Cephalosporins are β-lactam antibiotics. Their mechanism of action and structure are similar to penicillins. The similarity is that penicillins and cephalosporins share the same "core" - a β-lactam ring, with the cephalosporins having an additional atom in the side ring.

Contents:

  1. Cephalosporins - how do they work?
  2. Cephalosporins - breakdown
  3. Cephalosporins - can they be administered to pregnant women?
  4. Cephalosporins and contraception
  5. Cephalosporins - side effects
  6. Resistance to β-lactam antibiotics

Cephalosporins,that is a β-lactam antibiotic ,were isolated from theCephalosporium acremonium mushroom culture.It took place in 1948 - it was isolated by the Italian scientist Giuseppe Brotzu. Earlier noticed, the fungus extracts are active against the bacteria causing salmonellosis, brucellosis, plague, cholera and against the bacteria of Staphylococcus aureus. However, the research ended there.

In September 1953, a team led by Edward Abraham and Guy Newton isolated cephalosporin C, which was resistant to beta-lactamases (ie, bacterial β-lactam bond-disrupting enzymes). It was not until 1961 that the first cephalosporin was produced on an industrial scale and it was introduced to the American market in 1964.

Cephalosporins - how do they work?

Cephalosporins inhibit the construction of the bacterial cell wall, i.e. in short, they have a bactericidal effect. They bind to bacterial enzymes and inhibit their growth through the synthesis of the bacterial cell wall. Currently, 1st, 2nd, 3rd, 4th and 5th generation cephalosporins are used. What are the differences between antibiotics? The higher the generation level, the stronger the action against gram-negative bacteria.

Cephalosporins - breakdown

  • First generation cephalosporinshave a stronger effect on Gram-positive than Gram-negative. It is used in the treatment of cocci and bacilli, e.g. E.coli , or pneumonia bacilli. They are not suitable for treating infections caused by salmonella and Proteus bacteria. They do not work against enterococci, MRSA, or the Listeria species. What may be important is that they are an alternative to penicillins for difficult-to-treat urinary tract infections. Are notthey are drugs of first choice for infections in children!
  • Second-generation cephalosporinsare more effective against Gram-negative bacteria than against Gram-positive bacteria. They are bactericidal in the case of Sterptococcus cocci, Haemophilus influenzae, E-coli and Gram-positive anaerobic bacteria. They are used, inter alia, in the treatment of nosocomial infections, treatment of penicillin-resistant gonorrhea or infections of the urinary tract and kidneys caused by gram-negative bacteria and in severe bone inflammation. They are used as second-line drugs in skin, soft tissue and respiratory infections, including otitis media, pneumonia and acute bacterial sinusitis.
  • Third-generation cephalosporinsare effective in treating infections that are resistant to other antibiotics. Third-generation cephalosporins cross the blood-brain barrier and are therefore used in the treatment of bacterial meningitis. They affect gram-positive and gram-negative bacteria, they are especially active against blue oil rods.
  • 4th generation cephalosporinshave the broadest spectrum of activity of all cephalosporins. They get into in the cerebrospinal fluid, but can only be administered parenterally. In Poland, cefepime is available from this group of drugs. It is active against both gram-negative and gram-positive bacteria.
  • 5th generation cephalosporinsare also administered only intravenously. They inhibit the development of methicillin-resistant staphylococcus and other microorganisms that are resistant to antibiotic treatment.

Cephalosporins - can they be administered to pregnant women?

Antibiotics that are safe in all stages of pregnancy include penicillins, cephalosporins and erythromycin. The drugs of choice in pregnant women are second- or third-generation cephalosporins, or semi-synthetic penicillin with a beta-lactamase inhibitor. Cephalosporins, according to the FDA Classification (Food and Drug Administration), belong to category B, i.e. "Drugs with which experiments on animals did not show any harmful effects to the fetus, but no control tests were performed in pregnant women or drugs with harmful effects on the fetus has been found in animals, but has not been confirmed in pregnant women. " 1

Cephalosporins and contraception

Cephalosporins may reduce the effectiveness of oral hormonal contraception. During the use of this group of antibiotics, as well as 7 days after the end of treatment, it is recommended to use additional, non-hormonal methods.contraception.

Cephalosporins - side effects

Cephalosporins, especially the newer ones (2nd, 3rd, 4th generation), are relatively low-toxic. However, they can cause:

  • allergic reactions (especially in people with allergies)
  • disturbances of the bacterial flora (diarrhea), therefore it is recommended to use probiotic preparations at the same time
  • kidney damage (especially when administered with other nephrotoxic antibiotics such as aminoglycosides)
  • blood clotting disorder (in this case, remember to inform the doctor if the patient is additionally taking blood thinners)
  • disulfiram reaction (when combined with alcohol)

However, whether the given effects occur and with what intensity depends on the general condition of the patient, on other preparations used in parallel, as well as on whether the patient uses the drug in accordance with the doctor's recommendations.

One of the side effects of using cephalosporins may be anaphylactic reactions. However, they are relatively rare. It is from 0.1% to 0.0001% of all cases and they do not have to affect the entire body, but only individual organs - for example:

  • skin: then there are urticaria changes of varying severity, erythema, itching, swelling of the lips,
  • eyes: redness of the conjunctiva, lacrimation, itching is visible
  • gastrointestinal: these can be abdominal pain, diarrhea, nausea, vomiting
  • of the cardiovascular system: here there may be a drop in blood pressure, heart rhythm disturbances, and in extreme cases even collapse
  • of the respiratory tract: in this case, the patient may complain of itchy nose, runny nose, difficult-to-control sneezing, hoarseness, difficulty breathing, paroxysmal "dry" cough, and even wheezing
  • other systemic symptoms are: headache, anxiety, chest pain and stinging, seizures

Severe anaphylactic reactions may be preceded by symptoms such as: itching of the palate, face, hands, feet; metallic taste in the mouth, hoarseness, restlessness, anxiety, erythema.

Resistance to β-lactam antibiotics

Antibiotic abuse and misuse are becoming more common today. This is causing the spread of microbial resistance worldwide. The danger increases when bacteria so far sensitive to a given group of antibiotics become resistant to it, and this is due to the exchange of genetic material between strains of a given species, and even between species of bacteria.

That's why it's so important to firstDo not take antibiotics "just in case", but only when it is really necessary, secondly, follow the doctor's instructions and take antibiotics in the right way.

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