Cephalosporins

Creator: Brian J. Werth
Published: 2022-06-14

Brian J. Werth

, PharmD, University of Washington School of Pharmacy

Reviewed/Revised Jun 2022 | Modified Sep 2022

VIEW PROFESSIONAL VERSION

Use of Cephalosporins During Pregnancy and Breastfeeding

Topic Resources

Cephalosporins are a subclass of antibiotics Overview of Antibiotics Antibiotics are drugs used to treat bacterial infections. They are not effective against viral infections and most other infections. Antibiotics either kill bacteria or stop them from reproducing... read more called beta-lactam antibiotics (antibiotics that have a chemical structure called a beta-lactam ring). Beta-lactam antibiotics also include carbapenems Carbapenems Carbapenems 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 cephalosporins... read more , monobactams Aztreonam Aztreonam is the only antibiotic in an antibiotic class called monobactams, which are a subclass of beta-lactam antibiotics (antibiotics that have a chemical structure called a beta-lactam ring)... read more , and penicillins Penicillins Penicillins are a subclass of antibiotics called beta-lactam antibiotics (antibiotics that have a chemical structure called a beta-lactam ring). Carbapenems, cephalosporins, and monobactams... read more .

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.

Cephalosporins

Drug	Common Uses	Some Potential Side Effects
1st generation
Cefadroxil Cefazolin Cephalexin	Mainly skin and soft-tissue infections Overview of Bacterial Skin Infections The skin provides a remarkably good barrier against bacterial infections. Although many bacteria come in contact with or reside on the skin, they are normally unable to establish an infection... read more 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 Given by injection: Serious infections (such as meningitis Acute Bacterial Meningitis Acute bacterial meningitis is rapidly developing inflammation of the layers of tissue that cover the brain and spinal cord (meninges) and of the fluid-filled space between the meninges (subarachnoid... read more or infections acquired in a hospital Hospital-Acquired Infections People who are admitted to the hospital are at risk of acquiring an infection there. Such infections are called nosocomial infections. In the United States, approximately 4 to 5% of people who... read more )	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	Infections due to susceptible bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA Methicillin-resistant Staphylococcus aureus (MRSA) Staphylococcus aureus is the most dangerous of all of the many common staphylococcal bacteria. These gram-positive, sphere-shaped (coccal) bacteria (see figure ) often cause skin infections... read more ) and Enterococcus faecalis Enterococcal Infections Enterococcal infections are caused by a group of gram-positive, sphere-shaped (coccal) bacteria called enterococci, which normally reside in the intestine of healthy people but sometimes cause... read more	Gastrointestinal upset and diarrhea* Nausea Allergic reactions (more likely in people allergic to penicillin)
Ceftobiprole†	Infections due to susceptible bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA Methicillin-resistant Staphylococcus aureus (MRSA) Staphylococcus aureus is the most dangerous of all of the many common staphylococcal bacteria. These gram-positive, sphere-shaped (coccal) bacteria (see figure ) often cause skin infections... read more ) and Enterococcus faecalis Enterococcal Infections Enterococcal infections are caused by a group of gram-positive, sphere-shaped (coccal) bacteria called enterococci, which normally reside in the intestine of healthy people but sometimes cause... read more	Gastrointestinal upset and diarrhea* Nausea Allergic reactions (more likely in people allergic to penicillin)
Novel cephalosporins
Cefiderocol	Urinary tract infections Overview of Urinary Tract Infections (UTIs) In healthy people, urine in the bladder is sterile—no bacteria or other infectious organisms are present. The tube that carries urine from the bladder out of the body (urethra) contains no bacteria... read more due to susceptible bacteria, such as Escherichia coli Escherichia coli Infections Escherichia coli (E. coli) are a group of gram-negative bacteria that normally reside in the intestine of healthy people, but some strains can cause infection in the digestive... read more , Klebsiella pneumoniae Klebsiella, Enterobacter, and Serratia Infections Klebsiella, Enterobacter, and Serratia are closely related gram-negative bacteria that occasionally infect the urinary tract or respiratory tract of people in hospitals... read more , Proteus mirabilis, Pseudomonas aeruginosa 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 , and Enterobacter Klebsiella, Enterobacter, and Serratia Infections Klebsiella, Enterobacter, and Serratia are closely related gram-negative bacteria that occasionally infect the urinary tract or respiratory tract of people in hospitals... read more , in people over 18 years of age who have limited or no alternative treatment options	Gastrointestinal upset and diarrhea* Nausea Allergic reactions (more likely in people allergic to penicillin)
Ceftolozane plus tazobactam	Complicated urinary tract or abdominal infections, or hospital-acquired pneumonia Hospital-Acquired Pneumonia Hospital-acquired pneumonia is lung infection that develops in people who have been hospitalized, typically after about 2 days or more of hospitalization. Many bacteria, viruses, and even fungi... read more or ventilator-associated pneumonia due to sensitive organisms	Gastrointestinal upset and diarrhea* Nausea Allergic reactions (more likely in people allergic to penicillin) Kidney and liver problems
* Almost any antibiotic can cause Clostridioides difficile–induced diarrhea Clostridioides (formerly Clostridium) difficile–Induced Colitis Clostridioides difficile (C. difficile)–induced colitis is an inflammation of the large intestine (colon) that results in diarrhea. The inflammation is caused by toxin produced... read more and inflammation of the colon (colitis), but clindamycin, penicillins, cephalosporins, and fluoroquinolones are the most common causes.
† Ceftobiprole is not available in the United States.

Cephalosporins are among the safest antibiotics to use during pregnancy but are not without risks. Each drug is slightly different and may have different side effects. (See also Drug Use During Pregnancy Safety of Medications During Pregnancy During pregnancy, women may need to take medications to treat new or existing health conditions. Also, certain vitamins are recommended during pregnancy. Before taking any medication (including... read more .)

Use of cephalosporins during breastfeeding is discouraged because these drugs may affect the baby's digestive tract. (See also Drug Use During Breastfeeding Medication and Substance Use During Breastfeeding When women who are breastfeeding have to take a medication, they wonder whether they should stop breastfeeding. The answer depends on the following: How much of the medication passes into the... read more .)

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

VIEW PROFESSIONAL VERSION

Advanced Search:

Cephalosporins

Cephalosporins

Use of Cephalosporins During Pregnancy and Breastfeeding

Was This Page Helpful?

Test your knowledge