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11.2 Other Cell Wall Synthesis Inhibitors
11.2 Other Cell Wall Synthesis Inhibitors
11.2 Other Cell Wall Synthesis Inhibitors
CLINICAL USES
OUTLINE
I. Cephalosporins ● Clinical Uses (Cefazolin & Cephalexin):
A. First Generation ○ Gram (+) cocci
B. Second Generation ■ Staphylococci
C. Third Generation
■ Streptococci
D. Fourth Generation
E. Advanced Generation ○ E. coli
II. Adverse Reactions of Cephalosporins ○ K. pneumoniae
III. Aztreonam ○ Surgical prophylaxis in selected
IV. Carbapenems conditions
A. Imipenem ○ Minimal activity
B. Meropenem
■ Gram (-) cocci
C. Ertapenem
V. Vancomycin ■ Enterococci
VI. Fosfomycin ■ MRSA
VII. Bacitracin ■ Most gram (-) rods
VIII. Cycloserine
IX. Daptomycin
SECOND GENERATION
● This is the prototype of first-generation, oral ● Less activity against gram (+)
cephalosporins. Oral administration twice daily is ● Extended coverage for gram (-)
effective against pharyngitis. ● Marked differences in activity occur among the
● Prototype: meaning pharmacokinetics were all drugs
based on Cephalexin (if they follow the ○ Cefotetan, Cefoxitin
pharmacokinetics of cephalexin, they will be ■ B. fragilis
grouped here even if they are newly discovered) ○ Cefamandole, Cefuroxime, Cefaclor
● Originally developed for pharyngitis ■ H. influenzae or M. catarrhalis
● Mostly gram (+)
○ Cell wall are thicker THIRD GENERATION
○ Most gram (-) are resistant to ● Greater coverage for gram (-)
beta-lactams ● Cefdinir & Cefixime
● Administered orally ● Cefotaxime
● Ceftazidime
● Ceftriaxone
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MT6314 - PHARMACOLOGY & TOXICOLOGY IMT 2025
CEFTAZIDIME
FOURTH GENERATION
● This is active against Pseudomonas aeruginosa
(hospital acquired, meaning it has a lot of
CEFEPIME
resistance since it has met almost all antibiotics)
● This is active against Pseudomonas aeruginosa
CEFTRIAXONE ● Clinical Uses:
● This drug has the longest half-life of any ○ More resistant to beta-lactamases
cephalosporin (6 to 8 hours), which permits produced by gram (-) organisms
once-a-day dosing. High levels of the drug can be ■ Enterobacter
achieved in blood and CSF. It is effective against ■ Haemophilus
genital, anal, and pharyngeal penicillin-resistant ■ Neisseria
Neisseria gonorrhoeae. The drug is excreted in bile ■ Some penicillin-resistant
and may be used in patients with renal pneumococci
insufficiency. It has good penetration into bone. ○ Combines the gram (+) activity of 1st gen
● Prototype and wider gram (-) spectrum of 3rd gen
● We must know how the drug is going to be ○ Habang tumataas yung generation,
excreted so the dose may be adjusted accordingly nababawasan ang coverage sa gram (+),
(ex: if the patient has a renal insufficiency or a pero nagwwiden and spectrum sa gram (-)
liver disease) ○ Nasakanya na lahat
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MT6314 - PHARMACOLOGY & TOXICOLOGY IMT 2025
BACITRACIN
● Obtained from the Tracy strain of Bacillus subtilis
in 1943
● Peptide antibiotic
● Coverage: gram-positive microorganisms
● MOA: Inhibits cell wall formation by interfering
with the lipid carrier that transfers peptidoglycan
subunits to the growing cell wall