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PRACTITIONERS SECTION |
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| Year : 2000 | Volume
: 54
| Issue : 4 | Page : 151-153 |
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The cephelosporins
Correspondence Address:
PMID: 11227126
How to cite this article:
. The cephelosporins. Indian J Med Sci 2000;54:151-3 |
The cephelosporins are antibiotics similar to penicillin derived from fungus. In Sardinia Prof Bottzu cultured this fungus from sewage fall identified as capholosporim acremonium. The fungus was further investigated by Harvard Flowery and he found that the fungus produced not one but several antibiotics.
The cephelosporins are board spectrum.B lactum antibacterial antibiotics. They were introduced in 1960 in clinical practice. Since then they are widely used as compared to previously used antibiotics because of low toxicity and favourable broad spectrum activity Pharmacokinetics. Now a days they are used as first line agents in the treatment of many infections i.e. pneumonia, meningitis and gonorrhea.
Cephelosporins bears close resemblance in the composition of penicillins. They are water salable and stable to change in pH, and temperature. Various cephelosporins differ in their antibacterial spectrum and their resistant to betalactum.
Cephelosporins act by inhibiting bacterial cell wall synthesis in a manner similar to penicillins and are bactericidal. Resistance to cephelosporins develop slowly. Cross resistance for other beta lactum agents also occurs.
Cephelosporins are administered orally or by intravenous route. lntramuscular injections are painful. Their body distribution is similar to penicillins. The concentration in eye and C.S.F. is poor. There are differences in pharmacokinetics amongst various cephelisporins. They are eliminated mainly by kidney and high concentration is achieved in urinary tract. Exceretion is reduced in cases of renal insufficiency and in case of renal function impairment, the dose of cephelosporins should be reduced. Adverse reactions are occasional allergy, skin rash, fever, serum sickness and anaphylactic should not be used in those who reactions (rare). Cephelosporins have history of reaction to penicillin.
Food and antacids reduced absorption of the orally administered cephelosporins but some of the newer ones are readily absorbed with food. They all penetrate well into most tissues and all compartments Orally given cephelosporins do not achieve high concentration in C.S.F. Orally they are to be given three or four times a day. Most parenterally administered cephelosphorins have relatively short half life (0.5 to 2 hrs.) and thus require administering every 6 to 8 hours. The dosage vary with the preparation and generation of cephelosporins and are available from the manufacturers.
Cephelosporins are quite often first line of treatment in many infections including pneumonia, meningitis. New cephelosporins are introduced frequently, each one has a unique spectrum of activity or advantage over previously available drugs.
The various cephelosphorins are usually classified into generation based on the development and also loosely on their spectrum of activity. They are available in both oral and parental form.
Fourth generation cephelosphorin was introduced in 1997. Cafe-pine is new one with properties Like third generation but most resistant to some beta lactums. It is used parenterally .
Spectrum of activity and clinical indications cephelosphorins have broad spectrums and low toxicity. They are good choice for initial empirical treatment of many infectious diseases. They are easy to administer. They are effective for treatment of many conditions including pneumonia, skin and soft tissue infections and meningitis. The differences amongst numerous cephelosphorins are subtle, however an understanding of these differences is essential for optimal use of them. As a result of wide spread use of cephelosphorins bacterial resistance to these drugs are increasingly common. They are not effective against enterolocci (strap faccalis) and against anaerobic infections. Except for caphataxime, cephtriaxone, coffazidine and ceftiaxime CNS penetration is poor. These four drugs are useful from gram negative bacillary meningitis.
Cephelosphorins are commonly used in pneumonia and when it become complication of sedentary life and some of noso comial infections. They are used in meningitis and is considered a drug of choice. Penicillin resistant gonococci is commonly susceptible to cepholosphorins. They have been used in preoperative antimicrobial prophylaxis. They have been used in endocarditis. Cephelosphorins are in use for more three decades and have been used in treatment of many infections. Choosing a proper cephelosphorin is a difficult task. It depends upon understanding of its activity, toxicity and cost. It should not be used where other cheaper and effective antibiotics are available. The advent of new fourth generation of cephelosphorin will prolong their utility. To increase their usefulness and to prevent drug resistance other effective antibiotics should be used in combination. E. B.
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