BetaLactams

BetaLactams

1. Mechanism

   • Prevent crosslinking of peptidoglycans
   • Bactericidal
   • Renal adjusted

2. Penicilins

   • Antistaphylococcal
     • AE: Neutropenia
       • Tissue necrosis
         • Interstitial Nephritis
     • Naficillin, Oxacillin, Dicloxacillin
     • MSSA, Endocarditis, Meningitis, Osteomylitis
   • Aminopenicillin
     • AE: Thrombocytopenia
       • Diarrheaa
     • Enterococcal (doc), UTI, SSSI
     • Amoxicillin, Ampicillin
   • Extended Spectrum
     • AE: Diarrhea
       • Thrombocytopenia
     • Piperacillin, Ticarcillin
     • HAI, UTI, SSSI
   • AE: Hepatitis
     • Seizure
       • Hemolytic anemia
   • Tons of resistance pencillinase
   • Syphillis (doc), Grp A Strep

3. Cephalosporin

   • Ist Gen
     • Surgical Prophylaxis, MSSA (doc)
       • Cephalexin, Cefazolin
   • 2nd Gen
     • URI
       • Cefuroxieme, Cefoxitin
   • 3rd Gen
     • Strep pneumo, meningitis, URI
       • Ceftriaxone = meiningitis
   • 4th Gen
     • MDRO, Cellulitis, PNA, CNS, UTI
       • Cefepime
       • Gram -ves: Pseudomonas, E. Coli, Klebsiella
   • 5th Gen
     • MRSA!
       • Ceftaroline

4. Carbapenems

   • Gram (+): Stap, Strep, Entero, Listeria
     • Gram (-): Pseudomonas, SPACE
       • Anaerobes: B. Fragilis
         • PNA, MDRO, SSSI,
   • AE: Seizures
     • Thrombocytopenia
       • Transaminitis
   • Imipenem (seizure); Ertapenem (NO pseudomonas)
     • Meropenem (CNS); Doripenem