Third generation cephalosporins: Uses, common brands, and safety info

Third-generation cephalosporins are a group of antibiotics that can treat a variety of bacterial infections. They are considered broad-spectrum antibiotics that can get rid of gram-positive and gram-negative bacteria. These types of antibiotics are bactericidal, and they kill bacteria by interrupting their cell wall. Compared to earlier cephalosporins like first-generation and second-generation cephalosporins, the third-generation cephalosporins provide more coverage against gram-negative bacteria. Third-generation cephalosporins may be prescribed to treat infections like meningitis, pneumonia, gonorrhea, and osteomyelitis. 

Continue reading to learn more about third-generation cephalosporins, their side effects, and precautions.

Other third-generation cephalosporins

• Sefdin (cefdinir) 

• Zinir (cefdinir) 

• Omnicef (cefdinir) 

• Kefnir (cefdinir) 

• Moxalactam (latamoxef)

• Fixx (cefixime) 

• Zifi (cefixime) 

• Claforan (cefotaxime)

• Convenia (cefovecin)

• Pecef (cefpodoxime)

• Simplicef (cefpodoxime)

• Cedax (ceftibuten)

• Naxcel (ceftiofur)

• Excenel (ceftiofur)

• Cefizox (ceftizoxime)

• Cefobid (cefoperazone)

• Meezat (ceftazidime)

• Fortum (ceftazidime)

• Fortaz (ceftazidime)

• Ceptaz (ceftazidime)

What are third-generation cephalosporins?

Cephalosporins are a broad group of antibiotics that have different uses and characteristics. These antibiotics were first discovered in 1945 from a mold called Acremonium and have since been developed as semisynthetic antibiotics. They are currently subgrouped into five generations based on their chemical structure and uses. 

The older cephalosporins are primarily effective against gram-positive bacteria while the newer cephalosporins have greater activity against gram-negative bacteria. The third-generation cephalosporins are commonly prescribed because they cover a broad range of bacterial species and isolates. Third-generation cephalosporins are active against gram-positive species, such as Streptococcus and Staphylococcus, although they may be weaker against gram-positive bacteria than the first- and second-generation cephalosporins. However, unlike first- and second-generation cephalosporins, they are more effective against beta-lactamase-producing bacteria, such as Escherichia coli, Haemophilus influenza, and Klebsiella. 

Cephalosporins have a beta-lactam ring, similar to penicillins. They can be used to treat various infections, including infections of the respiratory tract, urinary tract, central nervous system, bones, joints, and skin. They may sometimes be combined with other antibiotics like penicillins, quinolones, and aminoglycosides. They may also be taken with beta-lactamase inhibitors for improved effectiveness against certain bacteria. 

Third-generation cephalosporins are antimicrobial agents that come in different strengths and formulations. The chosen formulation depends on the drug prescribed. They may be administered as oral tablets, oral capsules, intramuscular injections, or intravenous injections. 

How do third-generation cephalosporins work?

Normally, bacteria maintain their cell wall through the production of peptidoglycan. The bacterial cell wall is made up of a peptidoglycan layer, which maintains the structure of the bacteria and plays a role in bacterial cell division. Without the peptidoglycan layer, the bacteria can’t divide and grow. Penicillin-binding proteins (PBPs) are necessary for the final step in producing peptidoglycan. 

The structure of cephalosporins contains a beta-lactam ring, which attaches to penicillin-binding proteins (PBP) and blocks the production of peptidoglycan. This mechanism of action results in the death of the bacterial cell. Third-generation cephalosporins, like some other antimicrobial agents, are bactericidal, meaning they destroy bacteria.

Some bacteria produce an enzyme called beta-lactamase, which breaks down the beta-lactam structure in third-generation cephalosporins. Cephalosporins may be combined with a beta-lactamase inhibitor to block the beta-lactamase enzyme. Without a beta-lactamase inhibitor, third-generation cephalosporins, among other beta-lactam antibiotics, may be ineffective against resistant beta-lactamase-producing bacteria. Avycaz combines a third-generation cephalosporin, ceftazidime, with a beta-lactamase inhibitor, avibactam. 

What are third-generation cephalosporins used for?

Third-generation cephalosporin antibiotics are indicated to treat a variety of bacterial infections. They can be used for the treatment of infections, which include:

• Lower respiratory tract infections

• Intra-

  abdominal infections

• Urinary tract infections

• Kidney infections

• Skin and soft tissue infections

• Central nervous system infections

• Bone and joint infections

Third-generation cephalosporins are active against infections of the lower respiratory tract, such as community-acquired pneumonia. They’re also commonly used to treat urinary tract and sexually transmitted infections, such as gonorrhea. Cefixime and cefpodoxime have been shown to have 90% or higher efficacy in treating gonorrhea. 

Because they can cross the blood-brain barrier, third-generation cephalosporins may be prescribed to treat central nervous system infections, like meningitis. Unlike first- and second-generation cephalosporins, the third-generation cephalosporins penetrate more easily into the cerebrospinal fluid. 

