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one of several broad spectrum antibiotic substances obtained from fungi and related to penicillin (trade names Mefoxin); addition of side chains has produced semisynthetic antibiotics with greater antibacterial activity (同)Mefoxin

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/01/30 18:33:23」(JST)

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Structure of the classical cephalosporins

The cephalosporins (sg. pron.: /ˌsɛfəlɵˈspɔrɨn/) are a class of β-lactam antibiotics originally derived from the fungus Acremonium, which was previously known as "Cephalosporium".^[1]

Together with cephamycins, they constitute a subgroup of β-lactam antibiotics called cephems.

Medical use

Cephalosporins are indicated for the prophylaxis and treatment of infections caused by bacteria susceptible to this particular form of antibiotic. First-generation cephalosporins are active predominantly against Gram-positive bacteria, and successive generations have increased activity against Gram-negative bacteria (albeit often with reduced activity against Gram-positive organisms).

Adverse effects

Common adverse drug reactions (≥ 1% of patients) associated with the cephalosporin therapy include: diarrhea, nausea, rash, electrolyte disturbances, and/or pain and inflammation at injection site. Infrequent ADRs (0.1–1% of patients) include vomiting, headache, dizziness, oral and vaginal candidiasis, pseudomembranous colitis, superinfection, eosinophilia, and/or fever.

The commonly quoted figure of 10% of patients with allergic hypersensitivity to penicillins and/or carbapenems also having cross-reactivity with cephalosporins originated from a 1975 study looking at the original cephalosporins,^[2] and subsequent "safety first" policy meant this was widely quoted and assumed to apply to all members of the group.^[3] Hence, it was commonly stated that they are contraindicated in patients with a history of severe, immediate allergic reactions (urticaria, anaphylaxis, interstitial nephritis, etc.) to penicillins, carbapenems, or cephalosporins.^[4] This, however, should be viewed in the light of recent epidemiological work suggesting, for many second-generation (or later) cephalosporins, the cross-reactivity rate with penicillin is much lower, having no significantly increased risk of reactivity in the studies examined.^[3]^[5] The British National Formulary previously issued blanket warnings of 10% cross-reactivity, but, since the September 2008 edition, suggests, in the absence of suitable alternatives, oral cefixime or cefuroxime and injectable cefotaxime, ceftazidine, and ceftriaxone can be used with caution, but the use of cefaclor, cefadrocil, cefalexin, and cefradine should be avoided.^[6]

Several cephalosporins are associated with hypoprothrombinemia and a disulfiram-like reaction with ethanol.^[7]^[8] These include latamoxef, cefmenoxime, moxalactam, cefoperazone, cefamandole, cefmetazole, and cefotetan. This is thought to be due to the N-methylthiotetrazole (NMTT) side-chain of these cephalosporins, which blocks the enzyme vitamin K epoxide reductase (likely causing hypothrombinemia) and aldehyde dehydrogenase (causing alcohol intolerance).^[9]

Mechanism of action

Cephalosporins are bactericidal and have the same mode of action as other beta-lactam antibiotics (such as penicillins) but are less susceptible to penicillinases. Cephalosporins disrupt the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity. The final transpeptidation step in the synthesis of the peptidoglycan is facilitated by transpeptidases known as penicillin-binding proteins (PBPs). PBPs bind to the D-Ala-D-Ala at the end of muropeptides (peptidoglycan precursors) to crosslink the peptidoglycan. Beta-lactam antibiotics mimic the D-Ala-D-Ala site, thereby competitively inhibiting PBP crosslinking of peptidoglycan.

Resistance

Resistance to cephalosporin antibiotics can involve either reduced affinity of existing penicillin-binding-protein components or the acquisition of a supplementary beta-lactam-insensitive penicillin-binding-protein. Currently, some Citrobacter freundii, Enterobacter cloacae and Escherichia coli strains are resistant to cephalosporin. Some Morganella morganii, Proteus vulgaris, Providencia rettgeri, Pseudomonas aeruginosa and Serratia marcescens strains have also developed resistance to cephalosporin to varying degrees.^[10]

Classification

The cephalosporin nucleus can be modified to gain different properties. Cephalosporins are sometimes grouped into "generations" by their antimicrobial properties. The first cephalosporins were designated first-generation cephalosporins, whereas, later, more extended-spectrum cephalosporins were classified as second-generation cephalosporins. Each newer generation has significantly greater Gram-negative antimicrobial properties than the preceding generation, in most cases with decreased activity against Gram-positive organisms. Fourth-generation cephalosporins, however, have true broad-spectrum activity.

