j******e
发帖数: 50 | 1 目前就做了这些和大家分享一下，还没有写到ceftaroline，大家有没有补充的呀
First Generation Cephalosporins
• best activity against gram positive aerobes, with limited
activity against gram negative aerobes
• Gram-positive: MSSA, penicillin susceptible, S.pneumoniae, group
streptococci, viridan streptococci
• Gram-netagive: E.coli, K.pneumoniae, p.mirabilis
Second Generation Cephalosporins
• slightly less active against gram-positive aerobes, but more
active against gram negative aerobes
• Gram positive: MSSA, pen-susp S.pneumoniase, Group Streptococci,
Viridans Streptococci
• Gram negative: E.coli, K.pneumoniae, P.mirabilis, H.influenzae, M
catarrhalis, Neisseria spp
Third Generation Cephalosporins
• Less active against gram positive aerobes, but have greater
activity against gram negative aerobes
• Ceftriaxone and Cefotaxime have the best activity against gram-
positive aerobes including penicillin resisitant S.pneumoniae
• Strong inducers of ESBL production
• Gram negative aerobes: E.coli, P.mirabilis, M.catarrhalis, N.
meningitis, Citrobacter spp, Acinetobacter sp, serratia marcescens, K.
pneumoniae, H.influenzae, N.gonorrhea, enterobacter spp, morganella morganii
, providential
• only ceftazidime covers pseudomonas aeruginosa
Fourth Generation cephalosporins
• extended spectrum of activity
• Gram positive: similar to ceftriaxone
• Gram negative: similar to ceftazidime including pseudomonas
aeruginosa also covers beta-lactamase producing enterobacter spp
• stable against B-lactamase, poor inducers of ESBLs
IV to PO conversion-cephalosporins
• cefazolin to cephalexin: cheapest price and good palatability but
QID dosing may compromise compliance
• Cefoxitin to cefuroxime axetil+metronidazole
• Ceftriaxone or cefotaxime to cefdinir or cefixime
• Ceftazidime or cefepime to: treating pseudomonas? if Yes,
ciprofoxaxin, if not, cefdinir | l******k
发帖数: 27533 | 2 赞美！
单独记下哪两个有anaerobes,哪两个有pseudomonas coverage会比较好
Institutional antibiogram指导灵活运用
Ceftaroline很直接呀，skin soft tissue MRSA infection. Ongoing clinical trial
for pneumonia indication. 一般病人fail or can not vancomycin才用这个，太贵
啦！
group
★ 发自iPhone App: ChineseWeb 8.7
【在 j******e 的大作中提到】
: 目前就做了这些和大家分享一下，还没有写到ceftaroline，大家有没有补充的呀
: First Generation Cephalosporins
: • best activity against gram positive aerobes, with limited
: activity against gram negative aerobes
: • Gram-positive: MSSA, penicillin susceptible, S.pneumoniae, group
: streptococci, viridan streptococci
: • Gram-netagive: E.coli, K.pneumoniae, p.mirabilis
: Second Generation Cephalosporins
: • slightly less active against gram-positive aerobes, but more
: active against gram negative aerobes
| j******e
发帖数: 50 | 3 so from first generation to third generation cephalosporin, decrease in
activity against gram positive, but increase in activity against gram
negative,
only ceftazidime and cefepime have activity against pseudomonas
ceftaroline: SSSI MRSA
Anaerobic coverage: cefepime?
trial
【在 l******k 的大作中提到】
: 赞美！
: 单独记下哪两个有anaerobes,哪两个有pseudomonas coverage会比较好
: Institutional antibiogram指导灵活运用
: Ceftaroline很直接呀，skin soft tissue MRSA infection. Ongoing clinical trial
: for pneumonia indication. 一般病人fail or can not vancomycin才用这个，太贵
: 啦！
:
:
: group
: ★ 发自iPhone App: ChineseWeb 8.7
| l******k
发帖数: 27533 | 4 anaerobic coverage 是cefotetan and cefoxitin 吧
【在 j******e 的大作中提到】
: so from first generation to third generation cephalosporin, decrease in
: activity against gram positive, but increase in activity against gram
: negative,
: only ceftazidime and cefepime have activity against pseudomonas
: ceftaroline: SSSI MRSA
: Anaerobic coverage: cefepime?
:
: trial
| j******e
发帖数: 50 | 5 师姐好强哦。我自己都写下来了还是不记得。。
cefotetan and cefoxitin are the only two has anaerobic coverage
cefepime is the only one has pseudomonas coverage...
【在 l******k 的大作中提到】
: anaerobic coverage 是cefotetan and cefoxitin 吧
| l******k
发帖数: 27533 | 6 没有没有啦
真正的ID大牛师姐在版面，我这是碰巧记得而已。。。
【在 j******e 的大作中提到】
: 师姐好强哦。我自己都写下来了还是不记得。。
: cefotetan and cefoxitin are the only two has anaerobic coverage
: cefepime is the only one has pseudomonas coverage...
| a*****8
发帖数: 2115 | 7 anaerobic coverage: cefoxitin and cefotetan. However, resistance towards
cefotetan had increased through out the years. So usually cefoxitin would be
preferred over cefotetan.
Pseodomonas coverage: ceftazidime and cefepime.
Another important thing to remember about cephalosporin is they DO NOT have
enterococcus coverage (like VRE). But if you want to go into more depth that
ceftriaxone have been used as synergistic agent with ampicillin or dapto in
treating enterococcus bacteremia or endocarditis.
