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 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 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 | ||
Mainly skin and soft-tissue infections Given before surgical procedures to prevent infections | Gastrointestinal upset and diarrhea* Nausea Allergic reactions (more likely in people allergic to penicillin) | |
2nd generation | ||
Some respiratory infections Abdominal infections | Gastrointestinal upset and diarrhea* Nausea Allergic reactions (more likely in people allergic to penicillin) | |
3rd generation | ||
Cefditoren Cefoperazone Ceftibuten | 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 | ||
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 | ||
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) | |
Ceftobiprole† | 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) |
Novel cephalosporins | ||
Urinary tract infections due to susceptible bacteria, such as Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, and Enterobacter, 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 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 | ||
† Ceftobiprole is not available in the United States. | ||
(See also Overview of Antibiotics.)
Use of Cephalosporins During Pregnancy and Breastfeeding
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.)
Use of cephalosporins during breastfeeding is discouraged because these drugs may affect the baby's digestive tract. (See also Drug Use During Breastfeeding.)
