Class
Fourth generation cephalosporin
Pharmacodynamics
- Beta lactam antibiotic
- Inhibits transpeptidation reaction of bacterial cell wall synthesis
- Halts peptidoglycan synthesis, leading to inhibition of bacterial growth, and ultimately cell death (bacteriocidal)
- Beta-lactam antibiotics kill bacterial cells only when they are actively growing and synthesising cell wall
Pharmacokinetics
- Penetrates well into CSF
- Half-life 2 hours
- Renal clearance
Antimicrobial activity
- More resistant to chromosomal B-lactamases (e.g. those produced by Enterobacter)
- Good activity against P aeruginosa, Enterobacter, MSSA, S. pneumoniae
- Highly active against Haemophilus and Neisseria sp.
- Commonly used in empirical treatment of febrile neutropenia
Adverse effects of cephalosporins
- Allergy:
- Cross-allergenicity between penicillins and cephalosporins is ~1%
- Toxicity:
- Thrombophlebitis after IVI
- Renal toxicity: interstitial nephritis, tubular necrosis (rare)
- Methylthiotetrazole-containing agents (cefotetan, cefoperazone) may cause bleeding disorders and disulfiram-like reactions
Precautions/contraindications
- Penicillin anaphylaxis
- Dose reduction in renal failure
Further reading
- Buttner R. Pharm 101: Cephazolin. LITFL
- Buttner R. Pharm 101: Cefuroxime. LITFL
- Buttner R. Pharm 101: Ceftriaxone. LITFL
References
- Katzung BG. Basic and Clinical Pharmacology. 14e. 2018: 802-806, 812
Pharmacology 101
Top 200 drugs
MBBS FACEM DDU (Emergency) CCPU. Emergency Physician in Melbourne, Australia. Co-Ultrasound Lead for Emergency Medicine at The Alfred Hospital. Special interests in diagnostic and procedural ultrasound, medical education, and ECG interpretation. Editor of the LITFL ECG Library.
