We’re going to continue posting transcripts of MedCram lectures here on our blog as we finish them!<\/p>\n
<\/iframe><\/p>\n<p>“Welcome to another MedCram Lecture! We\u2019re going to talk about Cephalosporins and specifically, the different generations of Cephalosporins, some representative antibiotics in each class and what are the unique things about those generations and what they do in their coverage.<\/p>\n<p>There are 5 generations of Cephalosporins. We\u2019ve got the 1st generation of Cephalosporins, we\u2019ve got the 2nd \u2013 which we\u2019ll talk about \u2013 the 3rd \u2013 which is the workhorse of the pneumonia scene \u2013 we\u2019ve got the 4th generation \u2013 which has got the Pseudomonas coverage \u2013 and then finally the 5th, which is an interesting generation that we\u2019ll talk about.<\/p>\n<p>As we go from first, to second, to third, to fourth, you\u2019ll see that there is better and better Gram negative coverage, so at the very beginning, with 1st generation Cephalosporins, we have medications like Cefazolin and Cefalexin and these antibiotics really have no anaerobic coverage, but what they did have a lot of coverage for is Gram positives. This is going to be our Gram positive box and this is going to be our Gram negative box. In terms of Gram positives, it has really good Staph and actually pretty good Strep coverage.<\/p>\n<p>Where do we see these things being used? We see these things being used in, for instance, skin infections, because this has really good Gram positive coverage; no anaerobic coverage, good Staph and Strep, and in terms of Gram negative, it would still take care of regular Gram negative, like E. coli, Proteus and Klebsiella.<\/p>\n<p>When they went on to the 2nd generation of Cephalosporins, here we\u2019re talking about medications like Cefuroxine and like Cefotetan. The biggest thing about this was that now, we had anaerobic coverage.<\/p>\n<p>That was the big thing, and as a result of that, we\u2019re now looking at intra-abdominal. The reason why we could do that was because there\u2019s a lot of anaerobic bacteria intra-abdominally, but in terms of the Staph and Strep, it stayed the same; going from the 1st generation to the 2nd, there was really no change. We didn\u2019t lose much in terms of Staph and Strep, but going from 1st generation to 2nd generation, we actually got a little bit better Gram negative coverage. That\u2019s what made it really well in terms of intra-abdominal infections \u2013 the 2nd generation was better in terms of that.<\/p>\n<p>Let\u2019s go on to the 3rd generation. 3rd generation Cephalosporins \u2013 there are three major examples and you should know these. One of them is Ceftriaxone, the other one is Cefotaxine and the last one is a very important one called Ceftazidine. In terms of anaerobic coverage, it lost it again; no anaerobic coverage here, whereas we had it back in the 2nd generation. In terms of Gram positives here, it was okay, definitely very good in Pneumococcus. In terms of Staph, probably not as good of coverage in terms of Staph Aureus. Because it has good Pneumococcal coverage, 3rd generation Cephalosporins were really good at lung infections, so we\u2019re talking about community-acquired pneumonia.<\/p>\n<p>There are a couple of things I should mention here, specifically that Ceftazidine is covering Pseudomonas. That\u2019s an important thing we\u2019re going to have to bring up, here where we talked about Gram negatives, is that here, it\u2019s even better. You can see as we go up the list in terms of generations, that the Gram negative coverage keeps getting better; specifically, if you\u2019re using Ceftazidime, you can now cover Pseudomonas.<\/p>\n<p>Even if you are not, we are talking good coverage with Neisseria Gonorrhoeae, we\u2019re talking about Enterobacter, we\u2019re talking about Seratia. Here\u2019s the big one: if you use Ceftazidime, it will cover Pseudomonas. That\u2019s a big one because Pseudomonas is the infection that people get in nursing homes, specifically in their lung. So, that\u2019s 3rd generation, probably one of the best up to that point in terms of Gram negative coverage.<\/p>\n<p>Now, 4th generation \u2013 the big one you got to know there is Cefepime. Cefepime is important because it also covers the big P, the big Pseudomonas. In terms of anaerobic coverage, still no anaerobic coverage. So far, the only one that covers anaerobs is the 2nd generation Cephalosporins. The 4th generation of Cephalosporins were something quite amazing because what it did is it took the strength of the 1st generation for Gram positives \u2013 really strong \u2013 and it added the great Gram negative coverage of the third and made it strong. Cefepime is really outstanding. So, what are we using these for? We are using these for very serious infections anywhere, because it\u2019s got excellent coverage, strong Gram positive, strong Gram negative, and extra bonus is it covers Pseudomonas. We can think of, for instance, immunocompromised patients, of fever of unknown origin. This 4th generation of Cephalosporins had excellent, excellent coverage.