Generation depends on spectrum of bacteria covered.

Cefixime – G negative

3rd Gen . Oral

Cefditoren(Ceftorin)

Cefixime Uses :- UTI,GI(Enteric Fever)

Ear Infections – usually due to H.Influenza(which is G –ve),so cefixime may act.
Dose of cefixime 10mg/kg body wt.
Cefdinir(300mg) – dose- 10mg/kg
All 3 third gen oral cephalosporins are interchangeable(can be used).

Now-a-days resistance to ceftriaxone has also been found..

Cephalexin acts agains E.Coli,so choose this in UTI.

In Sinusitis – use cefdinir(10days) and Levofloxacin(15days).
Levofloxacin dose is 750mg bd in those whose weight is > 50kg.
Cefaclor is very costly,not used.
Cefditoren is good.
10-15% cross-reactivity occuse between penicillins and cephalosporins.
If cephalosporins need to be given at home,do test dose.
If loose motions occur with amoxicillin , don’t use cephalosporins.
Roxithromycin is useless.
Salicylates raise levels of cephalosporins.
Cephalosporins are nephrotoxic.Absorption of cephalosporins decreases with alcohol.All
cephalosporins should be taken after food.While cipro should be taken half hour before
food.Oflox after food.Azithromycin before food.Doxy before food.

Parentral Cephalosporins
Cefazolin – Ist gen. (Trade name-Reflin) Rs.33 per gram.
Cefuroxime – IInd gen. (Trade names – Ceftum,Supacef)
Ceftriaxone(Monocef) 250,500,1g,2g.
Cefepine IVth gen. – even not used.

Beta-lactam inhibitors are clauvulinic acid(used in augmentin),Sulbactum and

Tazobactam.
Ceftriaxone + Sulbactum combn. = 1g + 500mg respectively = Trade name-Ofromax
forte(greater potent than monocef only.)= Rs.106. while ceftriaxone only is Rs.60.
Ceftrixone injn. Is painful,useful in uncomplicated UTI.
IV ceftriaxone not to be used in OPD.Oflomax forte dose is 1.5-2g bd.

IIIrd gen.-Ceftazidime(used in hospitals for Pseudomonas)

Cefoperazone not used because it reduces platelet count and causes bleeding.
Tazect=poperacillin(which is an extended spectrum penicillin) + Tazobactum=This
combination is a potent antibiotic used in major hospitals.
Amox + Clox (250 + 250) is subtherapeutic..
Levoflox 750 used for URTI.
For pharyngitis = in order of preference – Doxy,Levofloxacin and Azithromycin can be
used,Cipro not effective in RTI.
All quinolones – not to be used in patients with h/o convulsions . Quinolones interact
with aminophylline(deriphylline)-deriphylline levels raised=can cause convulsions..
How-ever Levofloxacin is safer than Cipro in combn. With Deriphyllin.
Terramycin(500qds) – same indications as doxy.