By the of this lecture the student will be able to: Describe the mode of action of cephalosporins Differentiate the spectrum of activity of the 4 classes of cephalosporins State the side effects & therapeutic uses of cephalosporins Describe the mechanism of action of vancomycin
Cephalosporins
Cephalosporins:Mechanism of action
Cephalosporins inhibit the peptidoglycan synthesis of bacterial cell wall in a manner similar to that of penicillin and are considered bactericidal.
Cephalosporins: Generations
- First-generation cephalosporins - Second-generation cephalosporins - Third-generation cephalosporins - Fouth-generation cephalosporins
In general, 1st generation cephalosporins have better activity against gram-positive bacteria and less gram-negative activity, while 3rd generation agents, with a few exceptions, have better gram-negative activity and less gram-positive activity. The fourth generation agent has both gram-positive and gram-negative activity. Elimination is primarily via the kidneys, though a few exceptions include ceftriaxone which have significant biliary elimination 6
10
Ceftriaxone One of the broadest spectrum cephalosporins high activity against G- bacteria. low activity against G+ bacteria. The highest resistance to -lactamase.
11
12
15
16
Cephalosporins
NB: Patients with history of penicillin allergy may tolerate cephalosporins. But patients with history of anaphylaxis should never receive cephalosporins Non of the cephalosporins is active against MRSA.
17
Vancomycin
It is active only against gram-positive bacteria especially staphylococci. Vancomycin inhibits synthesis of bacterial cell wall phospholipids as well as peptidoglycan polymerization .
22