<\/p>\n<p>When we go to the 5th generation of Cephalosporins, the 5th generation is kind of unusual because we\u2019ve got different players in that generation, which are very, very different from each other. The first one that I want to talk to you about is Ceftolozane. It actually is combined with Tazobactam, which is a beta-lactamase inhibitor. The other one is Ceftraroline. These are very different 5th generation Cephalosporins.<\/p>\n<p>Again, for the second time, we have good anaerobic coverage. You should know that the 2nd and the 5th generation have anaerobic coverage. Let\u2019s talk about these two players. Ceftolozane\/Tazobactam \u2013 what they did, they took Ceftazidime, that structure, and they basically made it better and this is the most potent anti-Pseudomonal Cephalosporin that we currently have. They added on Tazobactam, which is a beta-lactamase inhibitor. This is a super-anti-Pseudomonal that works well.<\/p>\n<p>Just to review, we\u2019ve got three Cephalosporins that have anti-Pseudomonal coverage and I think that\u2019s important to know \u2013 Ceftazidime, Cefepime and Ceftolazene. We use Ceftriaxone as our 3rd generation Cephalosporin to treat community-acquired pneumonia. Notice that Ceftriaxone, or Rocephin, does not have any anti-Pseudomonal coverage. So, if a patient is coming in from a nursing home or some institution or a hospital, they are at risk for having Pseudomonas; you should not use Ceftriaxone. Do not use Ceftriaxone because Ceftriaxone has no anti-Pseudomonal coverage. The only one that has anti-Pseudomonal coverage is Ceftazidime, Cefepime and Ceftolazene. This is a great anti-Pseudomonal medication.<\/p>\n<p>What is Ceftaroline? What is so good about it? Ceftaroline \u2013 Teflaro is the trade name \u2013 actually covers MRSA. It is the only Cephalosporin that can actually treat MRSA. That\u2019s pretty important. It\u2019s currently indicated for skin and soft tissue infections and also community-acquired pneumonia. It has not, as of this tapping, gotten the FDA approval for MRSA pneumonia.<\/p>\n<p>One other bit of advice information I want to give you is sometimes, when they are actually testing bacteria, like Gram negatives, for Cefepime, they\u2019ll notice that it is sensitive to Cefepime, but it\u2019s not sensitive to any other Cephalosporin. This you should think about in terms of, if it is possible, to be an extended-spectrum beta-lactamase. If they are, you should not use any Cephalosporins, whatsoever, and to switch to Monobactam and we\u2019ll talk about that in one of our next lectures.<\/p>\n<p>Just to review here again, we\u2019ve got the 1st, 2nd, 3rd, 4th and 5th generation. The 1st generation was really good on Gram positives, Staph and Strep, did not have anaerobic coverage and had so-and-so Gram negative coverage; really good for skin infections like Cefazoline, Cefalexin. Because it had good Gram negative coverage like E. coli, you could use it in simple urinary tract infections.<\/p>\n<p>Going to 2nd generation, we\u2019ve got anaerobic coverage, we\u2019ve got better Gram negative coverage; this is intra-abdominal because of that anaerobic and that better Gram negative coverage.<\/p>\n<p>3rd generation is the workhorse for community-acquired pneumonia, because of the Ceftriaxone, but you should also know that it also holds Ceftazidine, which is an anti-Pseudomonal and it\u2019s got one of the best Gram negative coverage out of all of the generations.<\/p>\n<p>4th generation took the best of both worlds. It took the 1st generation Gram positive coverage and it took the 3rd generation Gram negative coverage, put it all together and you got Cefepime, which is anti-Pseudomonal, for serious infections where you need broad-spectrum antibiotics.<\/p>\n<p>Finally, the 5th generation has two odd players that are really different from each other. Ceftolozane, which is the anti-Pseudomonal, which you have to worry about in hospital-acquired infections, but also, coverage with Ceftaroline, also something you have to worry about in hospital-acquired infections \u2013 two different drugs, same generation.<\/p>\n<p>Thanks for joining us!”<\/p>\n<!-- AddThis Advanced Settings generic via filter on the_content --><!