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Cephalosporins (Cephalosporins) are a class of antibiotics obtained by using natural cephalosporin C obtained from cephalosporin cultivation as a raw material and semi-synthetic modification of its side chain. About 30 kinds of commonly used are divided into one, two, three, and four generations according to their chronology and antibacterial performance.

Pioneer 1

(drug)

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Cephalosporins (Cephalosporins) are a class of antibiotics obtained by using natural cephalosporin C obtained from cephalosporin cultivation as a raw material and semi-synthetic modification of its side chain. About 30 commonly used, according to its invention

Pioneer One: Ceftiofen

Pioneer II: Ceftiodine

Pioneer IV: Cephalexin

Pioneer V: Cefazolin

Pioneer Six: Cefraditin

Cephalosporins (Cephalosporins) are a class of antibiotics obtained by using natural cephalosporin C obtained from cephalosporin cultivation as a raw material and semi-synthetic modification of its side chain. About 30 kinds of commonly used are divided into one, two, three, and four generations according to their chronology and antibacterial performance.

1. Generation of cephalosporins

The first generation of cephalosporins was launched in the early 1960s. In terms of antibacterial performance, the first-generation cephalosporin-sensitive bacteria are mainly -hemolytic streptococcus and other streptococci, including Streptococcus pneumoniae (but enterococcus is resistant), Staphylococcus (including enzyme-producing strains), Haemophilus influenzae, E. coli, Klebsiella, Proteus mirabilis, Salmonella, Shigella, etc. Different varieties of cephalosporins can have their own antibacterial characteristics. For example, cephalosporin has a better antibacterial effect on Gram-positive bacteria, while cefazolin has certain effects on certain Gram-negative bacteria. However, the first-generation cephalosporins have weak resistance to the -lactamase of gram-negative bacteria, so the gram-negative bacteria are more resistant to the antibiotics of the current generation. The first-generation cephalosporins were ineffective against microorganisms such as indole-positive Proteus, Citrobacter, Aerobacter, Pseudomonas, Serratia, Bacteroides, Streptococcus faecium (except cephalosporin).

Commonly used varieties of this generation of antibiotics are cefazolin, cefalexin, cefradidin, cefadroxil, and the like. Except for cefazolin, which can only be used for injection, the others can be used orally, also known as oral cephalosporins. Cefalotin, cefotaxime, cefalexin, cefotaxime, and cefpirin have all been used less or not.

2. Second-generation cephalosporins

The antibacterial efficacy of the second-generation cephalosporins against Gram-positive bacteria is similar to or lower than that of the first-generation bacteria, while the effect on Gram-negative bacteria is superior, as shown in:

(1) Strong resistance to enzymes Some Gram-negative bacteria (such as E. coli, Proteus mirabilis, etc.) are easily resistant to first-generation cephalosporins. Second-generation cephalosporins are often effective against these resistant strains.

(2) Broad antibacterial spectrum The antibacterial spectrum of the second-generation cephalosporins has been expanded compared to the first generation, and it has antibacterial effects on Neisseria, some indole-positive proteobacteria, some citrate bacteria, and some intestinal spp. .

The second-generation cephalosporins are not effective against Pseudomonas (Pseudomonas aeruginosa), Acinetobacter, Serratia, Streptococcus faecalis, etc.

The main varieties of second-generation cephalosporins used in clinical applications include cefmendo, cefoxitin (mefuxin), cefuroxime (celixin), cefaclor, etc.

3. The third generation of cephalosporins

The third-generation cephalosporins are generally less effective against Gram-positive bacteria than the first-generation (some species are similar), and their effects on Gram-negative bacteria are superior to the second-generation cephalosporins.

(1) Antibacterial spectrum is expanded. The antibacterial spectrum of the third-generation cephalosporin is expanded compared with the second generation. It is effective against Bacillus effective (different varieties of drugs have different antibacterial efficacy). It is not effective for Streptococcus faecalis and Clostridium difficile.

(2) For some Gram-negative strains that are resistant to first- or second-generation cephalosporins, third-generation cephalosporins are often effective.

Commonly used are: cefoperazone (pioneer prime), ceftriazine (rosetin, bacitride), cefotaxime sodium, ceftazidime, ceftizoxime and so on.

4. Fourth generation cephalosporins

The third-generation cephalosporins have a weak effect on Gram-positive bacteria and cannot be used to control Staphylococcus aureus infections. In recent years, some new varieties such as Cefpirome have been discovered. They not only have the antibacterial properties of the third-generation cephalosporins, but also have antibacterial effects on staphylococci. They are called fourth-generation cephalosporins.

The classification of the first to fourth generations is not only applicable to cephalosporins, but other -lactam antibiotics can also be classified according to this.

Latacephalosporin, cefpirome, aztreonam, etc. are commonly used.