The classification of cephalosporins into "generations" is commonly practised, although the exact categorization is often imprecise. For example, the fourth generation of cephalosporins is not recognized as such in Japan.^{[citation needed]} In Japan, cefaclor is classed as a first-generation cephalosporin, though in the United States it is a second-generation one; and cefbuperazone, cefminox, and cefotetan are classed as second-generation cephalosporins. Cefmetazole and cefoxitin are classed as third-generation cephems. Flomoxef and latamoxef are in a new class called oxacephems.

Most first-generation cephalosporins were originally spelled "ceph-" in English-speaking countries. This continues to be the preferred spelling in the United States, Australia and New Zealand, while European countries (including the United Kingdom) have adopted the International Nonproprietary Names, which are always spelled "cef-". Newer first-generation cephalosporins and all cephalosporins of later generations are spelled "cef-", even in the United States.

Some state, although cephalosporins can be divided into five or even six generations, the usefulness of this organization system is of limited clinical relevance.^[11]

Fourth-generation cephalosporins as of March, 2007, were considered to be "a class of highly potent antibiotics that are among medicine's last defenses against several serious human infections" according to the Washington Post.^[12]

The mnemonic "LAME" is used to note organisms against which cephalosporins do not have activity: Listeria, Atypicals (including Mycoplasma and Chlamydia), MRSA, and enterococci.^{[citation needed]}

Fifth-generation cephalosporins are effective against MRSA, however.

#	Members	Description
1	Cefacetrile (cephacetrile), Cefadroxil (cefadroxyl; Duricef), Cephalexin (cefalexin; Keflex), Cefaloglycin (cephaloglycin), Cefalonium (cephalonium), Cefaloridine (cephaloradine), Cefalotin (cephalothin; Keflin), Cefapirin (cephapirin; Cefadryl), Cefatrizine, Cefazaflur, Cefazedone, Cefazolin (cephazolin; Ancef, Kefzol), Cefradine (cephradine; Velosef), Cefroxadine, Ceftezole	Gram-positive: Activity against penicillinase-producing, methicillin-susceptible staphylococci and streptococci (though they are not the drugs of choice for such infections). No activity against methicillin-resistant staphylococci or enterococci. Gram-negative: Activity against Proteus mirabilis, some Escherichia coli, and Klebsiella pneumoniae ("PEcK"), but have no activity against Bacteroides fragilis, Pseudomonas, Acinetobacter, Enterobacter, indole-positive Proteus, or Serratia
2	Cefaclor (Ceclor, Distaclor, Keflor, Raniclor), Cefonicid (Monocid), Cefprozil (cefproxil; Cefzil), Cefuroxime (Zefu, Zinnat, Zinacef, Ceftin, Biofuroksym,^[13] Xorimax), Cefuzonam, second-generation cephalosporins with antianaerobe activity: Cefmetazole, Cefotetan, Cefoxitin. The following cephems are also sometimes grouped with second-generation cephalosporins: Carbacephems: loracarbef (Lorabid); Cephamycins: cefbuperazone, cefmetazole (Zefazone), cefminox, cefotetan (Cefotan), cefoxitin (Mefoxin), Cefotiam.	Gram-positive: Less than first-generation. Gram-negative: Greater than first-generation: HEN (Haemophilus influenzae, Enterobacter aerogenes and some Neisseria + the PEcK described above
3	Cefcapene, Cefdaloxime, Cefdinir (Sefdin, Zinir, Omnicef, Kefnir), Cefditoren, Cefetamet, Cefixime (Fixx, Zifi, Suprax), Cefmenoxime, Cefodizime, Cefotaxime (Claforan), Cefovecin (Convenia), Cefpimizole, Cefpodoxime (Vantin, PECEF), Cefteram, Ceftibuten (Cedax), Ceftiofur, Ceftiolene, Ceftizoxime (Cefizox), Ceftriaxone (Rocephin). Third-generation cephalosporins with antipseudomonal activity: Cefoperazone (Cefobid), Ceftazidime (Fortum, Fortaz). The following cephems are also sometimes grouped with third-generation cephalosporins: Oxacephems: latamoxef (moxalactam).	Gram-positive: Some members of this group (in particular, those available in an oral formulation, and those with antipseudomonal activity) have decreased activity against Gram-positive organisms. Gram-negative: Third-generation cephalosporins have a broad spectrum of activity and further increased activity against Gram-negative organisms. They may be particularly useful in treating hospital-acquired infections, although increasing levels of extended-spectrum beta-lactamases are reducing the clinical utility of this class of antibiotics. They are also able to penetrate the CNS, making them useful against meningitis caused by pneumococci, meningococci, H. influenzae, and susceptible E. coli, Klebsiella, and penicillin-resistant N. gonorrhoeae. Since 2007, third-generation cephalosporins (ceftriaxone or cefixime) have been the only recommended treatment for gonorrhea in the United States.^[14]
4	Cefclidine, cefepime (Maxipime), cefluprenam, cefoselis, Cefozopran, Cefpirome (Cefrom), Cefquinome The following cephems are also sometimes grouped with fourth-generation cephalosporins: Oxacephems: flomoxef	Gram-positive: They are extended-spectrum agents with similar activity against Gram-positive organisms as first-generation cephalosporins. Gram-negative: Fourth-generation cephalosporins are zwitterions that can penetrate the outer membrane of Gram-negative bacteria.^[15] They also have a greater resistance to beta-lactamases than the third-generation cephalosporins. Many can cross the blood–brain barrier and are effective in meningitis. They are also used against Pseudomonas aeruginosa.
5	Ceftobiprole, Ceftaroline	Ceftobiprole has been described as "fifth-generation" cephalosporin,^[16]^[17] though acceptance for this terminology is not universal. Ceftobiprole (and the soluble prodrug medocaril) are on the FDA fast-track. Ceftobiprole has powerful antipseudomonal characteristics and appears to be less susceptible to development of resistance. Ceftaroline has also been described as "fifth-generation" cephalosporin, but does not have the anti-pseudomonal or VRE coverage of ceftobiprole^[18]

