• Ineffective against MRSA, listeria, Pseudomonas, enterococcus
• variable resistance to beta lactamases
• useful in targeted therapy and in patients with non severe allergy to narrow spectrum penicillins
• use in moderate-broad spectrum bactericidal. Use in septicaemia, pneumonia, meningitis, bilary tract infections, peritonitis, and urinary tract infections.

MOA: Bacteriacidal. Interfere with cell wall peptidoglycan synthesis binding to penicillin binding proteins → cell lysis and death

Side effects

• Common side effects include: diarrhoea, nausea, vomiting, pain and inflammation at injection site, rash, headache, dizziness, allergy, Clostridium difficile infection, superinfection.
• monitor renal function due to renal clearance
• rapid IV of large dose can → seizure
• structurally simiar to penicillins therefore can have hypersensitivity in ~10% of penecillin hypersensitive patients.

Cefalexin 500mg, PO 6hrly for 14days (max 4g daily)

second line empirical treatment for mild pyelonephritis.

in signs of sepsis, inedaquate cover of possible organisms makes this a poor choice.

Ceftriaxone 1g IV daily