FBMS 4

Cefazolin

1st generation, IV

Cephalexin

1st generation, Keflex, No activating side chain; no metabolic inactivation, PO

Cefadroxil

1st generation, No activating side chain; no metabolic inactivation, PO

Cefuroxime

2nd gener, Ceftin, Z-oxime; strong resistance & steric bulk, IV

Cefoxitin

2nd generation, C-7 methoxy group; Stability to B-lactamase, IV

Cefotetan

2nd generation, C-7 methoxy group; Stability to B-lactamase, clotting difficulties, alcohol intolerance, MTT side chain percipitation, IV

Cefaclor

2nd generation, acid stable, less active GN than other 2nd gens, PO

Cefprozil

2nd generation, more potent than cefaclor especailly against GN

Cefotaxime

3rd generation, aminothiazolyl group broadens spectrum & increase B-lactamase stability, carboxylic acid necessary to make short half life, IV

Ceftizoxime

3rd generation, aminothiazolyl group broadens spectrum & increase B-lactamase stability, IV

Ceftriaxone

3rd generation, aminothiazolyl group broadens spectrum & increase B-lactamase stability, meningitis infections, IV

Ceftazidime

3rd generation, aminothiazolyl group broadens spectrum & increase B-lactamase stability, large oxime strongly inhibits most B-lactamases, more GP than other 3rd gens, unstable to aminoglycosides and vancomycin, IV

Cefixime

3rd generation, poor activity against staphylococci, PO

Ceftibuten

3rd generation, PO

Cefpodoxime proxetil

3rd generation, Prodrug, PO

Cefdinir

3rd generation, Omnicef, PO

Cefditoren Pivoxil

3rd generation, Prodrug, PO

Cefepime

4th generation, Aminothiazolyl, Quaternary N-methylpyrrolidine helps penetraate GN, Used IM and IV against UTI, skin infections, pneumonia and intra-abdominal infections

Ceftaroline

5th generation, Active against MRSA due to activity against “abnormal” PBP-2a and S. pneumoniae against PBP-2x, active against normal PBPs, IV

Imipenem

carbapenem, penetrates porins, stable B-lactamases, Renal dehydropeptidase-1 deactivates; give with cilastatin, treats aerobic GN, anaerobes, S, aureus, can cause seizures, IV

Meropenem

carbapenem, side chain protects from dehydropeptidase-1, less seizure risk, IV

Doripenem

carbapenem, single agent, more active against pseudomonas species, IV

Ertapenem

carbapenem, used for serious GN infections, IV

Aztreonam

monobactam, synthetic, GN, strong binding to PBP-3, GN infections, IV

Erythromycins

macrolide, Ethylsuccinate prodrug used as suspension to mask bitter taste, PO

Clarithromycin

macrolide, C-6 methoxy, PO

Azithromycin

macrolide, zithromax, long half life, brooadest spectrum, firs line, PO

Telithromycin

macrolide, BBW in pts with myasthenia gravis, PO

Fidaxomicin

macrolide, very narrow spectrum, bactericidal, not orally absorbed, treats c. diff, $$$, PO

Lincomycin

Lincosamides, serious infections in PNC allergic pts, BBW can cause pseudomembranous colitis, PO

Clindamycin

Lincosamides, Cleocin, bioactive, lipophilic, topical acne, PO

Tetracycline, Democlocycline, Minocycline, Doxycycline

Tetracyclines, 30s, terminates peptide chain growth, bacteriostatic, PO

Tigecycline

Glycylcycline, broad spectrum, lack resistance issues, IV

Omadacycline

Glycylcycline, MRSA & VRE, IV PO

Eravacycline

Glycylcycline, MRSA, MDR strains, IV

Amikacin

Aminoglycoside, HABA inhibits distal amino sugar ring, broader spectrum than kanamycin, IV

Tobramycin

Aminoglycoside, lacks C-3 hydroxyl, broader spectrum than kanamycin, IV

Gentamicin

Aminoglycoside, broader spectrum, IV

Streptomycin

Aminoglycoside, treats tuberculosis, IV

Neomycin

Aminoglycoside, supresses gut flora for bowel surgery, BBW systemic toxicity, PO

Plazomicin

Aminoglycoside, Increases spectrum against resistant bacteria GN & GP, IV