21/02/2025
𝗖𝗘𝗣𝗛𝗔𝗟𝗢𝗦𝗣𝗢𝗥𝗜𝗡 𝗚𝗘𝗡𝗘𝗥𝗔𝗧𝗜𝗢𝗡𝗦: 𝗔 𝗖𝗢𝗠𝗣𝗥𝗘𝗛𝗘𝗡𝗦𝗜𝗩𝗘 𝗚𝗨𝗜𝗗𝗘
1. First Generation
Coverage:
🟣 Gram-positive: Excellent activity, especially against Staphylococcus aureus (excluding MRSA) and Streptococcus pyogenes.
🟣 Gram-negative: Limited activity, primarily effective against Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis.
Examples:
🟣 Cefazolin (IV)
🟣 Cephalexin (oral)
🟣 Cefadroxil (oral)
Uses:
🟣 Surgical prophylaxis (e.g., cefazolin)
🟣 Skin and soft tissue infections
🟣 UTIs caused by susceptible organisms
2. Second Generation
Coverage:
🟠 Gram-positive: Similar to the first generation but slightly less effective.
🟠 Gram-negative: Expanded activity, covering Haemophilus influenzae, Enterobacter species, Neisseria gonorrhoeae, Escherichia coli, and Proteus mirabilis.
🟠 Some agents (e.g., cephamycins like cefotetan, cefoxitin) have anaerobic coverage.
Examples:
🟠 Cefuroxime (IV/oral)
🟠 Cefoxitin (IV) – a cephamycin
🟠 Cefotetan (IV) – a cephamycin
🟠 Cefaclor (oral)
Uses:
🟠 Respiratory tract infections (e.g., sinusitis, otitis media, bronchitis)
🟠 Surgical prophylaxis for abdominal and pelvic surgeries (e.g., cefoxitin, cefotetan)
🟠 Mixed anaerobic infections (cephamycins)
3. Third Generation
Coverage:
🔴 Gram-positive: Good activity but less effective against Staphylococcus aureus than earlier generations.
🔴 Gram-negative: Broad-spectrum coverage, including Enterobacteriaceae, Haemophilus influenzae, and Neisseria.
🔴 Some agents (e.g., ceftazidime) cover Pseudomonas aeruginosa.
🔴 Generally poor anaerobic coverage.
Examples:
🔴 Ceftriaxone (IV)
🔴 Cefotaxime (IV)
🔴 Ceftazidime (IV) – covers Pseudomonas
🔴 Cefdinir (oral)
🔴 Cefixime (oral)
Uses:
🔴 Community-acquired pneumonia
🔴 Meningitis (ceftriaxone, cefotaxime)
🔴 Gonorrhea (ceftriaxone)
🔴 Severe UTIs and pyelonephriti
🔴 Hospital-acquired infections (Pseudomonas coverage with ceftazidime)
4. Fourth Generation
Coverage:
🔵 Gram-positive: Good coverage, including Streptococcus pneumoniae.
🔵 Gram-negative: Very broad, including Pseudomonas aeruginosa, Enterobacter species, and other resistant gram-negative organisms.
🔵 No anaerobic coverage.
Example:
🔵 Cefepime (IV)
Uses:
🔵 Hospital-acquired pneumonia
🔵 Febrile neutropenia
🔵 Complicated UTIs
🔵 Infections caused by multidrug-resistant organisms (Pseudomonas focus)
5. Fifth Generation
Coverage:
🟤 Gram-positive: Excellent activity, including MRSA and penicillin-resistant Streptococcus pneumoniae.
🟤 Gram-negative: Broad-spectrum but no Pseudomonas coverage.
🟤 Minimal anaerobic coverage.
Example:
🟤 Ceftaroline (IV)
Uses:
🟤 Skin and soft tissue infections (e.g., caused by MRSA)
🟤 Community-acquired pneumonia
