Which medications in the drug class Cephalosporins are used in the treatment of Acute Sinusitis?

Updated: Mar 01, 2018
  • Author: Itzhak Brook, MD, MSc; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Cephalosporins

Cephalosporins are structurally and pharmacologically related to penicillins. They inhibit bacterial cell wall synthesis, resulting in bactericidal activity. Cephalosporins are divided into first, second, third and fourth generation. First-generation cephalosporins have greater activity against gram-positive bacteria, and succeeding generations have increased activity against gram-negative bacteria and decreased activity against gram-positive bacteria.

Cefprozil

Cefprozil is a second-line agent. It binds to one or more of the penicillin-binding proteins, which, in turn, inhibits cell wall synthesis and results in bactericidal activity.

Cefuroxime (Ceftin, Zinacef)

Cefuroxime is a second-line agent. It is a second-generation cephalosporin that maintains the gram-positive activity of first-generation cephalosporins, adding activity against Proteus mirabilis, H influenzae, Escherichia coli, Klebsiella pneumoniae, and M catarrhalis.

Cefpodoxime

Cefpodoxime is a second-line agent. It binds to one or more penicillin-binding proteins, which, in turn, inhibits cell wall synthesis and results in bactericidal activity.

Cefixime (Suprax)

Cefixime is a second-line agent. By binding to one or more penicillin-binding proteins, it arrests bacterial cell wall synthesis and inhibits bacterial growth.

Ceftriaxone (Rocephin)

Ceftriaxone is a third-generation cephalosporin with broad-spectrum, gram-negative activity; it has lower efficacy against gram-positive organisms and higher efficacy against resistant organisms. It arrests bacterial growth by binding to one or more penicillin binding proteins. It has good penetration.

Cefdinir

Classified as a third-generation cephalosporin, cefdinir inhibits mucopeptide synthesis in the bacterial cell wall. It is typically bactericidal, depending on organism susceptibility, dose, and serum or tissue concentrations.

Cefaclor

Cefaclor is used for treatment of infections caused by susceptible organisms including H influenzae and for treatment of otitis media, sinusitis, and infections involving the respiratory tract. It may not be appropriate in acute sinusitis, owing to less activity and the potential for severe allergic reactions.

Cefotaxime (Claforan)

Cefotaxime is a third-generation cephalosporin with broad gram-negative spectrum, lower efficacy against gram-positive organisms, and higher efficacy against resistant organisms. It arrests bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins, which, in turn, inhibits bacterial growth.

Ceftazidime (Fortaz, Tazicef)

Ceftazidime is a third-generation cephalosporin with broad-spectrum, gram-negative activity, including pseudomonas; lower efficacy against gram-positive organisms; and higher efficacy against resistant organisms. It arrests bacterial growth by binding to one or more penicillin-binding proteins, which, in turn, inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall synthesis, thus inhibiting cell wall biosynthesis.


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