Cephalosporins
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Anti-Infective Drugs
- Vancomycin
- Metronidazole
- Penicillins
- Cephalosporins
- Macrolides
- Fluoroquinolones
- Aminoglycosides
- Tetracyclines
- Sulfonamides
- Rifampin
- Isoniazid
- Ethambutol
- Chloroquine
- Acyclovir
- Oseltamivir
- Azoles
- Nystatin
- Amphotericin B
Summary
Cephalosporins are a class of antibiotics that are used to treat a wide variety of bacterial infections. Cephalosporins are easy to recognize because they all start with “ceph-”, like ceftriaxone, cefazolin, and cephalexin. Cephalosporins can have a cross sensitivity with penicillins, so if a patient is allergic to one, the severity of the allergic reaction should be determined before giving the other. Patients taking cephalosporins should avoid alcohol to prevent a disulfiram-like reaction. Cephalosporins can cause bleeding so other drugs that cause bleeding should be avoided, like NSAIDs and anticoagulants.
Key Points
- Cephalosporins
- Key Drugs
- Cef-, Ceph-
- Ceftriaxone (Rocephin)
- Cefazolin (Ancef)
- Cephalexin (Keflex)
- There are 5 different generations of cephalosporins and each generation has coverage for a slightly different spectrum of bacteria
- Cef-, Ceph-
- Mechanism
- Beta-lactam Antibiotic
- Inhibits bacterial cell wall synthesis
- Beta-lactam Antibiotic
- Clinical Uses
- Bacterial infections
- Surgical infection prophylaxis against skin flora
- Otitis media
- Meningitis
- Appendicitis
- Urinary Tract Infections
- Respiratory Infections
- Etc.
- Bacterial infections
- Side Effects and Adverse Reactions
- Cross-sensitivity with penicillins
- The structure and function of cephalosporins is similar to that of penicillins (beta lactam antibiotics) so there can be cross sensitivity
- Cross-allergenicity rates are relatively low (only about 1-4%)
- If the patient has a penicillin allergy, the order for cephalosporins should be questioned.
- Disulfiram-like reaction
- Do not take with alcohol
- Bleeding
- Secondary to vitamin K deficiency, as cephalosporin prevents vitamin K activation which is required for the synthesis of blood clotting factors
- Thrombocytopenia
- Avoid drugs that may promote bleeding (e.g. NSAIDS, anticoagulants)
- Clostridium Difficile overgrowth
- Broad-spectrum antibiotics like cephalosporins can cause C. difficile overgrowth by killing existing gut flora to open a niche.
- Cephalosporins cannot treat C. difficile infections
- Severe diarrhea should be reported, as it may indicate a c. diff. infection
- Other types of superinfection secondary to antibiotic use include yeast (Candida) infections.
- GI Distress (nausea, vomiting, diarrhea, anorexia)
- May be taken with food to reduce GI distress
- Cross-sensitivity with penicillins
- Key Drugs