Infectious Disease Book

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Third Generation Broad-Spectrum CephalosporinsAka: Third Generation Cephalosporins, Ceftriaxone, Ceftizoxime, Cefotaxime, Cefpodoxime, Cefixime, Claforan, Rocephin, Vantin

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  1. See Also
    1. Third Generation Anti-Pseudomonal Cephalosporins
  2. Coverage:
    1. Gram Positive Cocci
      1. Less activity than First Generation Cephalosporins
    2. EKP Gram Negative Bacteria
    3. ESP Gram Negative Bacteria
      1. Better activity than First Generation Cephalosporins
      2. Better activity than Second Generation Cephalosporins
    4. No Pseudomonas activity
  3. Oral agents
    1. Cefixime (Suprax)
      1. Adult
        1. Standard: 400 mg PO divided qd to bid
        2. Gonorrhea: 400 mg PO for single dose
      2. Child: 8 mg/kg/day divided qd to bid
    2. Cefpodoxime (Vantin)
      1. Good activity Gram Positive organisms
        1. Covers Staphylococcus aureus
        2. Covers Pneumococcus
      2. Adult: 100 to 400 mg PO bid
      3. Child
        1. Pharyngitis: 10 mg/kg/day divided bid
        2. Otitis Media: 10 mg/kg/day divided qd
  4. Parenteral agents
    1. Cefotaxime (Claforan)
      1. Most Staphylococcus aureus and Anaerobic activity
      2. Adult: 1 to 2 grams IM or IV every 6 to 8 hours
      3. Child
        1. Standard: 50-150 mg/kg/day IM or IV divided q4-6h
        2. Meningitis: 200 mg/kg/day IV divided q6-8h
        3. Maximum dose: 2 grams
    2. Ceftizoxime (Cefizox)
      1. Moderate Staphylococcus aureus and Anaerobic Activity
      2. Adult: 1 to 2 grams IV every 8 to 12 hours
      3. Child: 50 mg/kg/dose IV every 6 to 8 hours
    3. Ceftriaxone (Rocephin)
      1. Least Staphylococcus and Anaerobic activity
      2. Dilute in Lidocaine 1% for Intramuscular Injection
      3. Adult
        1. Standard: 1-2 grams IM or IV every 24 hours
        2. Gonorrhea: 125 mg IM single dose
      4. Child
        1. Standard: 50-75 mg/kg/day IV divide q12-24 hours
        2. Meningitis: 100 mg/kg/day IV divided q12-24 hours
        3. Otitis Media: 50 mg/kg IM single dose (max: 1g)
        4. Maximum Dose: 2 grams (4 grams for Meningitis)

Cefotaxime (C0007554)

Definition (MSH)Semisynthetic broad-spectrum cephalosporin.
Definition (PDQ)A third generation semisynthetic cephalosporin antibiotic with bactericidal activity. Cefotaxime inhibits mucopeptide synthesis by binding to and inactivating penicillin binding proteins thereby interfering with the final transpeptidation step required for cross-linking of peptidoglycan units which are a component of bacterial cell walls. This results in a reduction of cell wall stability and causes cell lysis. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39177&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=39177&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C354" NCI Thesaurus)
Definition (NCI)A third generation semisynthetic cephalosporin antibiotic with bactericidal activity. Cefotaxime inhibits mucopeptide synthesis by binding to and inactivating penicillin binding proteins thereby interfering with the final transpeptidation step required for cross-linking of peptidoglycan units which are a component of bacterial cell walls. This results in a reduction of cell wall stability and causes cell lysis.
ConceptsOrganic Chemical (T109) , Antibiotic (T195)
MSHD002439
EnglishCefotaxim, Cefotaxime, CEFOTAXIME PREPARATION, Cefotaxime product, Cephotaxim
Spanishcefotaxima
Parent ConceptsCephacetrile (C0007714), Cephalosporins (C0007732), Third generation cephalosporin (C0304320)
SourcesLNC, MSH, NCI, NDFRT, PDQ, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Ceftizoxime (C0007560)

