PEBC: What You Need to Know: Cephalosporins

Indications:

-skin infections (1st generation)

-meningitis, pneumonia

-urinary tract infections and gonorrhea

Examples:

1st generation: cephalexin, cefazolin

2nd generation: cefuroxime, cefprozil

3rd generation: cefixime, cefotaxime, ceftriaxone

4th generation: cefepime

Antibacterial Coverage:

-1st generation cephalosporins have the best gram-positive activity.

-As the generation number increases, the gram-positive activity decreases, but gram-negative activity increases.

-4th generation cephalosporins are an exception, with broad gram-positive and gram-negative activity.

Adverse Effects:

-gastrointestinal symptoms: nausea, vomiting, diarrhea

-Less than 1% allergic cross-reactivity with penicillin

-biliary sludge in children (ceftriaxone)

-rarely seizures

-Clostridium difficile infection

Drug Interactions:

-cefuroxime should not be coadministered with acid reducers such as proton pump inhibitors due to reduced absorption