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Second generation cephalosporins

Medically reviewed by Carmen Pope, BPharm. Last updated on April 12, 2023.

Other names: second-generation cephalosporins

What are Second generation cephalosporins?

After the first cephalosporin was discovered in 1945, scientists improved the structure of cephalosporins to make them more effective against a wider range of bacteria. Each time the structure changed, a new "generation" of cephalosporins were made. There are five generations of cephalosporins. Second generation cephalosporins were the second generation of cephalosporins to be developed.

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.

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
cefaclor Generic only
cefamandole Discontinued
cefmetazole Discontinued
cefonicid Discontinued
cefotetan Cefotan
cefoxitin Generic only
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

    View by  Brand | Generic
    Drug Name Avg. Rating Reviews
    Ceftin (Pro)
    Generic name: cefuroxime
    50 reviews
    Generic name: cefprozil
    11 reviews
    Lorabid (Pro)
    Generic name: loracarbef
    1 review
    Generic name: cefuroxime
    No reviews
    Generic name: cefoxitin
    No reviews
    Lorabid Pulvules
    Generic name: loracarbef
    No reviews
    Cefotan (Pro)
    Generic name: cefotetan
    No reviews
    For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective).

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