Other

These cephems have progressed far enough to be named, but have not been assigned to a particular generation: Cefaloram, Cefaparole, Cefcanel, Cefedrolor, Cefempidone, Cefetrizole, Cefivitril, Cefmatilen, Cefmepidium, Cefoxazole, Cefrotil, Cefsumide, Ceftioxide, Cefuracetime.^{[citation needed]}Nitrocefin, a chromogenic cephalosporin substrate is used for detection of beta-lactamase enzymes.

History

See also: Discovery and development of cephalosporins

Cephalosporin compounds were first isolated from cultures of Cephalosporium acremonium from a sewer in Sardinia in 1948 by Italian scientist Giuseppe Brotzu.^[19] He noticed these cultures produced substances that were effective against Salmonella typhi, the cause of typhoid fever, which had beta-lactamase. Guy Newton and Edward Abraham at the Sir William Dunn School of Pathology at the University of Oxford isolated cephalosporin C. The cephalosporin nucleus, 7-aminocephalosporanic acid (7-ACA), was derived from cephalosporin C and proved to be analogous to the penicillin nucleus 6-aminopenicillanic acid (6-APA), but it was not sufficiently potent for clinical use. Modification of the 7-ACA side-chains resulted in the development of useful antibiotic agents, and the first agent cefalotin (cephalothin) was launched by Eli Lilly and Company in 1964.

