Cephalosporins: how do they work?

AND

How do cephalosporins work?

Bacteria grow and replicate by forming a cell wall using cross-linking peptidoglycan units (sugar and amino acids) and penicillin-binding proteins (PBP, peptidoglycan transpeptidase) (Bui and Preuss, 2023). Using their beta-lactam ring structure, cephalosporins integrate into the cell wall of susceptible, mature Gram-positive or Gram-negative bacteria. It binds to at least one or more penicillin-binding proteins, stopping cell wall formation, resulting in cell death (Bui and Preuss, 2023; Facts and Comparisons, 2023).

AND

Generations of cephalosporins

Cephalosporins are divided into five “generations” of antibiotics based on their activity against aerobic and Gram-negative bacilli, in addition to Gram-positive bacteria.
AND

AND

Nursing Considerations (Letourneau, 2022; Bui and Preuss, 2023)

Cephalosporins are probably the most common beta-lactam antibiotics. Nurses should consider the next when administering these antimicrobials to their patients.

• Most parenteral cephalosporins have a brief serum half-life, requiring more frequent dosing. Cefazolin and ceftriaxone have longer half-lives and don’t require frequent dosing.
• In patients with severe renal impairment, the dosage of cephalosporins (except ceftriaxone) will should be adjusted. The total each day dose mustn’t exceed 2 grams in patients with renal and hepatic impairment.
• () can develop resistance to cephalosporins by changing the structure of their PBPs. These are generally known as methicillin-resistant (MRSA) and are vulnerable to 5^vol generation of cephalosporins.
• Common unintended effects include nausea, vomiting, decreased appetite and abdominal pain. Less common unintended effects include drug-induced immunohemolytic anemia (DIIHA), vitamin K deficiency, nephrotoxicity, and pseudomembranous colitis.
• Cephalosporins are contraindicated in patients who’ve a history of allergic reactions or who may experience an anaphylactic response to penicillin or other beta-lactam drugs, in neonates with hyperbilirubinemia that will cause jaundice, and in children lower than 28 days of age in the event that they are expected to receive containing calcium.
• Cefepime toxicity may cause seizures and encephalopathy.

Full information may be present in the drugs’s package leaflet or within the Nursing2024 Medicines Manual + medicines updates.
AND

AND
Bui, T., & Preuss, C. V. (2023, March 24). Cephalosporins. https://www.ncbi.nlm.nih.gov/books/NBK551517/

AND
Facts and Comparisons (2021, September 14). Cephalosporins. . https://fco.factsandcomparisons.com/lco/action/doc/retrieve/docid/fc_dfc/5545961

AND
Letourneau, A. R. (2022, August 16). Cephalosporins. . https://www.uptodate.com/contents/cephalosporins

AND
Werth, B. J. (2022, September). Cephalosporins. . https://www.merckmanuals.com/professional/infectious-diseases/bacteria-and-antibiotic-drugs/cephalosporins

AND