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Antibiotics (Extended Notes) Cephalosporins
..Related to penicillins - similar coverage - affect cell wall synthesis - broad spectrum - allergies overlap with penicillins. 1-6% of people with a penicillin allergy have a cephalosporin allergy also. ..Renally excreted - watch out for dosing in renal failure. Recently fallen out of favour due to C. diff risk.
..Indications: meningitis for ceftriaxone. Severe pneumonia, peritonitis, second-line in sepsis, if you're worried about a UTI in pregnancy. First line in ascending cholangitis and cholecystitis.
1. Cefalexin - susceptible to beta-lactamases, UTIs in pregnancy
2. Cefuroxime - good against Haemophilus influenza and gonorrhoea
3. Ceftriaxone - usually used, salts can precipitate in gall bladder with calcium, careful in renal failure and when giving calcium Quinolones - Ciprofloxacin (all quinolones have flox in the name) Inhibitors of DNA making. Active against G+ve and G-ve, not good against Strep. pneumo, so not in pneumococcal pneumonia. Five indications: (SCAN Ships) S almonella CA mpylobacter N eisseria Ships - Shigella and Pseudomonas Most anaerobes are not susceptible. Many staphs are resistant. Indications: RTIs if not pneumococcal, UTI, GI infection, bone & joint infections, gonorrhoea, septicaemia for sensitive organisms. NOT safe in pregnancy. CAN use in penicillin allergy. Generally a second-line agent due to an increased risk of C. diff. Amoxifloxacin - second or third line in respiratory tract stuff
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