-- AddThis Share Buttons generic via filter on the_content -->","protected":false},"excerpt":{"rendered":"<p>We’re going to continue posting transcripts of MedCram lectures here on our blog as we finish them! “Welcome to another MedCram Lecture! We\u2019re going to talk about Cephalosporins and specifically, the different generations of Cephalosporins, some representative antibiotics in each class and what are the unique things about those generations and what they do in…<!-- AddThis Advanced Settings generic via filter on get_the_excerpt --><!-- AddThis Share Buttons generic via filter on get_the_excerpt --><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v21.7 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Cephalosporins Explained Clearly Transcript - Medcram Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cephalosporins Explained Clearly Transcript - Medcram Blog\" \/>\n<meta property=\"og:description\" content=\"We’re going to continue posting transcripts of MedCram lectures here on our blog as we finish them! “Welcome to another MedCram Lecture! We\u2019re going to talk about Cephalosporins and specifically, the different generations of Cephalosporins, some representative antibiotics in each class and what are the unique things about those generations and what they do in…\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/\" \/>\n<meta property=\"og:site_name\" content=\"Medcram Blog\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/MedCram\/\" \/>\n<meta property=\"article:published_time\" content=\"2017-02-04T08:42:24+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2019-10-31T16:23:59+00:00\" \/>\n<meta name=\"author\" content=\"medcram\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@medcramvideos\" \/>\n<meta name=\"twitter:site\" content=\"@medcramvideos\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"medcram\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/\"},\"author\":{\"name\":\"medcram\",\"@id\":\"https:\/\/blog.medcram.com\/#\/schema\/person\/0caa0bb38a30e2342cf84313805d7aff\"},\"headline\":\"Cephalosporins Explained Clearly Transcript\",\"datePublished\":\"2017-02-04T08:42:24+00:00\",\"dateModified\":\"2019-10-31T16:23:59+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/\"},\"wordCount\":1459,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/blog.medcram.com\/#organization\"},\"articleSection\":[\"Pharmacology\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/\",\"url\":\"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/\",\"name\":\"Cephalosporins Explained Clearly Transcript - Medcram Blog\",\"isPartOf\":{\"@id\":\"https:\/\/blog.medcram.com\/#website\"},\"datePublished\":\"2017-02-04T08:42:24+00:00\",\"dateModified\":\"2019-10-31T16:23:59+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/blog.medcram.com\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Pharmacology\",\"item\":\"https:\/\/blog.medcram.com\/category\/pharmacology\/\"},{\"@type\":\"ListItem\",\"position\":3,\"name\":\"Cephalosporins Explained Clearly Transcript\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/blog.medcram.com\/#website\",\"url\":\"https:\/\/blog.medcram.com\/\",\"name\":\"Medcram Blog\",\"description\":\"Medcram Blog\",\"publisher\":{\"@id\":\"https:\/\/blog.medcram.com\/#organization\"},\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/blog.medcram.com\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/blog.medcram.com\/#organization\",\"name\":\"MedCram\",\"url\":\"https:\/\/blog.medcram.com\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/blog.medcram.com\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/blog.medcram.com\/wp-content\/uploads\/2017\/05\/logo.png\",\"contentUrl\":\"https:\/\/blog.medcram.com\/wp-content\/uploads\/2017\/05\/logo.png\",\"width\":152,\"height\":89,\"caption\":\"MedCram\"},\"image\":{\"@id\":\"https:\/\/blog.medcram.com\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/www.facebook.com\/MedCram\/\",\"https:\/\/twitter.com\/medcramvideos\",\"https:\/\/www.instagram.com\/medcram\/\",\"https:\/\/www.youtube.com\/c\/medcram\"]},{\"@type\":\"Person\",\"@id\":\"https:\/\/blog.medcram.com\/#\/schema\/person\/0caa0bb38a30e2342cf84313805d7aff\",\"name\":\"medcram\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/blog.medcram.com\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/b827782758e993ee6d0d16075cd53c00?