Cephalosporin generations have confused tens of thousands of students; their names and individual characteristics proving to be nothing other than a nexus of confusion. Here, we go some way toward clarifying what is otherwise an arcane subject.
Whilst we are examining fifth generation cephalosporins here, you can find the other generations in the links below:
- First-Generation Cephalosporins
- Second-Generation Cephalosporins
- Third-Generation Cephalosporins
- Fourth-Generation Cephalosporins
- Fifth-Generation Cephalosporins
Each review goes through the main examples of each class, their pharmacology, what differentiates them from earlier and later classes, as well as assessing some of the main side effects and drug interactions associated with each generation.
What are 5th Generation Cephalosporins?
Fifth generation cephalosporins are a contentiously named class, because there is no consensus on what exactly constitutes this most novel class. The terminology is not universally accepted, though it can be assumed, in time, that it will.
Like penicillins, cephalosporins are bactericidal in effect – meaning that they actively kill bacteria rather than merely suppressing their growth (an effect that defines bacteriostatic antibacterials).
Fifth generation cephalosporins include drugs such as:
Like their fourth-generation counterparts, members of the fifth generation are quite easy to commit to memory. Unlike other generations, all of the above members of one class begin with the same prefix, ‘ceft’.
As well as this, fifth generation drugs also contain ‘ol’ in their name. The combination of ‘ceft’ + ‘ol’ means that it becomes almost impossible not to identify drugs of this generation. Of course, this assumes that future members of this class follow the same nomenclature.
Spectrum of Activity
Fifth generation cephalosporins have broad-spectrum activity. Let’s review some of their main pharmacological features:
- Ceftobiprole is used in the treatment of hospital-acquired pneumonia (HAP) and community-acquired pneumonia (CAP). It is only available in IV form. Ceftobiprole is not licensed for use in the United States.
- Ceftaroline does not have the antipseudomonal activity that ceftobiprole has. It is, however, active against MRSA and Gram-positive bacteria. As with later cephalosporin generations, the fifth generation also has extended activity against Gram-negatives.
- Ceftolozane is given with the beta-lactamase inhibitor, tazobactam, in the treatment of complicated UTIs and intraabdominal infections. It is only available for use via intravenous means.
Adverse effects are like other cephalosporins of other generations. Side effects include nausea, vomiting, diarrhea, injection site pain and abdominal pain. Some patients experience skin rash and headache.
Check out the links at the top of this page for more information on the pharmacology of the remaining cephalosporin generations.