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Cephalosporins ˌsef-ə-lə-ˈspōr-ən, -ˈspȯr-

By Hans P. Schlecht, MD, MSc, Assistant Professor of Medicine, Department of Medicine, Division of Infectious Diseases & HIV Medicine, Drexel University College of Medicine ; Christopher Bruno, MD, Assistant Professor of Medicine, Division of infectious Diseases & HIV Medicine, Drexel University College of Medicine

Cephalosporins are a subclass of antibiotics called beta-lactam antibiotics (antibiotics that have a chemical structure called a beta-lactam ring). Beta-lactam antibiotics also include carbapenems, monobactams, and penicillins.

There are five generations of cephalosporins. The different generations are effective against different types of bacteria.

Some bacteria have an outer covering (cell wall) that protects them. Like the other beta-lactam antibiotics, cephalosporins work by preventing bacteria from forming this cell wall, resulting in death of the bacteria.

Because cephalosporins are structurally similar to the penicillins, some people who have an allergic reaction to penicillins may have an allergic reaction to cephalosporins.

Cephalosporins

Drug

Common Uses

Some Side Effects

1st generation

Cefadroxil

Cefazolin

Cephalexin

Given before surgical procedures to prevent infections

Gastrointestinal upset and diarrhea*

Nausea

Allergic reactions (more likely in people allergic to penicillin)

2nd generation

Cefaclor

Cefotetan

Cefoxitin

Cefprozil

Cefuroxime

Some respiratory infections

For cefoxitin, abdominal infections

Gastrointestinal upset and diarrhea*

Nausea

Allergic reactions (more likely in people allergic to penicillin)

3rd generation

Cefdinir

Cefditoren

Cefixime

Cefotaxime

Cefpodoxime

Ceftazidime

Ceftibuten

Ceftriaxone

Given by mouth: Broad coverage of many bacteria for people with mild-to-moderate infections, including skin and soft-tissue infections

Given by injection: Serious infections (such as meningitis or infections acquired in a hospital)

Gastrointestinal upset and diarrhea*

Nausea

Allergic reactions (more likely in people allergic to penicillin)

4th generation

Cefepime

Serious infections (including Pseudomonas infections), particularly in people with a weakened immune system, and infections due to susceptible bacteria that are resistant to other antibiotics

Gastrointestinal upset and diarrhea*

Nausea

Allergic reactions (more likely in people allergic to penicillin)

5th generation

Ceftaroline

Infections due to susceptible bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA) and Enterococcus faecalis

Gastrointestinal upset and diarrhea*

Nausea

Allergic reactions (more likely in people allergic to penicillin)

*Almost any antibiotic can cause Clostridium difficile–induced diarrhea and inflammation of the colon (colitis), but clindamycin, penicillins, cephalosporins, and fluoroquinolones are the most common causes.

Use of Cephalosporins During Pregnancy and Breastfeeding

Cephalosporins are among the safest antibiotics to use during pregnancy, but each drug is slightly different and may have different side effects.

Use of cephalosporins during breastfeeding is discouraged because these drugs may affect the baby's digestive tract.

Resources In This Article

Drugs Mentioned In This Article

  • Generic Name
    Select Brand Names
  • SUPRAX
  • No US brand name
  • SPECTRACEF
  • KEFLEX
  • FORTAZ, TAZICEF
  • MAXIPIME
  • CEFTIN, ZINACEF
  • CEDAX
  • CLAFORAN
  • CLEOCIN
  • MEFOXIN
  • ROCEPHIN
  • ANCEF, KEFZOL