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/b827782758e993ee6d0d16075cd53c00?s=96&d=mm&r=g\",\"caption\":\"medcram\"}}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Cephalosporins Explained Clearly Transcript - Medcram Blog","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/","og_locale":"en_US","og_type":"article","og_title":"Cephalosporins Explained Clearly Transcript - Medcram Blog","og_description":"We’re going to continue posting transcripts of MedCram lectures here on our blog as we finish them! “Welcome to another MedCram Lecture! We\u2019re going to talk about Cephalosporins and specifically, the different generations of Cephalosporins, some representative antibiotics in each class and what are the unique things about those generations and what they do in…","og_url":"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/","og_site_name":"Medcram Blog","article_publisher":"https:\/\/www.facebook.com\/MedCram\/","article_published_time":"2017-02-04T08:42:24+00:00","article_modified_time":"2019-10-31T16:23:59+00:00","author":"medcram","twitter_card":"summary_large_image","twitter_creator":"@medcramvideos","twitter_site":"@medcramvideos","twitter_misc":{"Written by":"medcram","Est. reading time":"7 minutes"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"Article","@id":"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/#article","isPartOf":{"@id":"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/"},"author":{"name":"medcram","@id":"https:\/\/blog.medcram.com\/#\/schema\/person\/0caa0bb38a30e2342cf84313805d7aff"},"headline":"Cephalosporins Explained Clearly Transcript","datePublished":"2017-02-04T08:42:24+00:00","dateModified":"2019-10-31T16:23:59+00:00","mainEntityOfPage":{"@id":"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/"},"wordCount":1459,"commentCount":0,"publisher":{"@id":"https:\/\/blog.medcram.com\/#organization"},"articleSection":["Pharmacology"],"inLanguage":"en-US","potentialAction":[{"@type":"CommentAction","name":"Comment","target":["https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/#respond"]}]},{"@type":"WebPage","@id":"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/","url":"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/","name":"Cephalosporins Explained Clearly Transcript - Medcram Blog","isPartOf":{"@id":"https:\/\/blog.medcram.com\/#website"},"datePublished":"2017-02-04T08:42:24+00:00","dateModified":"2019-10-31T16:23:59+00:00","breadcrumb":{"@id":"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/#breadcrumb"},"inLanguage":"en-US","potentialAction":[{"@type":"ReadAction","target":["https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/"]}]},{"@type":"BreadcrumbList","@id":"https:\/\/blog.medcram.com\/pharmacology\/cephalosporins-explained-clearly-transcript\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https:\/\/blog.medcram.com\/"},{"@type":"ListItem","position":2,"name":"Pharmacology","item":"https:\/\/blog.medcram.com\/category\/pharmacology\/"},{"@type":"ListItem","position":3,"name":"Cephalosporins Explained Clearly Transcript"}]},{"@type":"WebSite","@id":"https:\/\/blog.medcram.com\/#website","url":"https:\/\/blog.medcram.com\/","name":"Medcram Blog","description":"Medcram Blog","publisher":{"@id":"https:\/\/blog.medcram.com\/#organization"},"potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/blog.medcram.com\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"},{"@type":"Organization","@id":"https:\/\/blog.medcram.com\/#organization","name":"MedCram","url":"https:\/\/blog.medcram.com\/","logo":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blog.medcram.com\/#\/schema\/logo\/image\/","url":"https:\/\/blog.medcram.com\/wp-content\/uploads\/2017\/05\/logo.png","contentUrl":"https:\/\/blog.medcram.com\/wp-content\/uploads\/2017\/05\/logo.png","width":152,"height":89,"caption":"MedCram"},"image":{"@id":"https:\/\/blog.medcram.com\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/www.facebook.com\/MedCram\/","https:\/\/twitter.com\/medcramvideos","https:\/\/www.instagram.com\/medcram\/","https:\/\/www.youtube.com\/c\/medcram"]},{"@type":"Person","@id":"https:\/\/blog.medcram.com\/#\/schema\/person\/0caa0bb38a30e2342cf84313805d7aff","name":"medcram","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/blog.medcram.com\/#\/schema\/person\/image\/","url":"https:\/\/secure.gravatar.com\/avatar\/b827782758e993ee6d0d16075cd53c00?s=96&d=mm&r=g","contentUrl":"https:\/\/secure.gravatar.com\/avatar\/b827782758e993ee6d0d16075cd53c00?s=96&d=mm&r=g","caption":"medcram"}}]}},"_links":{"self":[{"href":"https:\/\/blog.medcram.com\/wp-json\/wp\/v2\/posts\/126"}],"collection":[{"href":"https:\/\/blog.medcram.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blog.medcram.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blog.medcram.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/blog.medcram.com\/wp-json\/wp\/v2\/comments?post=126"}],"version-history":[{"count":0,"href":"https:\/\/blog.medcram.com\/wp-json\/wp\/v2\/posts\/126\/revisions"}],"wp:attachment":[{"href":"https:\/\/blog.medcram.com\/wp-json\/wp\/v2\/media?parent=126"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blog.medcram.com\/wp-json\/wp\/v2\/categories?post=126"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blog.medcram.com\/wp-json\/wp\/v2\/tags?post=126"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}