All of the following cephalosporins are active against Pseudomonas except:
Correct Answer: Cefaclor
Description: Third Generation Cephalosporins
These are active against gram negative organisms resistant to other beta lactam antibiotics.
These can also penetrate the blood brain barrier (except cefoperazone and cefixime).
Ceftazidime (maximum), ceftolozane and cefoperazone are active against pseudomonas.
Ceftazidime is drug of choice for meliodiosis (caused by Burkholderia pseudomallei).
Ceftizoxime has maximum activityy against Bacteroides.
Ceftriaxone is the first choice drug for gonorrhoea, salmonellosis (including typhoid), E. coli sepsis, Proteus, Serratia, Haemophilus and empirical therapy for bacterial meningitis.
Long term use of > 2g/d of ceftriaxone is associated with biliary sludging syndrome and cholelithiasis due to precipitation in bile.
Most of these drugs are reserved for serious infections.
Ceftriaxone has long plasma half life.
Cefotaxime is metabolized to an active metabolite (desacetyl-cefotaxime).
Note: Cefaclor is a 2nd generation cephalosporin and is ineffective against pseudomonas and MRSA.
Category:
Pharmacology
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