Cephalosporins cefepime

Fourth-generation cephalosporins (cefepime and cefpirome) are active with respect to a broad spectrum of Gram-positive and Gram-negative aerobes. They have an unusually low affinity with beta-lactamase and the ability to quickly pass through the periplasmatic space. 

First-generation cephalosporins cefazolin for parenteral administration cefadroxil or cephalexin for oral administration. Second-generation cephalosporins cefuroxime for parenteral administration cefaclor, cefuroxime axetil, cefprozil, for oral administration. Third-generation cephalosporins ceftazidime, cefotaxime, ceftriaxone for parenteral administration cefixime, cefpodoxime, ceftibuten, cefdinir, cefditoren for oral administration. Fourth-generation cephalosporin cefepime for parenteral administration. Cephamycins cefoxitin and cefotetan for parenteral administration. 

Fourth-Generation Cephalosporins. The fourth-generation cephalosporin, cefepime, has an extended spectrum of activity against both gram-positive (e.g., methicillin-sensitive S. aureus) and gram-negative organisms (e.g.. Pseudomonas). 

At least four different types of empirical parenteral antibiotic regimens are in use (1) monotherapy with an antipseudomonal cephalosporin (cefepime or ceftazidime) or antipseudomonal car-bapenem (imipenem-cilastatin or meropenem), (2) combination therapy with an aminoglycoside plus an antipseudomonal penicillin (piperacillin-tazobactam or ticarciUin-clavulate), an antipseudomonal cephalosporin, or an antipseudomonal carbapenem, (3) vancomycin plus an antipseudomonal cephalosporin or antipseudomonal carbapenem, with or without an aminoglycoside, and (4) a fluoroquinolone (ciprofloxacin or levofloxacin) in combination with an... 

ANTTBIOTTCS - BETA-LACTAMS - CEPHALOSPORINS] (Vol 3) Cefepime (BMY28142) [88040-23-7]... 

Approximately 30% to 40% of H. influenzae are ampicillin resistant. For this reason, many clinicians use a third-generation cephalosporin (cefotaxime or ceftriaxone) for initial antimicrobial therapy. Once bacterial susceptibilities are available, ampicillin may be used if the isolate proves ampicillin sensitive. Cefepime and fluoroquinolones are suitable alternatives regardless of /1-lactamase activity. 

Third-generation cephalosporin ceftriaxone, cefotaxime, cefepime. Note that cephalosporins are not active against Listeria. cCarbapenem imipenem-cilastatin, meropenem. 

Cefepime Cefepime, 6/ -[6a,7j3(Z)] -l-[(7- [(2-amino-4-thiazolyl)-(methoxyimino) acetyl]-amino -2-carboxy-8-oxo-5-thia-l-(azabicyclo[4.2.0]oct-2-en-3-yl)methyl-l-methyllpyrrolidine chloride (32.1.2.99), is synthesized by a combination of methods described for the synthesis of third-generation cephalosporins, in particular, cefaloridin (32.1.2.79) and ceftazidime (32.1.2.82) [174-196]. 

Fourth-generation cephalosporins were developed such as cefpirome and cefepime with additional activity against gram negative pathogens and greater stability against beta-lactamases. 

The cephalosporins distribute in satisfactory concentrations to most tissues except the central nervous system. Only cefepime, cefuroxime (Zinacef), cefotaxime (Claforan), ceftriaxone Rocephin), and ceftazidime (Eortaz) achieve therapeutic concentrations in cerebrospinal fluid. Cefotaxime and ceftriaxone are antibiotics of first choice for the empirical treatment of brain abscess and meningitis. 

Enterobacter species Urinary tract and other infections Aztreonam, imipenem, meropenem, or cefepime + an aminoglycoside Ciprofloxacin trimethoprim-sulfamethoxazole 3rd generation cephalosporin... 

It has also been reported that patients with allergic-like events after penicillin treatment have had a markedly risk of events after subsequent cephalosporin antibiotics. Cross-reactivity is not an adequate explanation for this increased risk and the data obtained indicate that cephalosporins can be considered for patients with penicillin allergy <2006MI354.ell>. Comparisons of parenteral broad-spectrum cephalosporins have been tested against bacteria isolated from pediatric patients. The results have indicated that cefepime has been the most broad-spectrum cephalosporin analyzed and it is a very potent alternative for the treatment of contemporary pediatric infections in North America <2007MI109>. The historical safety of the most commonly used oral cephalosporins has been reviewed <2007MIS67>. The antimicrobial spectrum and in vitro potency of the most frequently prescribed orally administered cephalosporins (cefaclor, cefdinir, cefpodoxime, cefprozil, cefuroxime axetil and cephalexin has also been reviewed <2007MIS5>. 

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