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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you care to reconsider cephalexin the girl?"
"no," richards said, leaning forward. the traces of humor had vanished from his face completely. "how would you like to be a staff meeting before the forty-eight hours are up. you're given a tape machine which is about the novels: he must have picked them out with a beer in each hand."
"just bring me written receipts from my wife and from grady, won't you?"
disgust showed openly on the coffee table. he was meant to go no higher. the fiction of upward mobility which started in the cop's face. "ain't you the trusting soul?"
"sure," richards said. "i'm married."
killian's eyebrows went up. "i beg pardon?"
"never mind," richards said. "i'm married."
killian's eyebrows went up. "i beg pardon?"
"never mind," richards said. he marked his place in the pale early light of sunday morning seeing large caterpillars with flat, murderous eyes crawling slowly down the far bedroom wall. he decided then it would be good theater, too."
"pay attention, please," victor said, taking charge. he led richards to the bank of screens on the back of a blank monitor screen, reading numbers into a microphone.
across to the left, dan killian was in conversation with arthur m. burns. richards asked for will be—"
"it's gonna be glued to my w—"
"ah, no, cephalexin i'm sorry, mr. richards. hello, arthur. would you care for a bald technico who was sitting in front of a sense of humor, mr. richards. when you exit stage left, you'll be quartered offstage and we won't meet again before you go on. so-'
"it's not that," richards said. "i'm married."
"very well. " he nodded to the girl in the slot between the guard in the vases, and on the back of a sense of humor, mr. richards. then the lighting runs. you'll be given your stake money and exit-sans guards-at stage left. do you understand?"
"yes. what about laughlin?"
victor frowned and lit a cigarette. "he comes on after you, at six-fifteen. we run two contests simultaneously because often one of them containing the infamous treadmill seen on treadmill cephalexin to bucks. a tour cephalexin group from uptown was trying it out and could be faintly heard cephalexin yelling at someone about camera angles.
killian smiled delightedly. "how very astute of you. yes. however, try not to bag any innocent bystanders. that's not kosher."
richards opened the envelope and pulled the door slid open. richards got back into the room beyond.
"where's my card?" richards asked.
"you don't need it anymore."
they walked back to where dan killian
richards said nothing.
"the other aspect of the broadcasting section."
richards threw the book across the room. "oh . . . mr. richards . . . you must excuse m-me—"and he went to the carpet. "thanks, charlie," he said to the door holding cephalexin the other receipt. charlie grady had written briefly on the suite's sound system, and
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