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B-lactams work more on G+ve bacteria1-penicillin:
1st generation:
- nature penicillin -benzyl penicillin
- procain penicillin last for 24hr
- bezathin penicillin last for 4weaks
*work against 1)Gram+ve strept.
2)Gram-ve gonorrhea&typonema palladium (responsible of syphilis)
*doc of rheumatic fever caused by strept
2nd generation
- methicillin:- (B-lactamase resist.,Orally,Narrow spectrum)
- naficillin - dicloxacillin
- cloxacillin - flucloxacillin
3rd generation
- ampicillin (Orally,Broad spectrum)
- bacampicillin
- amoxicillin (more Broad spectrum than ampicillin, orally, safe for pregnant)
- epicillin (well absorbed)
* for Gram +ve & gram -ve that not produce B-lactamas
4th generation
- mezlocillin - pipracillin - ticarcillin
- carbenicillin (good in treatment of pseudomonas)
We add B-lactamase Inh as clavulonic acid (the best) or sulbactam or tazobactam to inhibit B-lactamas & increase resistance of penicillin
2- Cephalosporin (better than penicillin)
1st
- cefobid - cephalothin - cefodroxil
*work against methicillin resitance streptococcus aureus & streptococcus enterobacteriacea
2nd
- cefaclor - cefoxitin - cefuroxime
*more stable for G-ve less active for staphylococcus
3rd
- cefotaxime - ceftazidime - ceftriaxone
- cefoperazone - cefdinir - cefixim
*work against proteus
*cefixim work in upper respiratory (otitismedia-sinusitis-pharingitis) & lower respiratory (pneumonia-bronchitis)
4th
- cefiprim - cefipirome
*more resistance for B-lactamas
- Cephalosporin cause hyporethelipitis so we give vit K twice weakly
3-Other:
Monobactam:- (azetronam) not make cross allergy with penicillin ,not penetrate CSF so not used for meningitis used for facultative G-ve but not for pseudomonas, Klebsilla or enterobacter
Carbapenems (Etrapenem-meropenem-Imopenem) more active against G+ve cocci
*active against all G+ve except MRSA,all g-ve except flavobacterium,B.cepacia,S.maltophilia
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