The cephalosporin family of medications is a chemically modified version of penicillin that stops growth and kills a broad spectrum of bacteria by making it impossible for bacteria to create a cell wall. There are four generations of cephalosporins.

Cephalosporin can be prescribed for patients who are allergic to penicillin. However, about 10% of those patients might also be allergic to cephalosporins. Do not administer cephalosporins to patients who have had a serious reaction to penicillin such as anaphylaxis.

Prescribers use cephalosporins to combat a wide variety of infections and typically use it as a prophylaxis to prevent a bacterial infection to occur during or after surgery.

Cephalosporins also have side effects which include diarrhea, abdominal cramps or distress, oral and/or vaginal candidiasis, rash, pruritis, redness, or edema. There is also an increase of bleeding and bruising with four commonly prescribed cephalosporins: cefamandole, cefmetazole, cefoperazone, and cefotetan.

The patient assessment for cephalosporins is the same as for penicillin. However, pay particular attention to any previous bleeding disorder reported by the patient because cephalosporins can exacerbate this condition.

Before administering cephalosporins, assess for allergies, vital signs, and urine output. Check laboratory results, especially those that indicate renal and liver function such as BUN, serum creatinine, AST, ALT, ALP, and bilirubin. Also monitor bleeding time (PT and PTT) and white blood cell count. Obtain a tissue or blood specimen for a culture and sensitivity if possible to determine if cepha-losporins are the right antibiotic.

Administer cephalosporins using the same methods as used for penicillin. If given IM, it should be injected deeply into a large muscle mass. This decreases pain, induration (becoming hard), and a sterile abscess.

The patient should be provided with the same instructions as is given to a patient who is receiving penicillin (see Penicillin and Patient Education).

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