Ampicillin, amoxicillin, piperacillin: Greater activity versus Gram-negative bacteria; addition of β-lactamase inhibitor restores activity against many β-lactamase-producing bacteria
CEPHALOSPORINS •CefazolinPrevents bacterial cell wall synthesis by binding to and inhibiting cell wall transpeptidases Rapid bactericidal activity against susceptible bacteria Skin and soft tissue infections, urinary tract infections, surgical prophylaxis
IV administration • renal clearance (half-life 1.5 h) • given every 8 h • poor penetration into the central nervous system (CNS) • Toxicity: Rash, drug fever
Cephalexin: Oral, first-generation drug used for treating skin and soft tissue infections and urinary tract infections
Cefuroxime: Oral and intravenous, second-generation drug, improved activity versus pneumococcus and Haemophilus influenzae
Cefotetan, cefoxitin: Intravenous, second-generation drugs, activity versus Bacteroides fragilis allows for use in abdominal/pelvic infections
Ceftriaxone: Intravenous, third-generation drug, mixed clearance with long half-life (6 hours), good CNS penetration, many uses including pneumonia, meningitis, pyelonephritis, and gonorrhea
Cefotaxime: Intravenous, third-generation, similar to ceftriaxone; however, clearance is renal and half-life is 1 hour
Ceftazidime: Intravenous, third-generation drug, poor Gram-positive activity, good activity versus Pseudomonas aeruginosa
Cefepime: Intravenous, fourth-generation drug, broad activity with improved stability to chromosomal β-lactamases
Ceftaroline: Intravenous, active against methicillin-resistant staphylococci, broad Gram-negative activity not including Pseudomonas aeruginosa
Ceftazidime-avibactam, ceftolozane-tazobactam: Intravenous, cephalosporin-β-lactamase inhibitor combination drugs, broad activity with improved stability to chromosomal β-lactamase and some extended-spectrum β-lactamases
Meropenem, doripenem: Intravenous, similar activity to imipenem; stable to renal dehydropeptidase, lower incidence of seizures
Ertapenem: Intravenous, longer half-life allows for once-daily dosing, lacks activity versus Pseudomonas aeruginosa and Acinetobacter •VancomycinInhibits cell wall synthesis by binding to the D-Ala-D-Ala terminus of nascent peptidoglycan Bactericidal activity against susceptible bacteria, slower kill than β-lactam antibiotics Infections caused by Gram-positive bacteria including sepsis, endocarditis, andmeningitis•C difficile colitis (oral formulation)
Teicoplanin: Intravenous, similar to vancomycin except that long half-life (45–70 h) permits once-daily dosing
Dalbavancin: Intravenous, very long half-life (>10 days) permits once-weekly dosing
Oritavancin: Intravenous, very long half-life (>10 days) permits once-weekly dosing
Telavancin: Intravenous, once-daily dosing
Oral, IV administration • renal clearance (half-life 6 h) • starting dose of 30 mg/kg/d in two or three divided doses in patients with normal renal function • trough concentrations of • Toxicity: “Red man” syndrome • nephrotoxicity