (but increased cost) MOA: Inhibit cell wall synthesis ? osmotically induced cell lysis Usually bactericidal – a function of dosage, organism susceptibility, tissue concentrations, and growth rate Cross allergenicity with penicillins is 5-16% Drug interactions: Alcohol use may produced a disulfiram like reaction - NMTT Aminoglycoside nephrotoxicity can be increased Anticoagulant effects can be potentiated - NMTT Antacids can decrease plasma concentrations of oral agents Loop diuretic nephrotoxicity can be increased Monitor renal function since all are renally excreted Cefoperazone the exception ;Classified by Generations - explosive advances First Generation Epitomized by cefazolin Good activity against Gram(+) Modest Gram(-) activity Second Generation Increased Gram(-) activity Some active against baccillus fragilis (highly resistant anaerobe) Third Generation - cost vs. efficacy “Broad” spectrum with high penicillinase resistance Greater Gram (-) spectrum Less active than G1 against most Gram(+) More active than G1 against enterobacter Fourth Generation - Cefepime Extended range of activity compared to G3 – More Gram (+) Increased stability against b-lactamases VERY useful for Gram(-) strains resistant to G3;Cephalosporin Antibiotics;G1 PO: Cephalexin, Cephradine, Cephadroxil Parenteral: Cefapirin, Cefazolin G2 PO: Cefaclor, Loracarbef, Cefprozil, Cefuroxime Parenteral: Cefmetazole, Cefotetan, Cefonacid, Cefamandol, Cefoxitin G3 PO: Cefpodoxime, Cefixime, Cefdinir, Ceftitbuten Parenteral: Cefotaxime, Ceftizoxime, Ceftriaxone, Ceftazidime, Cefaperazone G4 - Cefepime ;Cephalosporin Deactivation;1st Generation Cephalosporins;1st Generation Cephalosporins;2nd Generation Cephalosporins;2nd Generation Cephalosporins;2nd Generation