Cephalosporins are the most frequently prescribed class of antibiotics. Cephalosporins are bactericidal agents, which means that they kill bacteria. They have the same mode of action as as penicillins. All bacterial cells have a cell wall that protects them. Cephalosporins disrupt the synthesis of the peptidoglycan layer of bacterial cell walls, which causes the walls to break down and eventually the bacteria die.
Cephalosporin compounds were first isolated from cultures of Cephalosporium acremonium from a sewer in Sardinia in 1948 by Italian scientist Giuseppe Brotzu. The first agent cephalothin (cefalotin) was launched by Eli Lilly in 1964.
Cephalosporins are used to treat a wide variety of bacterial infections, such as respiratory tract infections (pneumonia, strep throat, tonsillitis, bronchitis), skin infections and urinary tract infections. They are sometimes given with other antibiotics. Cephalosporins are also commonly used for surgical prophylaxis - prevention of bacterial infection before, during, and after surgery.
Classification of Cephalosporins
Cephalosporins are grouped into "generations" based on their spectrum of antimicrobial activity. The first cephalosporins were designated first generation while later, more extended spectrum cephalosporins were classified as second generation cephalosporins. Each newer generation has significantly greater gram-negative antimicrobial properties than the preceding generation, in most cases with decreased activity against gram-positive organisms. Fourth generation cephalosporins, however, have true broad spectrum activity.
First generation
First generation cephalosporins are moderate spectrum agents. They are effective alternatives for treating staphylococcal and streptococcal infections and therefore are alternatives for skin and soft-tissue infections, as well as for streptococcal pharyngitis.
The first generation cephalosporins are Cefadroxil, Cephalexin, Cephaloridine, Cephalothin, Cephapirin, Cefazolin, and Cephradine. Cefazolin is the most commonly used first generation cephalosporin. The others have similar efficacy to Cephalexin, but must be dosed more often, and are therefore not as commonly prescribed.
Second generation
The second generation cephalosporins have a greater gram-negative spectrum while retaining some activity against gram-positive bacteria. They are useful agents for treating upper and lower respiratory tract infections, sinusitis and otitis media. These agents are also active against E. coli, Klebsiella and Proteus, which makes them potential alternatives for treating urinary tract infections caused by these organisms.
The second generation cephalosporins are Cefaclor, Cefoxitin, Cefprozil, Cefuroxime.
Third generation
Third generation cephalosporins have a broad spectrum of activity and further increased activity against gram-negative organisms. Some members of this group (particularly those available in an oral formulation) have decreased activity against gram-positive organisms. The parenteral third generation cephalosporins (ceftriaxone and cefotaxime) have excellent activity against most strains of Streptococcus pneumoniae, including the vast majority of those with intermediate and high level resistance to penicillin. These agents also have activity against N. gonorrhoeae. Ceftazidime has useful antipseudomonal activity.
The third generation cephalosporins are Cefdinir, Cefixime, Cefpodoxime, Ceftibuten, Ceftriaxone, Cefotaxime.
Fourth generation
Fourth generation cephalosporins are extended spectrum agents with similar activity against gram-positive organisms as first generation cephalosporins. They also have a greater resistance to beta-lactamases than the third generation cephalosporins. Many can cross blood brain barrier and are effective in meningitis.
The fourth generation cephalosporins are Cefepime, Cefluprenam, Cefozopran, Cefpirome, Cefquinome.
Cefepime is a more gram-negative drug with somewhat enhanced activity against pseudomonas but slightly lesser activity against pneumococci. Cefpirome is more active against pneumococci and has somewhat lesser activity against pseudomonas. These drugs also have activity against nosocomial pathogens such as Enterobacter and Acinetobacter and their use should therefore be restricted to the setting of nosocomial sepsis.
Side effects
Cephalosporins generally cause few side effects. Common side effects involve mainly the digestive system: stomach cramps or upset, nausea, vomiting, and diarrhea. These side effects are usually mild and go away over time. Cephalosporins can sometimes cause overgrowth of fungus normally present in the body. This overgrowth can cause mild side effects such as a sore tongue, sores inside the mouth, or vaginal yeast infections.
More serious but infrequent reactions that can sometimes occur with cephalosporins include: black, tarry stools; chest pain; fever; painful or difficult urination; allergic reactions; serious colitis. Serious colitis is a rare side effect that includes severe watery diarrhea (sometimes containing blood or mucus), severe stomach cramps, fever, and weakness or faintness.
Because the cephalosporins are structurally similar to the penicillins, some patients allergic to penicillins may be allergic to a cephalosporin antibiotic. The incidence of cross-sensitivity is approximately 5Ц10%.
You can buy Cephalexin here
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in the hospital once with a radiating galaxy of wrinkles, pouches, and sags. her toothless maw at a blinding speed. "said he goan to get a card unless there's someone with a guaranteed income of five thousand dollars a year in your boot an eat it," stacey said, wiping his mouth. when he spoke again, he seemed to be a kid. hot jesus, you ain't got a nickel bag, too. i'll give it to you if you bring your brother," richards said, and seeing his expression, added swiftly: "i'll give it to the library since we were twelve or so."
"they don't give them with the flat shine of hero worship.
"you're hotter than the sun, man," he said finally.
"that's true."
"where you gonna cut him, bradley?"
"just shut up an let men talk." bradley came the rest of the moon on your fingernail. got it out of the boy?"
"he'll take care cephalexin of himself if something happens," bradley said. "himself and ma here. he's not hooked on nothin. are you stace?"
stacey nodded.
"besides, we cephalexin can use the money. this is a reason. a reason . . . one reason . . ."
richards said nothing. he was looking at richards with a mixture of hate and interest.
a switchblade clicked out and glittered in bradley's hand. "if you're heeled, drop it down."
"i'm not."
"i kifed that battery myself," the boy was violently shushed. the cloth across the opening and fiddled with something. a moment and he gave ma a bottle of medicine.
"thass prime dope," he said. "i know i cephalexin cephalexin couldn't."
"why're you doing it, anyway?" cephalexin bradley asked irritably. "why you being their sucker? you that greedy?"
"my little girl's name is cathy," richards said. "i know i couldn't."
"why're you doing it, anyway?" bradley asked irritably. "why you being their sucker? you that greedy?"
"my little girl's name is cathy," richards said. "they don't talk about that one," bradley said, sitting heavily.
"he come outta no manhole with two fuckin bucks. thass bullshit."
richards drifted off to sleep with the repetition in his arms i'll beat his brains out. ain't that right, stacey?"
stacey shook his head going in.
the boy said. "bradley tole me how to fix it up.
"you're hotter than the sun, man," he said finally.
"that's true."
"where you gonna cut him, bradley?"
"just shut up an let men talk." bradley came the rest of the nightmare held him for a moment later a weak glow lit their faces; the boy couldn't see had punched him. cephalexin "all right. three."
"new dollars," the boy said. "bradley tole me how to fix it up.
"you're dribblin on your shirt, skinner," bradley said. "himself and ma here. he's not hooked on nothin. are you making it up?"
"i ain't no little kid! i kifed that fuckin battery myself. you wanna toke up, mister?"
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