Cephalosporins: Broad Spectrum Antibiotics-An Updated Review for Healthcare Professionals | ||
| Egyptian Journal of Chemistry | ||
| Volume 68, Issue 13, December 2025, Pages 1161-1174 PDF (590.03 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejchem.2025.404366.12049 | ||
| Authors | ||
| Mohammed Rashed Aldhahri* ; Ahmed Abdulkarim Sulaiman Alnughaymishi; Bandar Zaben Muhammad Alharbi; Rashed Obaid Al-Harbi; Thamer H. Aljuaid; Waleed Abdullah Alghamdi; Abdulrahman Abdullah Nazal Al-Anzi; Reem Mahmoud Nashar; Waad Ali Alshehri; Wejdan Saleh Alghamdi; Njoud Abdulrhman Almousa; Alhanouf Saad Bin Serran; Malath Ali Salami; Reema Ali Salami; Amal Hajjan Alanazi; Abdullah Mohammed Asiri | ||
| Ministry of National Guard, Saudi Arabia | ||
| Abstract | ||
| Background: Cephalosporins are cornerstone β-lactam antibiotics arranged into five generations that progressively expand gram-negative activity while preserving gram-positive coverage across common and severe infections. Aim: To synthesize practice-oriented guidance on spectrum, mechanisms, pharmacokinetics, indications, safety, contraindications, monitoring, and toxicity. Methods: Narrative review of the supplied article integrating generational profiles, cefiderocol approvals, population-specific dosing, adverse effects, and stewardship themes. Results: First generation targets staphylococci/streptococci; second adds respiratory gram-negatives and anaerobes; third broadens Enterobacteriaceae with CNS penetration (ceftazidime provides antipseudomonal activity); fourth-generation cefepime adds β-lactamase stability and antipseudomonal activity; fifth-generation ceftaroline uniquely covers MRSA. Cefiderocol, a siderophore cephalosporin, is FDA-approved for complicated UTI and ventilator-associated pneumonia due to resistant gram-negative bacilli. Safety issues include hypersensitivity, drug-induced immune hemolytic anemia, N-methyl-thiotetrazole–associated hypoprothrombinemia and disulfiram-like reactions, and antibiotic-associated Clostridioides difficile colitis. Contraindications include cephalosporin allergy, anaphylaxis to β-lactams, and neonatal ceftriaxone in hyperbilirubinemia or with calcium. Monitoring focuses on renal function, PT/INR, and hemolysis labs; cefepime neurotoxicity is the hallmark of overdose, and careful dose adjustment in renal impairment is essential. Conclusion: Cephalosporins remain versatile and effective; optimal outcomes require tailored selection and stewardship, while cefiderocol extends options against carbapenem-resistant gram-negatives | ||
| Keywords | ||
| cephalosporins; β-lactam; cefiderocol; MRSA; Pseudomonas aeruginosa; pharmacokinetics | ||
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