References

^ "cephalosporin" at Dorland's Medical Dictionary
^ Dash CH (1975). "Penicillin allergy and the cephalosporins". J. Antimicrob. Chemother. 1 (3 Suppl): 107–18. PMID 1201975.
^ ^a ^b Pegler S, Healy B (10 November 2007). "In patients allergic to penicillin, consider second and third generation cephalosporins for life threatening infections". BMJ 335 (7627): 991–991. doi:10.1136/bmj.39372.829676.47. PMC 2072043. PMID 17991982. //www.ncbi.nlm.nih.gov/pmc/articles/PMC2072043/.
^ Rossi S, editor. Australian Medicines Handbook 2006. Adelaide: Australian Medicines Handbook; 2006.
^ Pichichero ME (2006). "Cephalosporins can be prescribed safely for penicillin-allergic patients" (PDF). The Journal of family practice 55 (2): 106–12. PMID 16451776. http://www.jfponline.com/pdf%2F5502%2F5502JFP_AppliedEvidence1.pdf.
^ "5.1.2 Cephalosporins and other beta-lactams". British National Formulary (56 ed.). London: BMJ Publishing Group Ltd and Royal Pharmaceutical Society Publishing. September 2008. pp. 295. ISBN 0-85369-778-7.
^ Kitson TM (1987). "The effect of cephalosporin antibiotics on alcohol metabolism: a review". Alcohol 4 (3): 143–148. doi:10.1016/0741-8329(87)90035-8. PMID 3593530.
^ Shearer MJ, Bechtold H, Andrassy K et al. (1988). "Mechanism of cephalosporin-induced hypoprothrombinemia: relation to cephalosporin side chain, vitamin K metabolism, and vitamin K status". Journal of clinical pharmacology 28 (1): 88–95. PMID 3350995.
^ Stork CM (2006). "Antibiotics, antifungals, and antivirals". In Nelson LH, Flomenbaum N, Goldfrank LR, Hoffman RL, Howland MD, Lewin NA. Goldfrank's toxicologic emergencies. New York: McGraw-Hill. pp. 847. ISBN 0-07-143763-0. http://books.google.com/books?id=cvJuLqBxGUcC&pg=PA847. Retrieved 2009-07-03.
^ "Cephalosporin spectrum of resistance". http://antibiotics.toku-e.com/m/?w=cephalosporin. Retrieved 01 July 2012.
^ "Case Based Pediatrics Chapter". http://www.hawaii.edu/medicine/pediatrics/pedtext/s06c05.html.
^ Weiss, Rick (4 March 2007). "FDA Rules override Warnings about Drugs". March 4, 2007. http://www.washingtonpost.com/wp-dyn/content/article/2007/03/03/AR2007030301311.html.
^ Jędrzejczyk, Tadeusz. "Internetowa Encyklopedia Leków". leki.med.pl. http://www.leki.med.pl/lek.phtml?id=428&idnlek=2682&menu=4. Retrieved 2007-03-03.
^ Barclay, Laurie (April 16, 2007). "CDC issues new treatment recommendations for gonorrhea". Medscape. http://cme.medscape.com/viewarticle/555228. Retrieved 2009-07-01.
^ Richard L Sweet; Ronald S. Gibbs (1 March 2009). Infectious Diseases of the Female Genital Tract. Lippincott Williams & Wilkins. pp. 403–. ISBN 978-0-7817-7815-2. http://books.google.com/books?id=wuR_ngItU5oC&pg=PA403. Retrieved 8 September 2010.
^ Widmer AF (March 2008). "Ceftobiprole: a new option for treatment of skin and soft-tissue infections due to methicillin-resistant Staphylococcus aureus". Clin. Infect. Dis. 46 (5): 656–658. doi:10.1086/526528. PMID 18225983.
^ Kosinski MA, Joseph WS (July 2007). "Update on the treatment of diabetic foot infections". Clin Podiatr Med Surg 24 (3): 383–396. doi:10.1016/j.cpm.2007.03.009. PMID 17613382. http://journals.elsevierhealth.com/retrieve/pii/S0891-8422(07)00026-2.
^ Kollef MH (December 2009). "New antimicrobial agents for methicillin-resistant Staphylococcus aureus". Crit Care Resusc 11 (4): 282–6. PMID 20001879.
^ Podolsky, M. Lawrence (1998) Cures Out of Chaos: How Unexpected Discoveries Led to Breakthroughs in Medicine and Health, Harwood Academic Publishers

UpToDate Contents

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1. セフェム系 cephalosporins
2. セファロスポリン-アレルギー患者：セファロスポリンおよび関連抗菌薬のその後の使用 cephalosporin allergic patients subsequent use of cephalosporins and related antibiotics
3. セファロスポリンアレルギー：臨床症状および診断 cephalosporin allergy clinical manifestations and diagnosis
4. ペニシリン-アレルギー患者：セフェム系、カルバペネム系、およびモノバクタム系の使用 penicillin allergic patients use of cephalosporins carbapenems and monobactams
5. Intracranial epidural abscess

English Journal

A retrospective comparative study of 2-drug oral and intramuscular cephalosporin treatment regimens for pharyngeal gonorrhea.

