Other cephalosporins

What are Other cephalosporins?

Other cephalosporins include new cephalosporins that do not fit into one of the five existing generations of cephalosporins.

Cefiderocol is a first in its class siderophore cephalosporin with a unique mechanism of action and structure that combines a catechol-type siderophore (these chelate ferric iron via hydroxyl groups) with a cephalosporin core. This gives it enhanced stability against hydrolysis by many β-lactamases, including extended-spectrum β-lactamases, such as CTX-M, and carbapenemases.

Fifth-generation cephalosporins are indicated for treating bacteria that are otherwise resistant to other commonly used antibiotics. One example of this drug’s effectiveness is against MRSA.

What are examples of cephalosporins? Examples of cephalosporins include first-generation drugs cefazolin and cephalexin ; second-generation drugs cefuroxime and cefoxitin ; third-generation drugs ceftriaxone and ceftazidime; fourth-generation drug cefepime ; and fifth-generation drug ceftaroline.

Fourth-generation cephalosporins, such as cefpirome or cefepime, may be considered as single agent therapy because of their high potency against Gram-positive pathogens (S. pneumoniae and S. aureus) and Gram-negative bacilli 2,3,49.

Cephalexin, cephradine, cefaclor, cefixime, cefadroxil, cefprozil, cefpodoxime, ceftibuten, cefuroxime demonstrate effective absorption following oral administration. Excretion: Cephalosporins are primarily excreted via renal pathways, necessitating dosage adjustments in cases of renal insufficiency.

New generation (5th) of cephalosporins have been introduced on the market over the last decade to combat methicillin-resistant Staphylococcus aureus (MRSA), i.e., ceftaroline and ceftobiprole, and avoid the toxicity of vancomycin. To meet the challenge of multiresistant Enterobacteriaceae and Pseudomonas infections, a novel siderophore cephalosporin (cefiderocol) was approved by the US Food and Drug Administration (FDA) for complicated urinary infections and pyelonephritis in 2019. This promising novel cephalosporin is active in vitro against most multiresistant and carbapenem-resistant gram-negative strains, even those resistant to all other antibiotics including colistin. Thus, it will be a useful agent to reserve for these difficult to treat pan-resistant gram-negative bacteria such as P. aeruginosa, A. baumannii, S. maltophilia, B. cepacia, and Serratia spp.