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:

Abdominal pain
Diarrhea
Nausea
Rash
Vomiting.

Transient increases in liver enzymes have also been reported

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

List drug with Second generation cephalosporins

Drug Name
Cefaclor Generic name: Cefaclor
Cefotan Generic name: Cefotetan
Cefotetan Generic name: Cefotetan
Cefoxitin Generic name: Cefoxitin
Cefprozil Generic name: Cefprozil
Ceftin Generic name: Cefuroxime (oral/injection)
Cefuroxime (Injection, Intravenous) Generic name: Cefuroxime
Cefuroxime (Oral) Generic name: Cefuroxime
Cefuroxime oral/injection Generic name: Cefuroxime (oral/injection)
Cefzil Generic name: Cefprozil
Lorabid Generic name: Loracarbef
Lorabid Pulvules Generic name: Loracarbef
Loracarbef Generic name: Loracarbef
Mefoxin Generic name: Cefoxitin
Zinacef Generic name: Cefuroxime

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