Barbee LA, Kerani RP, Dombrowski JC, Soge OO, Golden MR.SourceDepartment of Medicine, University of Washington.
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.Clin Infect Dis.2013 Jun;56(11):1539-45. doi: 10.1093/cid/cit084. Epub 2013 Feb 13.
Background. The Centers for Disease Control and Prevention guidelines for pharyngeal gonorrhea treatment recommend dual therapy with intramuscular ceftriaxone and either azithromycin or doxycycline. Few clinical data exist to support this recommendation. Methods. We conducted a retrospective ana
PMID 23408680

Evaluation of an autogenous vaccine in cattle against Escherichia coli bearing the CTX-M-14 plasmid.

Reeves HE, Lotz SB, Kennedy E, Randall LP, Coldham NG, La Ragione RM.SourceDepartment of Bacteriology and Food Safety, Animal Health and Veterinary Laboratories Agency (AHVLA) Weybridge, New Haw, Addlestone, Surrey, KT15 3NB, United Kingdom. Electronic address: hannah.reeves@ahvla.gsi.gov.uk.
Research in veterinary science.Res Vet Sci.2013 Jun;94(3):419-24. doi: 10.1016/j.rvsc.2013.01.001. Epub 2013 Jan 26.
Enteric bacteria with resistance to third and fourth generation cephalosporin antibiotics, especially Escherichia coli bearing the blaCTX-M gene, have been detected in a wide range of food producing animals. However, commercial vaccines for these organisms are not currently available. An autogenous
PMID 23360687

Nationwide surveillance of bacterial pathogens from patients with acute uncomplicated cystitis conducted by the Japanese surveillance committee during 2009 and 2010: antimicrobial susceptibility of Escherichia coli and Staphylococcus saprophyticus.

Hayami H, Takahashi S, Ishikawa K, Yasuda M, Yamamoto S, Uehara S, Hamasuna R, Matsumoto T, Minamitani S, Watanabe A, Iwamoto A, Totsuka K, Kadota J, Sunakawa K, Sato J, Hanaki H, Tsukamoto T, Kiyota H, Egawa S, Tanaka K, Arakawa S, Fujisawa M, Kumon H, Kobayashi K, Matsubara A, Naito S, Tatsugami K, Yamaguchi T, Ito S, Kanokogi M, Narita H, Kawano H, Hosobe T, Takayama K, Sumii T, Fujii A, Sato T, Yamauchi T, Izumitani M, Chokyu H, Ihara H, Akiyama K, Yoshioka M, Uno S, Monden K, Kano M, Kaji S, Kawai S, Ito K, Inatomi H, Nishimura H, Ikuyama T, Nishi S, Takahashi K, Kawano Y, Ishihara S, Tsuneyoshi K, Matsushita S, Yamane T, Hirose T, Fujihiro S, Endo K, Oka Y, Takeyama K, Kimura T, Uemura T.SourceUrogenital sub-committee and the Surveillance Committee of Japanese Society of Chemotherapy (JCS), The Japanese Association for Infectious Diseases (JAID) and The Japanese Society for Clinical Microbiology (JSCM), Tokyo, Japan, bass@m.kufm.kagoshima-u.ac.jp.
Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy.J Infect Chemother.2013 May 3. [Epub ahead of print]
The Japanese surveillance committee conducted the first nationwide surveillance of antimicrobial susceptibility patterns of uropathogens responsible for female acute uncomplicated cystitis at 43 hospitals throughout Japan from April 2009 to November 2010. In this study, the causative bacteria (Esche
PMID 23640203

Frequency and factors associated with carriage of multi-drug resistant commensal Escherichia coli among women attending antenatal clinics in Central India.

Pathak A, Chandran P S, Mahadik K, Macaden R, Lundborg CS.AbstractBACKGROUND: Commensal Escherichia coli are a prominent reservoir of genes coding for antibiotic resistance and also responsible for endogenous infections in pregnant women. We studied the factors in pregnant women associated with carriage of multi-drug resistant (MDR) E. coli and genetic determinants of antibiotic resistance in them.
BMC infectious diseases.BMC Infect Dis.2013 May 2;13(1):199. [Epub ahead of print]
BACKGROUND: Commensal Escherichia coli are a prominent reservoir of genes coding for antibiotic resistance and also responsible for endogenous infections in pregnant women. We studied the factors in pregnant women associated with carriage of multi-drug resistant (MDR) E. coli and genetic determinant
PMID 23638834

Japanese Journal

Multidrug-Resistant Vibrio cholerae O1 was Responsible for a Cholera Outbreak in 2013 in Bagalkot, North Karnataka