Definition (MSH)A semisynthetic cephalosporin antibiotic which can be administered intravenously or by suppository. The drug is highly resistant to a broad spectrum of beta-lactamases and is active against a wide range of both aerobic and anaerobic gram-positive and gram-negative organisms. It has few side effects and is reported to be safe and effective in aged patients and in patients with hematologic disorders.
ConceptsOrganic Chemical (T109) , Antibiotic (T195)
MSHD015296
EnglishCeftizoxime, CEFTIZOXIME PREPARATION
Spanishceftizoxima
Parent ConceptsCefotaxime (C0007554), Cephalosporins (C0007732), Third generation cephalosporin (C0304320)
SourcesLNC, MSH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Rocephin (C0035750)

ConceptsOrganic Chemical (T109) , Antibiotic (T195)
MSHD002443
EnglishHoffman La Roche Brand of Ceftriaxone Sodium, Hoffman-La Roche Brand of Ceftriaxone Sodium, Rocefalin, Rocefin, Rocephin, Rocephine, Roche Brand of Ceftriaxone Sodium
SourcesMSH, NCI, PDQ, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)


cefpodoxime (C0055011)

Definition (NCI)A third generation semi-synthetic cephalosporin and a beta-lactam antibiotic with bactericidal activity. Cefpodoxime's effect is dependent on its binding to penicillin-binding proteins (PBPs) located in the bacterial cytoplasmic membrane. Binding results in the inhibition of the transpeptidase enzymes, thereby preventing cross-linking of the pentaglycine bridge with the fourth residue of the pentapeptide and interrupting consequent synthesis of peptidoglycan chains. As a result, cefpodoxime inhibits bacterial septum and cell wall synthesis formation.
ConceptsOrganic Chemical (T109) , Antibiotic (T195)
MSHC053268
Englishcefpodoxime, CEFPODOXIME PREPARATION
Spanishcefpodoxima
Parent ConceptsCephalosporins (C0007732), Third generation cephalosporin (C0304320)
SourcesLNC, MSH, NCI, NDFRT, PDQ, RXNORM, SCTSPA, SNOMEDCT, USPMG
Derived from the NIH UMLS (Unified Medical Language System)


Cefixime (C0060400)

Definition (MSH)A third-generation cephalosporin antibiotic that is stable to hydrolysis by beta-lactamases.
Definition (PDQ)A broad-spectrum, third-generation cephalosporin antibiotic derived semisynthetically from the marine fungus Cephalosporium acremonium with antibacterial activity. As does penicillin, the beta-lactam antibiotic cefixime inhibits bacterial cell wall synthesis by disrupting peptidoglycan synthesis, resulting in a reduction in bacterial cell wall stability and bacterial cell lysis. Stable in the presence of a variety of beta-lactamases, this agent is more active against gram-negative bacteria and less active against gram-positive bacteria compared to second-generation cephalosporins. Check for "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=37809&idtype=1" active clinical trials or "http://www.cancer.gov/Search/ClinicalTrialsLink.aspx?id=37809&idtype=1&closed=1" closed clinical trials using this agent. ("http://nciterms.nci.nih.gov:80/NCIBrowser/ConceptReport.jsp?dictionary=NCI_Thesaurus&code=C1100" NCI Thesaurus)
Definition (NCI)A broad-spectrum, third-generation cephalosporin antibiotic derived semisynthetically from the marine fungus Cephalosporium acremonium with antibacterial activity. As does penicillin, the beta-lactam antibiotic cefixime inhibits bacterial cell wall synthesis by disrupting peptidoglycan synthesis, resulting in a reduction in bacterial cell wall stability and bacterial cell lysis. Stable in the presence of a variety of beta-lactamases, this agent is more active against gram-negative bacteria and less active against gram-positive bacteria compared to second-generation cephalosporins.
ConceptsOrganic Chemical (T109) , Antibiotic (T195)
MSHD020682
EnglishCefixime, CEFIXIME PREPARATION
Spanishcefixima
Parent ConceptsCefotaxime (C0007554), Cephalosporins (C0007732), Third generation cephalosporin (C0304320)
SourcesLNC, MSH, MTH, NCI, NDFRT, PDQ, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Claforan (C0701052)

ConceptsOrganic Chemical (T109) , Antibiotic (T195)
MSHD002439
EnglishAventis Brand of Cefotaxime Sodium, Aventis Pharma Brand of Cefotaxime Sodium, Claforan, Hoechst Brand of Cefotaxime Sodium, Klaforan, Primafen
SourcesMSH, NCI, PDQ, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)


Vantin (C0724204)

ConceptsOrganic Chemical (T109) , Antibiotic (T195)
MSHC053267
EnglishVantin
SourcesMSH, NCI, PDQ, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



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