2nd Generation Cephalosporins

Cephalosporins (β-Lactams)

AMEG C

Drugs:

• Oral:
  • Cefaclor: Excreted in the bile, Off label
  • Cefuroxime Axetil: Off label
• Parenteral:
  • Cefuroxime: Off label
  • Cephamycins: Good for Anaerobic bacteria infections, not for food producing species
    • Cefoxitin
    • Cefotetan

Gr+ (+++), Gr- (++)
Antibacterial spectrum: Similar to Extended Spectrum Penicillins in combination with β-Lactamase Inhibitors

• But Amoxicillin-Clavulanic Acid is much cheaper, making 2nd Generation Cephalosporins less relevant
• Special group: Cephamycins (Cefoxitin, Cefotetan) is excellent against Anaerobic bacteria
  • Not allowed in food producing animals so only indicated for Oral cavity infections and Bite wounds
• Less effective against Gr+ bacteria than 1st Generation Cephalosporins
• Effective against several β-Lactamase producing Gr- bacteria: E coli, Klebsiella…

Pharmacokinetics:

• Hydrophilic > No Liver metabolism
• Excreted by the Kidney in active form > Very good for UTI
  • Except: Cefaclor excreted in the bile > Good alternative for renal patients
• Oral or Parenteral
• Good absorption, Good distribution

Indication:
Similar to Extended Spectrum Penicillins, but more expensive
Cephamycins: Oral cavity infections, Bite wounds