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Cephalosporins

By

Brian J. Werth

, PharmD, University of Washington School of Pharmacy

Reviewed/Revised Jun 2022 | Modified Sep 2022
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Topic Resources

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

Most 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 Allergies to Drugs People sometimes mistake many adverse drug reactions for allergies. For example, people who experience stomach discomfort after taking aspirin (a common adverse reaction) often say they are... read more to penicillins may have an allergic reaction to certain cephalosporins. A health care practitioner can help assess the risk of allergic cross-reactivity between specific antibiotics in people who believe they have had an allergic reaction.

Table

Cephalosporins

Drug

Common Uses

Some Potential 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

Cefoperazone

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

Gastrointestinal upset and diarrhea*

Nausea

Allergic reactions (more likely in people allergic to penicillin)

4th generation

Cefepime

Serious infections (including Pseudomonas infections Pseudomonas Infections Any of several types of the gram-negative bacteria Pseudomonas, especially Pseudomonas aeruginosa, can infect different parts of the body, particularly in people who have serious... read more ), 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

Gastrointestinal upset and diarrhea*

Nausea

Allergic reactions (more likely in people allergic to penicillin)

Ceftobiprole†

Gastrointestinal upset and diarrhea*

Nausea

Allergic reactions (more likely in people allergic to penicillin)

Novel cephalosporins

Cefiderocol

Gastrointestinal upset and diarrhea*

Nausea

Allergic reactions (more likely in people allergic to penicillin)

Ceftolozane plus tazobactam

Gastrointestinal upset and diarrhea*

Nausea

Allergic reactions (more likely in people allergic to penicillin)

Kidney and liver problems

† Ceftobiprole is not available in the United States.

Use of Cephalosporins During Pregnancy and Breastfeeding

NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
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