antibiotics - cephalosporin classification.ppt

classification of cephalosporin

1. Cephalosporin Classification
Cephalosporins may be classified by
their antimicrobial spectrum into four
generations
or
Some divide cephalosporins in seven
groups
ACTA FAC. MED. NAISS. 2003; 20 (2): 131-136

2. Cephalosporin Classification
•Thefirstgenerationcephalosporinshavegoodactivityagainst
gram-positivebacteriaandrelativelymodestactivityagainst
gram-negativebacteria.Streptococciandpneumococciare
susceptible.SomespeciesofStaphylococciaresensitivetothis
generation,butnotmethicillin-resistantS.aureusandS.
epidermidis.Enterococciareresistanttoo.Activityagainst
Moraxellacatarrhalis,E.coli,K.pneumoniaeandP.mirabilis
isgood.Mostoralcavityanaerobesaresensitive.
•Thesecondgenerationcephalosporinshaveincreasedactivity
againstgram-negativebacteria,butarelessactivethanthird-
generationagents.Cefoxitin,cefotetanandcefmetazoleare
activeaswellagainstB.fragilisgroup.

3. Cephalosporin Classification
•Thethirdgenerationcephalosporinsaregenerallylessactive
thanfirst-generationagentsagainstgram-positivecocci,but
theyaremuchmoreactiveagainstEnterobacteriaceae,
includingb-lactamase-producingstrains
•CeftazidimeandcefoperazoneareactiveagainstP.aeruginosa,
butlessactivethantherestthird-generationagentsagainst
gram-positivecocci.
•Thefourthgenerationcephalosporinssuchascefepimeand
cefpiromhaveanextendedspectrumofactivitycomparedto
thethird-generationandhaveincreasedstabilitytob-
lactamase-producingbacteria

4. Cephalosporin Classification
Generation Oral Parenteral
I cephalexin cefamezin
II cefaclor cefamandole
III ceftibuten
cefpodoxime
cefixime
cefotaxime
cefoperazone
ceftriaxone
ceftazidime
IV cefepime
cefpirome

5. Cephalosporin Classification
Group 1
(I-P)
Group 2
(I-O)
Group 3
(II-P)
Group 4
(III-P)
Cephaloridine
Cephalothin
Cephapirin
Cefazolin
Ceforanide
Cefadroxil
Cefaclor
Cephalexin
Cephradine
Loracarbef
Cefamandole
Cefoxitin
Cefonicid
Cefotetan
Cefuroxime
Cefotaxime
Ceftizoxime
Ceftriaxone

6. Cephalosporin Classification
Group 5
(III-O)
Group 6
(III-P)
Group 7
(IV-P)
Cefixime
Cefpodoxime
Cefprozil
Ceftibuten
Cephoperazone
Cefsulodin
Ceftazidime
Cefepime
Cefpirome

7. Cephalosporin Classification
•First generation:
–Group 1: cephalosporins for parenteral administration with
moderate antibacterial activity and resistance to
Staphylococci b-lactamases; hydrolyzed by a large number
of Enterobacterial b-lactamases.
–Group 2: cephalosporins for oral administration with
moderate antibacterial activity and resistance to
Staphylococci b-lactamases; moderately resistant to some
Enterobacterial b-lactamases.
•Second generation:
–Group 3: cephalosporins for parenteral administration with
moderate antibacterial activity and resistant to most b-
lactamases.

8. Cephalosporin Classification
•Third generation:
–Group 4: cephalosporins for parenteral
administration with increased antibacterial activity
and resistant to most b-lactamases.
–Group 5: cephalosporins for oral administration
with increased antibacterial activity and resistant to
most b-lactamases.
–Group 6: cephalosporins for parenteral
administration active against Pseudomonas
aeruginosa and resistant to most b-lactamases.

9. Cephalosporin Classification
•Fourth generation:
–Group 7: cephalosporins for parenteral
administration with increased antibacterial activity
against Enterobacteria, moderate activity against
Pseudomonas aeruginosa, stable to hydrolysis by
most b-lactamases and with enhanced anti
staphylococcal activity.