Bhattacharya Debdutta,Dey Shuchismita,Roy Subarna,Parande Mahantesh V.,Telsang M.,Seema M. H.,Parande Aisha V.,Mantur Basappa G.
Japanese Journal of Infectious Diseases 68(4), 347-350, 2015
… All of the cephalosporin-resistant V. …
NAID 130005088798

医療現場における薬物治療の安全性確保を目指した臨床薬理学・薬剤疫学研究

川上純一
薬学雑誌. 乙号 135(4), 619-624, 2015
… The risk of a tendon disorder in FQ-prescribed patients was 0.082% (95%CI: 0.049-0.137%), and significantly higher than that in cephalosporin-prescribed patients. … The risk ratio in FQ-prescribed patients in relation to cephalosporin-prescribed patients was 6.29 (95%CI: 2.27-17.46). …
NAID 130005060831

Outbreak of cholera by multidrug resistant Vibrio cholerae O1 in a back ward taluka of Bagalkot, North Karnataka

Bhattacharya Debdutta,Dey Shuchismita,Roy Subarna,Parande Mahantesh V.,Telsang M.,Seema M. H.,Parande Aisha V.,Mantur Basappa G.
Japanese Journal of Infectious Diseases advpub(0), 2015
… All the cephalosporin resistant strains were confirmed to produce extended spectrum beta lactamase. …
NAID 130004757180

犬猫における第三世代セファロスポリン感受性と耐性腸内細菌科細菌感染症の治療成績 (日本獣医師会学会学術誌) -- (小動物臨床関連部門)

木村唯,嶋田恵理子,宮本忠 [他]
日本獣医師会雑誌 = Journal of the Japan Veterinary Medical Association 67(6), 419-425, 2014-06
NAID 40020122507

Related Pictures

★リンクテーブル★

リンク元	「セフタジジム」「セファロスポリン系抗菌薬」「セフォペラゾン」「セフトリアキソン」「セフォタキシム」
拡張検索	「cephalosporinase」「deacetoxycephalosporin」「cephalosporin antibiotic」
関連記事	「cephalosporins」

「セフタジジム」

Cephalosporin
	Drug class
	; Core structure of the cephalosporins
Use	Bacterial infection
Biological target	Penicillin binding proteins
ATC code	J01D
External links
MeSH	D002511
AHFS/Drugs.com	Drug Classes

　　[★]

英: ceftazidime, CAZ
商: Fortaz, Ceptaz, Tazicer, Taxidime。セパダシン、モダケミン、モダシン、モベンゾシン
関: セファロスポリン系抗菌薬

抗菌薬

βラクタム系抗菌薬

セファロスポリン系抗菌薬

generation III cephalosporin

抗菌スペクトル

セフォペラゾン cefoperazone、セフタジジム ceftazidimeはセファロスポリン系抗菌薬第三世代のなかで緑膿菌に有効な抗菌薬。

効果・効能

モダシン静注用

適応菌種

本剤に感性のブドウ球菌属、レンサ球菌属、肺炎球菌、大腸菌、シトロバクター属、クレブシエラ属、エンテロバクター属、セラチア属、プロテウス属、モルガネラ・モルガニー、プロビデンシア属、インフルエンザ菌、シュードモナス属、緑膿菌、バークホルデリア・セパシア、ステノトロホモナス（ザントモナス）・マルトフィリア、アシネトバクター属、ペプトストレプトコッカス属、バクテロイデス属、プレボテラ属（プレボテラ・ビビアを除く）

適応症

敗血症、感染性心内膜炎、外傷・熱傷及び手術創等の二次感染、咽頭・喉頭炎、扁桃炎（扁桃周囲炎、扁桃周囲膿瘍を含む）、急性気管支炎、肺炎、肺膿瘍、膿胸、慢性呼吸器病変の二次感染、膀胱炎、腎盂腎炎、前立腺炎（急性症、慢性症）、腹膜炎、胆嚢炎、胆管炎、肝膿瘍、バルトリン腺炎、子宮内感染、子宮付属器炎、子宮旁結合織炎、化膿性髄膜炎、中耳炎、副鼻腔炎

「セファロスポリン系抗菌薬」

　　[★]

英: cephalosporin antibiotics, cephalosporin, cephalosporins
同: セフェム系抗菌薬？、セフェム系抗生物質？ cephem antibiotic？ cephem antibiotics
関: 抗菌薬、βラクタム系抗菌薬、第三世代抗生物質

