Cephalosporins: A Review

Abstract

Objectives After completing this article, readers should be able to: 1. Describe the mechanism of action of cephalosporins. 2. Delineate the two most common mechanisms of resistance to penicillins. 3. Discuss the most common adverse effects of common cephalosporins. 4. List which cephalosporins have activity against Pseudomonas. Oral Cefaclor 20 to 40 8 to 12 Cefadroxil 30 12 Cephalexin 25 to 100 6 to 8 Cefprozil 15 to 30 12 Cephradine 25 to 100 6 to 12 Cefuroxime, PO 20 to 30 12 Cefdinir 14 12 to 24* Cefpodoxime 10 12 Cefixime 8 12 to 24 Ceftibuten 9 24 Parenteral Cefazolin 50 to 100 8 Cefoxitin 80 to 160 4 to 6 Cefuroxime, IV 100 to 240 † 6 to 8 Ceftriaxone 50 to 100 12 to 24 Cefotaxime 100 to 300 † 6 to 8 Ceftazidime 100 to 150 8 Cefepime 150 8 to 12 §

Intestinal microbiome disruption in patients in a long-term acute care hospital: A case for development of microbiome disruption indices to improve infection prevention

“…This is biologically plausible for carbapenems, which have broad spectrum and distribution in tissues and feces, 23 as well as for intravenous ceftriaxone, which is excreted in stool at high concentrations. 24 Receipt of third- and fourth-generation cephalosporins has also been identified as an important and widespread risk factor for C. difficile- associated diarrhea. 25 The inverse correlation between antibiotic exposures and microbiome disruption reiterates the value and importance of implementing and maintaining an antimicrobial stewardship program to improve prescribing practices, in particular optimizing duration.…”

The role of Gr‐1+ cells and tumour necrosis factor‐α signalling during Clostridium difficile colitis in mice

“…Macrolide antibiotics can also affect inflammatory functions of pulmonary epithelial cells and modulate TNF‐ α , interleukin‐8 (IL‐8) and Granulocyte‐macrophage colony stimulating factor production by these cells . Ceftriaxone is a third‐generation cephalosporin with bactericidal activity against both Gram‐positive and Gram‐negative bacteria . Cefoperazone, another third‐generation cephalosporin, can markedly alter the composition of the intestinal microbiota and render mice susceptible to C. difficile infection .…”

Cephalosporins: pharmacology and chemistry

“…Antibiotics bind to penicillin binding proteins and prevent them from closure the ends of dividing bacteria and increase hyper osmotic pressure to kill the bacteria. 8 Cephalosporins are bactericidal and have the same mode of action as other beta-lactam antibiotics; such as penicillins. The peptidoglycan is an important substance for cell wall structural integrity.…”

“…TEM-1 β-lactamase is an example of Non-typeable Haemophilus influenza which is responsible for ineffectiveness of cefaclor and cefprozil. 8 …”