II. Background
- The fourth and Fifth Generation Cephalosporins are loosely grouped newer agents
- Contrast with the first to Third Generation Cephalosporins that formed discrete groups with similar antimicrobial activity
III. Medications: Fourth Generation
-
Cefepime (Maxipime)
- Broad spectrum Gram-positive and Gram-negative organisms (building on Third Generation Cephalosporin coverage)
- Beta-Lactamase resistant organisms
- More AmpB beta lactamase resistant than second and Third Generation Cephalosporins
- Better activity against Citrobacter and Enterobacter
- Pseudomonas coverage (similar to Ceftazidime)
- Although some anaerobic coverage, not active against Bacteroides fragilis
- Use with Metronidazole for intraabdominal infections
-
Ceftolozane and Tazobactam (Zerbaxa)
- Gram-Negative Bacteria (aerobes and Anaerobes)
- Multidrug Resistant Enterobacteriaceae (Ceftazidime-resistant, ESBL)
- Bacteroides
- Prevotella
- Pseudomonas aeruginosa
IV. Medications: Fifth Generation
-
Ceftaroline (Teflaro)
- Multidrug-resistant Staphylococcus Aureus
- Methicillin-resistant Staphylococcus Aureus (MRSA)
- Vancomycin-intermediate Staphylococcus Aureus (VISA) and heteroresistant VISA
- Vancomycin-Resistant Staphylococcus Aureus)
- StreptococcusPneumonia
- Includes drug-resistant strains
- Respiratory Gram-Negative Bacteria (including Beta-Lactamase-positive Bacteria)
- Multidrug-resistant Staphylococcus Aureus
-
Cefiderocol (Fetroja)
- General
- Structurally similar to Cefepime and Ceftazidime
- Effective against multi-drug resistant Gram Negative aerobic Bacteria
- Indicated in complicated Urinary Tract Infections including Pyelonephritis
- Does not provide adequate Gram Positive or anaerobic activity
- Covers Multidrug-Resistant Organisms in complicated Urinary Tract Infections
- General
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Related Studies
Concepts | Antibiotic (T195) , Organic Chemical (T109) |
SnomedCT | 354067001, 395959007 |
English | 4th generation cephalosporin, CEPHALOSPORIN 4TH GENERATION, fourth generation cephalosporins, fourth generation cephalosporins (medication), [AM118] CEPHALOSPORIN 4TH GENERATION, fourth generation cephalosporin, cephalosporin fourth generation, cephalosporins fourth generation, Fourth-generation cephalosporins, Fourth generation cephalosporin, Fourth generation cephalosporin (product), Fourth generation cephalosporin (substance) |
Spanish | cefalosporina de cuarta generación (producto), cefalosporina de cuarta generación (sustancia), cefalosporina de cuarta generación |