1st: Cephalexin (PO), Cefazolin (IM, IV)
Spectrum: MSSA, “PEK” organisms (Proteus, E. coli, Klebsiella)
Use: Pneumonia (outpatient), Cellulitis, UTIs
2nd: Cefoxitin (IV), Cefaclor (PO)
Spectrum: MSSA, Streptococcus, anaerobes, “HeNPEK” (Haemophilus, Neisseria
, Proteus, E. coli, Klebsiella)
Use: GI surgical prophylaxis
3rd: Ceftriaxone (IV, IM) Cefixime (PO)
Spectrum: Streptococcus, “HeNPEK M” (Haemophilus, Neisseria, Proteus, E.
coli, Klebsiella and Moraxella)
Use: Meningitis, pneumonia (hospitalized patients)
Ceftazidime (IV)
Spectrum: Pseudomonas, “HeNPEK M”, no gram positive
4th: Cefepime (IV)
Spectrum: Pseudomonas, best gram-negative of cephalosporins, sensitive gram-
positive
Use: All types of infections, empiric coverage
5th: Ceftaroline (IV)
Spectrum: pretty broad including MRSA, no anaerobic coverage
Use: FDA indications including cSSTI and pneumonia. But it also be used off
label in bacteremia, osteo and endocarditis. | a*****8
发帖数: 2115 | 8 Comment: Ceftaroline is actually not that expensive. Maybe slightly
expensive than vanco. Definitely not as expensive as daptomycin.
trial
【在 l******k 的大作中提到】
: 赞美！
: 单独记下哪两个有anaerobes,哪两个有pseudomonas coverage会比较好
: Institutional antibiogram指导灵活运用
: Ceftaroline很直接呀，skin soft tissue MRSA infection. Ongoing clinical trial
: for pneumonia indication. 一般病人fail or can not vancomycin才用这个，太贵
: 啦！
:
:
: group
: ★ 发自iPhone App: ChineseWeb 8.7
| a*****8
发帖数: 2115 | 9 I would not necessary call this as IV to PO. IV to PO is used in drugs that
have 100% bioavailability like levofloxacin, ciproflaxin, flagyl, linezolid
and metronidazole.
This list you have here is potential possible PO options for similar
coverage.
--cefazolin to cephalexin: really have to depend on what are you treating.
if just skin soft tissue infection, maybe. But if it is MSSA bacteremia or
endocarditis, I would never change to cephalexin.
--Depending on your hospital antibiogram, you can not assume your
susceptibilities are similar between ceftazidime or cefepime to
ciprofloxacin. Also levofloxacin also have pseudomonas coverage as well.
group
【在 j******e 的大作中提到】
: 目前就做了这些和大家分享一下，还没有写到ceftaroline，大家有没有补充的呀
: First Generation Cephalosporins
: • best activity against gram positive aerobes, with limited
: activity against gram negative aerobes
: • Gram-positive: MSSA, penicillin susceptible, S.pneumoniae, group
: streptococci, viridan streptococci
: • Gram-netagive: E.coli, K.pneumoniae, p.mirabilis
: Second Generation Cephalosporins
: • slightly less active against gram-positive aerobes, but more
: active against gram negative aerobes
| l******k
发帖数: 27533 | 10 笔记记下！谢谢师姐！
be
have
that
in
【在 a*****8 的大作中提到】
: anaerobic coverage: cefoxitin and cefotetan. However, resistance towards
: cefotetan had increased through out the years. So usually cefoxitin would be
: preferred over cefotetan.
: Pseodomonas coverage: ceftazidime and cefepime.
: Another important thing to remember about cephalosporin is they DO NOT have
: enterococcus coverage (like VRE). But if you want to go into more depth that
: ceftriaxone have been used as synergistic agent with ampicillin or dapto in
: treating enterococcus bacteremia or endocarditis.
: 1st: Cephalexin (PO), Cefazolin (IM, IV)
: Spectrum: MSSA, “PEK” organisms (Proteus, E. coli, Klebsiella)
| a*****8
发帖数: 2115 | 11
group
【在 j******e 的大作中提到】
: 目前就做了这些和大家分享一下，还没有写到ceftaroline，大家有没有补充的呀
: First Generation Cephalosporins
: • best activity against gram positive aerobes, with limited
: activity against gram negative aerobes
: • Gram-positive: MSSA, penicillin susceptible, S.pneumoniae, group
: streptococci, viridan streptococci
: • Gram-netagive: E.coli, K.pneumoniae, p.mirabilis
: Second Generation Cephalosporins
: • slightly less active against gram-positive aerobes, but more
: active against gram negative aerobes
| u*******s
发帖数: 688 | 12 mark！认真复习一下:)
be
have
that
in
【在 a*****8 的大作中提到】
: anaerobic coverage: cefoxitin and cefotetan. However, resistance towards
: cefotetan had increased through out the years. So usually cefoxitin would be
: preferred over cefotetan.
: Pseodomonas coverage: ceftazidime and cefepime.
: Another important thing to remember about cephalosporin is they DO NOT have
: enterococcus coverage (like VRE). But if you want to go into more depth that
: ceftriaxone have been used as synergistic agent with ampicillin or dapto in
: treating enterococcus bacteremia or endocarditis.
: 1st: Cephalexin (PO), Cefazolin (IM, IV)
: Spectrum: MSSA, “PEK” organisms (Proteus, E. coli, Klebsiella)
| j******e
发帖数: 50 | |
|
