Definition: what are cephalosporins?

Cephalosporins are antibiotics that can be taken orally or injected. Their mechanism of action consists in blocking the production of the bacterial wall to kill targeted bacteria, they are therefore bactericidal. Like structurally related penicillins, cephalosporins are part of the beta-lactam family.

In what drugs are they found?

The commercial specialties containing a cephalosporin are:

• Alfatil® (cefaclor) : tablet, capsule, powder for oral suspension
• Axepim® (cefepime) : powder for solution for injection
• Fortum® (ceftazidime) : powder for solution for injection
• Keforal® (cefalexin) : tablet, powder for oral suspension
• Orelox® (cefpodoxime) : tablet, granules for oral suspension
• Oroken® (cefixime) : tablet, powder for oral suspension
• Rocephine (ceftriaxone) : powder for solution for injection
• Zinnat® (cefuroxime) : tablet, granules for oral suspension

Several generics are also available.

Indications: when to take a cephalosporin?

Not all cephalosporins have the same indications. They are mainly prescribed to treat the following bacterial infections:

• Strep A strep throat : Alfatil®, Orelox®, Keforal®, Zinnat®
• Acute sinusitis : Alfatil®, Orelox®, Keforal®, Zinnat®, Oroken®
• Otitis : Alfatil®, Keforal®, Zinnat®, Oroken®, Rocéphine®, Fortum® (for severe or chronic ear infections)
• Lower respiratory infections (superinfection of acute bronchitis, episodes of chronic bronchopneumopathy, pneumopathy): all cephalosporins. Fortum® has a specific indication in the management of cystic fibrosis.
• Urinary tract infections (cystitis, prostatitis, pyelonephritis depending on the molecule): all cephalosporins except Orelox®
• Skin infections : Zinnat®, Rocéphine®, Fortum®
• Lyme disease : Zinnat®, Rocéphine®
• Bone, joint, intra-abdominal infections and meningitis : Fortum®, Rocéphine®
• Genital gonococcal infections : Oroken®, Rocéphine®
• Febrile neutropenia (decrease in white blood cells associated with fever): Axepim®, Rocéphine®

What are the side effects of cephalosporins?

Adverse effects common to all cephalosporins are digestive disorders (diarrhea, nausea, vomiting), increased liver enzymes. More rarely, serious skin reactions, pseudomembranous colitis (severe inflammation of the colon), impaired kidney function and anaphylactic shock have been reported. More specifically, cephalosporins can cause:

• of the vaginal infections : Alfatil®, Axepim®, Fortum®, Rocéphine® and Zinnat®
• of the dizziness : Fortum®, Zinnat®, Rocéphine®, Oroken® and Orelox®
• a pain or irritation at the injection site for injectable forms
• a encephalopathy resulting in confusion and impaired consciousness: Alfatil®, Axepim® and Rocéphine®
• of the tinnitus : Orelox®

What are the contraindications of cephalosporins?

Cephalosporins are contraindicated in case of allergy to any component of the drug or an allergy to any of the cephalosporin antibiotics. Certain cephalosporins (Axepim®, Fortum®, Rocéphine®, Zinnat®) should not be administered in people with a history of allergic reactions severe related to taking an antibiotic from the beta-lactam family (e.g. penicillins). For other cephalosporins, the doctor and pharmacist will make sure to the absence of cross-allergy. In addition, drugs presented in the form of tablets are prohibited. in children under 6 years old. Cephalosporins can be prescribed for pregnant or breastfeeding women, however the risk-benefit balance will be assessed beforehand.

Sources:
– Public drug database
-ANSM
– Beta-lactams (penicillins – cephalosporins), Pharmacomédicale.org, 2017