Paper II
2017 August (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

4th generation cephalosporins

Q33 marksShort Notes

Answer

Fourth-generation cephalosporins have an extended spectrum covering both Gram-positive and Gram-negative organisms, including Pseudomonas.

Example

  • Cefepime

Properties

  • Broad spectrum: good activity against both Gram-positive cocci and Gram-negative bacilli (including Pseudomonas aeruginosa)
  • Greater resistance to hydrolysis by many beta-lactamases (including AmpC beta-lactamases) than third-generation agents
  • Good CSF penetration

Uses

  • Nosocomial infections, febrile neutropenia, severe hospital-acquired pneumonia, complicated urinary tract infections, meningitis

Adverse effects

  • Hypersensitivity reactions
  • GI upset
  • Neurotoxicity (encephalopathy/seizures) with high doses in renal impairment

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