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Second generation cephalosporins

Medically reviewed on Jul 26, 2018 by C. Fookes, BPharm

Other names: second-generation cephalosporins

What are Second generation cephalosporins?

Cephalosporins are a large group of antibiotics derived from the mold Acremonium (previously called Cephalosporium). Cephalosporins are bactericidal (kill bacteria) and work in a similar way to penicillins. They bind to and block the activity of enzymes responsible for making peptidoglycan, an important component of the bacterial cell wall. They are called broad-spectrum antibiotics because they are effective against a wide range of bacteria.

Since the first cephalosporin was discovered in 1945, scientists have been improving the structure of cephalosporins to make them more effective against a wider range of bacteria. Each time the structure changes, a new "generation" of cephalosporins are made. So far there are five generations of cephalosporins. Second generation cephalosporins were the second generation of cephalosporins to be developed.

What are second generation cephalosporins used for?

Second generation cephalosporins may be used to treat the following types of infections when caused by susceptible strains of bacteria:

  • Bone and joint infections
  • Gynecological infections
  • Intra-abdominal infections
  • Lower respiratory tract infections
  • Skin and skin structure infections
  • Urinary tract infections

Cephalosporins are not usually used as a first-choice antibiotic. They tend to be reserved for use when other antibiotics (often penicillins) cannot be used.

What are the differences between second generation cephalosporins?

Second generation cephalosporins have activity against gram-negative aerobes such as Morganella morganii, Neisseria gonorrhoeae (non-penicillinase producing strains), Haemophilus influenzae, Klebsiella species, and Escherichia coli; gram-positive aerobes such as Streptococcus pneumoniae, Staphylococcus aureus, S. epidermidis and S. pyrogenes; and several types of anaerobes.

Some bacteria, such as most strains of Pseudomonas aeruginosa and Acinetobacter species, are resistant to second generation cephalosporins.

Second-generation cephalosporins are more active against gram-negative bacteria than first generation cephalosporins

Generic name Brand name examples
cefotetan Cefotan
cefoxitin Mefoxin
cefprozil Cefzil
cefuroxime Ceftin, Zinacef
loracarbef Discontinued

Are second generation cephalosporins safe?

Second generation cephalosporins are generally safe, with low toxicity and good efficacy against susceptible bacteria.

Allergic reactions have been reported with all cephalosporins including second generation cephalosporins and symptoms may include a rash, hives (urticaria), swelling, or rarely, anaphylaxis. Up to 10% of people with a history of penicillin allergy will also be allergic to cephalosporins.

Drug-induced hemolytic anemia has been associated with the use of some cephalosporins, including second generation cephalosporins; suspect and investigate further if anemia develops during or after treatment.

Rarely, some people may develop a super-infection due to overgrowth of a naturally occurring bacterium called Clostridium difficile, following use of any antibiotic, including cephalosporins. Symptoms may include severe diarrhea.

Rarely, seizures have been reported with cephalosporins; the risk may be greatest in those with kidney disease.

For a complete list of severe side effects, please refer to the individual drug monographs.

What are the side effects of second generation cephalosporins?

Second generation cephalosporins generally cause few side effects. The most common side effects reported include:

Transient increases in liver enzymes have also been reported

For a complete list of side effects, please refer to the individual drug monographs.

 

 

    List of Second generation cephalosporins:

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    Drug Name Reviews Avg. Ratings
    Lorabid (Pro)
    generic name: loracarbef
    1 review
       
    9.0
    Cefotan (Pro)
    generic name: cefotetan
    0 reviews
       
    8.0
    Zinacef (Pro)
    generic name: cefuroxime
    0 reviews
       
    8.0
    Ceftin (Pro)
    generic name: cefuroxime
    37 reviews
       
    7.7
    Cefzil (Pro)
    generic name: cefprozil
    11 reviews
       
    6.3
    Lorabid Pulvules
    generic name: loracarbef
    0 reviewsAdd rating
    Mefoxin (Pro)
    generic name: cefoxitin
    0 reviewsAdd rating

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