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Cephalothin Side Effects

Medically reviewed by Last updated on Jul 24, 2022.

Applies to cephalothin: injectable powder for injection, intravenous solution.


Hypersensitivity reactions occur in up to 15% of patients with a history of penicillin allergy. Manifestations may include urticarial or maculopapular rash, bronchospasm, and drug fever. Anaphylaxis, including severe hypotension and cardiac arrest, is reported.[Ref]

Rare cases of renal insufficiency associated with cephalothin may be hypersensitivity-mediated since fever, eosinophilia, and rash are often also present.

A case of occupational contact dermatitis due to cephalosporin allergy has been reported in a nurse who prepared cephalosporin solutions for administration to patients. The dermatitis resolved after the nurse stopped preparing the solutions.[Ref]


Renal side effects including renal insufficiency is rarely reported during therapy with most cephalosporins. Nephrotoxicity appears to be slightly more likely during cephalothin therapy, however. Risk factors include concomitant aminoglycoside therapy, preexisting renal insufficiency, elevated serum aminoglycoside levels, and high dose cephalothin therapy. Cephalothin may worsen renal function in patients with renal insufficiency. Frequent monitoring of the serum creatinine, maintenance of intravascular volume, and avoidance of potentially nephrotoxic agents during cephalothin therapy is recommended.[Ref]

Predisposing risk factors for nephrotoxicity include preexisting renal insufficiency, concomitant use of other potentially nephrotoxic drugs, and dehydration. Renal biopsy results in patients with suspected cephalothin-induced renal insufficiency have shown tubulo-interstitial nephritis. The mechanism may be hypersensitivity-mediated.[Ref]


One case of reversible aplastic anemia associated with cephalothin has been reported.[Ref]

Hematologic side effects include thrombocytopenia, hemolytic anemia, and rare cases of pancytopenia.[Ref]


Gastrointestinal side effects are unusual. Rare cases of pseudomembranous colitis associated with cephalothin are reported.[Ref]


Hepatic side effects are rare. Increases in serum transaminases associated with cephalothin are reported.[Ref]

Nervous system

Nervous system side effects are rare, and include reports of delirium and confusion.[Ref]

In rare cases of suspected cephalothin-associated confusion, cerebrospinal fluid has been sterile, but has, in rare cases shown high levels of drug.[Ref]


The incidence of phlebitis may be reduced by frequent intravenous site care and the addition of heparin 500 units and hydrocortisone 10 mg to each liter of intravenous cephalothin.[Ref]

Intravenous site phlebitis has been reported in up to 55% of patients.[Ref]

Women may experience an increased incidence of vaginal yeast infections while receiving cephalothin.[Ref]


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10. Wade JC, Schimpff SC, Wiernik PH "Antibiotic combination - associated nephrotoxicity in granulocytopenic patients with cancer." Arch Intern Med 141 (1981): 1789-93

11. Hansen MM, Kaaber K "Nephrotoxicity in combined cephalothin and gentamicin therapy." Acta Med Scand 201 (1977): 463-7

12. Engle JE, Drago J, Carlin B, Schoolwerth AC "Letter: Reversible acute renal failure after cephalothin." Ann Intern Med 83 (1975): 232-3

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15. Simpson IJ "Nephrotoxicity and acute renal failure associated with cephalothin and cephaloridine." N Z Med J 74 (1971): 312-5

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26. Miller WI, Souney PF, Chang JT "Hepatic dysfunction following nafcillin and cephalothin therapy in a patient with a history of oxacillin hepatitis." Clin Pharm 2 (1983): 465-8

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35. "Product Information. Keflin (cephalothin)." Lilly, Eli and Company (2001):

Further information

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Some side effects may not be reported. You may report them to the FDA.