Third-generation cephalosporins have a broad spectrum of activity and can be used as empiric therapy. Antibiotics are sometimes given as empiric therapy before it is known which bacteria is causing the infection. 

In general, third-generation cephalosporins are active against gram-negative bacilli and other pathogens. More specifically, third-generation cephalosporins are active against Pseudomonas aeruginosa, penicillinase-producing Neisseria gonorrhoeae, chancroid, Lyme disease, gram-negative sepsis, meningitis, and osteomyelitis. 

Who can take third-generation cephalosporins?

Adults

Third-generation cephalosporins are commonly prescribed in adults to treat a variety of infectious diseases. They are among the most commonly used broad-spectrum antibiotics. However, the use of a third-generation cephalosporin will depend on the infection being treated. These antibiotics may be administered as oral, intramuscular, and intravenous formulations. 

Children

Some third-generation cephalosporins may be used in children. However, ceftriaxone is not recommended for use in infants who are younger than 28 days old that are also receiving calcium-containing medicines. Ceftriaxone can interact with calcium-containing products and cause kidney or lung problems in infants. 

Seniors

Third-generation cephalosporins may be safe for use in older adults. However, seniors may need to be monitored more closely for adverse effects, especially if they have underlying medical conditions. These antibiotics are primarily eliminated from the body through the kidneys. Older adults may be more likely to have problems with kidneys, which can lead to other problems if they are also given a cephalosporin.

Are third-generation cephalosporins safe?

Third-generation cephalosporins have been used for decades and are generally safe for use. That being said, there may be some precautions to adhere to when taking a third-generation cephalosporin. 

Recalls

There are no current third-generation cephalosporins drug recalls.

Restrictions

People who have a known allergy to cephalosporins should avoid taking a third-generation cephalosporin. Some people may experience cross-sensitivity if they have had an allergy to penicillin in the past. Penicillins have similar chemical structures to cephalosporins. According to some studies, 10% of people with a penicillin allergy experience an allergic reaction to cephalosporins. 

Tell your doctor about other medical conditions you have or medications you take, before starting treatment with a cephalosporin. There may be an increased risk of bleeding when cephalosporins are taken with blood thinners, like warfarin. It is also recommended to avoid alcohol with cephalosporins due to an increased risk of disulfiram-like side effects, such as dizziness, nausea, and vomiting.  

Antibiotic therapy should only be used for infections caused by susceptible bacteria. Otherwise, there may be an increased risk of antibiotic resistance, which may require further treatment. A healthcare provider may prescribe a third-generation cephalosporin as empiric therapy before determining the exact species of the bacterial isolate. 

Can you take gonadotropin-releasing hormone agonists while pregnant or breastfeeding? 

Third-generation cephalosporins are generally safe in women who are pregnant or breastfeeding. Some cephalosporins may be absorbed into the breastmilk. However, the American Academy of Pediatrics has deemed the use of ceftriaxone, cefotaxime, and ceftazidime safe in breastfeeding women. 

Are third-generation cephalosporins controlled substances?

No, third-generation cephalosporins are not controlled substances.

Common third-generation cephalosporins side effects

The most common side effects of third-generation cephalosporins include:

• Diarrhea

• Nausea

• Vomiting

• Abdominal pain

• Rash

• Injection site reactions, such as redness, swelling, or itching around the injection site

The use of third-generation cephalosporins may increase the risk of serious adverse effects. Certain cephalosporins, such as cefoperazone, contain a N-methyl-thio-tetrazole (NMTT) side chain that decreases vitamin K-dependent clotting factors. Taking NMTT-containing cephalosporins may increase the risk of severe bleeding, especially in people with bleeding problems. 

Like other antibacterial agents, third-generation cephalosporins can increase the risk of superinfection and antimicrobial resistance. There have been reports of third-generation cephalosporins causing C. diff infections, which can lead to severe diarrhea. 

Allergic reactions are possible with third-generation cephalosporins. Seek immediate medical attention if you experience signs or symptoms of a severe allergic reaction, such as hives, difficulty breathing, or swelling of the face or throat. 

Third-generation cephalosporins carry a risk of other serious side effects, such as seizures and skin reactions. Skin reactions associated with Stevens-Johnson syndrome have been reported. Signs and symptoms of Stevens-Johnson syndrome include fever, painful rash, and blisters. 

This may not be a complete list of side effects. Consult a healthcare provider for other possible side effects, warnings, and drug interactions associated with cephalosporins. 

How much do third-generation cephalosporins cost?

Third-generation cephalosporins are available in brand-name and generic formulations. Most Medicare and insurance plans will cover the generic versions of third-generation cephalosporins. However, costs will vary depending on the insurance plan. Consult with your pharmacist or insurance company directly to determine the exact cost of your medication through your insurance plan. Without insurance, the price can vary depending on the medication and quantity of medication prescribed. Using a free prescription discount card from SingleCare may help reduce the cost of third-generation cephalosporins.