How Do Second-generation Cephalosporins Work?

Cephalosporins are broad-spectrum antibiotics used to manage a wide range of bacterial infections. They are derived from the mold Acremonium (previously called Cephalosporium). Cephalosporins are grouped into five generations based on their spectrum of coverage against gram-positive and gram-negative bacteria.

Second-generation cephalosporins act on both gram-positive and gram-negative bacteria. However, they are relatively less effective against gram-positive bacteria and more effective against gram-negative bacteria than first-generation cephalosporins.

They inhibit bacterial cell wall synthesis. The bacterial cell wall contains peptidoglycan units that increase the strength of the cell wall by cross-linking with each other through penicillin-binding proteins. Cephalosporins have beta-lactam rings that bind to the penicillin-binding protein and inhibit the cross-linking of peptidoglycans. Because of this action, the cell wall is compromised resulting in the lysis (rupture of the cell wall) and death of the bacterial cell.

Second-generation cephalosporins are divided into two subgroups:

• Second-generation subgroups include cefuroxime and cefprozil. Cefuroxime has increased coverage against H influenza.
• Cephamycin subgroup has increased coverage against bacteroides species

Second-generation cephalosporins are used to treat:

• Bone and joint infections
• Skin and soft tissue infections
• Gynecological infections
• Intra-abdominal infections
• Lower respiratory tract infections
• Serious urinary tract infections
• Meningitis in children
• Blood infection

Most of the minor side effects occur only once at the initiation of therapy and resolve within 1 to 2 days.

The common side effects include:

• Stomach discomfort
• Nausea and vomiting
• Decreased appetite
• Dizziness
• Skin rash
• Difficulty in breathing
• Low blood pressure
• Thrombocytopenia (low platelets)
• Fever
• Yeast infections
• Diarrhea
• Increase in liver enzymes

Rare but serious side effects may include:

• Hypersensitivity
• Drug-induced immune hemolytic disease

The information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Names of second-generation cephalosporins include:

• Ceclor (DSC)
• Cefaclor
• Cefotetan
• Cefoxitin
• Cefprozil
• Ceftin
• Cefuroxime
• Cefzil
• Raniclor (DSC)
• Zinacef