特徴

抗菌スペクトルが広い

グラム陽性菌、グラム陰性菌

酸に対して安定である
ペニシリナーゼに対して安定である

構造

副作用

過敏症(ペニシリン系抗菌薬と同様であるが、頻度はペニシリン系に比べ低い)
(1)ジスルフィラム様作用、(2)ビタミンK依存性の凝固因子の産生低下(cefotetanとcefoperazoneに特徴的。共通点はN-methylthiotetrazole(NMTT) side chainを持つこと)。(PPC.612)

セフェム系抗菌薬

第三世代セフェム

セフォタキシム	cefotaxime
セフトリアキソン	ceftriaxone
セフジニル	cefdinir
セフジトレンピボキシル	cefditoren pivoxil
セフチブテン	ceftibuten
セフポドキシムプロキセチル	cefpodoxime proxetil
セフチゾキシム	ceftizoxime
セフォペラゾン	cefoperazone
セフタジジム	ceftazidime

「セフォペラゾン」

　　[★]

英: cefoperazone CPZ
ラ: cefoperazonum
化: cefoperazone sodium セフォペラゾンナトリウム
商: CEFOBID。スペルゾン、スルタムジン、スルペゾール、スルペラゾン、セフォセフ、セフォビッド、セフォペラジン、セフォン、セフロニック、ナスパルン、バクフォーゼ、ワイスタール
関: セファロスポリン系抗菌薬

抗菌薬

βラクタム系抗菌薬

セファロスポリン系抗菌薬

generation III cephalosporin

抗菌スペクトル

セフォペラゾン cefoperazone、セフタジジム ceftazidimeはセファロスポリン系抗菌薬第三世代のなかで緑膿菌に有効な抗菌薬。

「セフトリアキソン」

　　[★]

英: ceftriaxone, CTRX
化: セフトリアキソンナトリウム ceftriaxone sodium
商: Rocephin。セフィローム、セフキソン、セロニード、リアソフィン、ロセフィン、ロゼクラート
関: 抗菌薬

first aid step1 2006 p.140,168,173

抗菌薬

βラクタム系抗菌薬

セファロスポリン系抗菌薬

generation III cephalosporin

第三世代セファロスポリン系抗菌薬：同系統の中では半減期が長い。1日1回投与でよい。
添付文書的には1日1-2g（力価）を1回又は2回に分けて静脈内注射又は点滴静注する。

Neisseria gonorrhoeae

「セフォタキシム」

　　[★]

英: cefotaxime CTX
ラ: cefotaximum cefotaxime sodium
化: cefotaxime sodium
商: CLAFORAN、クラフォラン、セフォタックス
関: 抗菌薬、セフェム系抗菌薬

抗菌薬

βラクタム系抗菌薬

セファロスポリン系抗菌薬

generation III cephalosporin

構造

「cephalosporinase」

　　[★]

セファロス・リナーゼ、セファロス・リン分解酵素

「deacetoxycephalosporin」

　　[★]

デアセトキシセファロス・リン

「cephalosporin antibiotic」

　　[★] セファロスポリン系抗菌薬

「cephalosporins」

　　[★] セファロスポリン系抗菌薬

[1] "cephalosporin" at Dorland's Medical Dictionary

[pmid1201975-2] Dash CH (1975). "Penicillin allergy and the cephalosporins". J. Antimicrob. Chemother. 1 (3 Suppl): 107–18. PMID 1201975.

[Pegler-3] Pegler S, Healy B (10 November 2007). "In patients allergic to penicillin, consider second and third generation cephalosporins for life threatening infections". BMJ 335 (7627): 991–991. doi:10.1136/bmj.39372.829676.47. PMC 2072043. PMID 17991982. //www.ncbi.nlm.nih.gov/pmc/articles/PMC2072043/.

[AMH2006-4] Rossi S, editor. Australian Medicines Handbook 2006. Adelaide: Australian Medicines Handbook; 2006.

[pmid16451776-5] Pichichero ME (2006). "Cephalosporins can be prescribed safely for penicillin-allergic patients" (PDF). The Journal of family practice 55 (2): 106–12. PMID 16451776. http://www.jfponline.com/pdf%2F5502%2F5502JFP_AppliedEvidence1.pdf.

[6] "5.1.2 Cephalosporins and other beta-lactams". British National Formulary (56 ed.). London: BMJ Publishing Group Ltd and Royal Pharmaceutical Society Publishing. September 2008. pp. 295. ISBN 0-85369-778-7.

[pmid3593530-7] Kitson TM (1987). "The effect of cephalosporin antibiotics on alcohol metabolism: a review". Alcohol 4 (3): 143–148. doi:10.1016/0741-8329(87)90035-8. PMID 3593530.

[pmid3350995-8] Shearer MJ, Bechtold H, Andrassy K et al. (1988). "Mechanism of cephalosporin-induced hypoprothrombinemia: relation to cephalosporin side chain, vitamin K metabolism, and vitamin K status". Journal of clinical pharmacology 28 (1): 88–95. PMID 3350995.

[Goldfrank-9] Stork CM (2006). "Antibiotics, antifungals, and antivirals". In Nelson LH, Flomenbaum N, Goldfrank LR, Hoffman RL, Howland MD, Lewin NA. Goldfrank's toxicologic emergencies. New York: McGraw-Hill. pp. 847. ISBN 0-07-143763-0. http://books.google.com/books?id=cvJuLqBxGUcC&pg=PA847. Retrieved 2009-07-03.

[10] "Cephalosporin spectrum of resistance". http://antibiotics.toku-e.com/m/?w=cephalosporin. Retrieved 01 July 2012.

[urlCase_Based_Pediatrics_Chapter-11] "Case Based Pediatrics Chapter". http://www.hawaii.edu/medicine/pediatrics/pedtext/s06c05.html.

[FDA_override-12] Weiss, Rick (4 March 2007). "FDA Rules override Warnings about Drugs". March 4, 2007. http://www.washingtonpost.com/wp-dyn/content/article/2007/03/03/AR2007030301311.html.

[biofuroksym-13] Jędrzejczyk, Tadeusz. "Internetowa Encyklopedia Leków". leki.med.pl. http://www.leki.med.pl/lek.phtml?id=428&idnlek=2682&menu=4. Retrieved 2007-03-03.

[14] Barclay, Laurie (April 16, 2007). "CDC issues new treatment recommendations for gonorrhea". Medscape. http://cme.medscape.com/viewarticle/555228. Retrieved 2009-07-01.

[SweetGibbs2009-15] Richard L Sweet; Ronald S. Gibbs (1 March 2009). Infectious Diseases of the Female Genital Tract. Lippincott Williams & Wilkins. pp. 403–. ISBN 978-0-7817-7815-2. http://books.google.com/books?id=wuR_ngItU5oC&pg=PA403. Retrieved 8 September 2010.

[pmid18225983-16] Widmer AF (March 2008). "Ceftobiprole: a new option for treatment of skin and soft-tissue infections due to methicillin-resistant Staphylococcus aureus". Clin. Infect. Dis. 46 (5): 656–658. doi:10.1086/526528. PMID 18225983.

[pmid17613382-17] Kosinski MA, Joseph WS (July 2007). "Update on the treatment of diabetic foot infections". Clin Podiatr Med Surg 24 (3): 383–396. doi:10.1016/j.cpm.2007.03.009. PMID 17613382. http://journals.elsevierhealth.com/retrieve/pii/S0891-8422(07)00026-2.

[pmid20001879-18] Kollef MH (December 2009). "New antimicrobial agents for methicillin-resistant Staphylococcus aureus". Crit Care Resusc 11 (4): 282–6. PMID 20001879.

[19] Podolsky, M. Lawrence (1998) Cures Out of Chaos: How Unexpected Discoveries Led to Breakthroughs in Medicine and Health, Harwood Academic Publishers

Cephalosporin
Drug class
Core structure of the cephalosporins
Use	Bacterial infection
Biological target	Penicillin binding proteins
ATC code	J01D
External links
MeSH	D002511
AHFS/Drugs.com	Drug Classes

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cephalosporin

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「セフタジジム」

抗菌スペクトル

効果・効能

適応菌種

適応症

「セファロスポリン系抗菌薬」

特徴

構造

副作用

セフェム系抗菌薬

第三世代セフェム

「セフォペラゾン」

抗菌スペクトル

「セフトリアキソン」

「セフォタキシム」

構造

「cephalosporinase」

「deacetoxycephalosporin」

「cephalosporin antibiotic」

「cephalosporins」