- Body system
- Anti-infectives
- Name stem
- cef-, ceph-
- Drug cards
- 1 in this guide
Drugs in this class
Other examples: Cefazolin, Cephalexin, Cefuroxime, Cefepime, Ceftaroline.
How cephalosporins work
Block bacterial cell wall synthesis. Later generations generally have more gram-negative coverage.
Uses
- Surgical prophylaxis (cefazolin)
- Skin infections (cephalexin)
- Pneumonia and meningitis (ceftriaxone)
- Hospital-acquired infections, including Pseudomonas (cefepime)
Adverse effects
- Allergic reactions
- Diarrhea and C. difficile
- Phlebitis
- Neurotoxicity with cefepime in kidney impairment
Nursing considerations
- Ask about allergies. Cross-reactivity with penicillin allergy is low, but a severe penicillin reaction needs the prescriber's review.
- Do not give ceftriaxone with calcium-containing IV solutions.
- Monitor kidney function and the IV site.
Patient teaching
- Report diarrhea, rash or itching.
- Complete the full course.
Cephalosporins NCLEX practice questions
Answer each question to see the rationale.
3 questions. Choose an answer to see the rationale.
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Which IV solution must not be given at the same time as ceftriaxone?
Show answer
Answer A: Lactated Ringer's Ceftriaxone can form a precipitate with calcium; lactated Ringer's contains calcium.
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Which antibiotic is commonly given within 60 minutes before surgical incision for prophylaxis?
Show answer
Answer C: Cefazolin Cefazolin is the standard prophylaxis for many surgeries, given within 60 minutes before incision.
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A patient with a history of a mild rash to amoxicillin is ordered cefazolin. What is the best action?
Show answer
Answer C: Confirm the allergy is documented and known to the prescriber, then give it as ordered and monitor Cross-reactivity is low; with a non-severe reaction the prescriber may proceed. The nurse confirms the allergy is documented and that the prescriber knows, then gives the drug and monitors.
Frequently asked questions
What are cephalosporins?
Cephalosporins (cef- or ceph-) are beta-lactam antibiotics grouped in generations. Cefazolin is the classic surgical prophylaxis drug; ceftriaxone must not be mixed with calcium.
How do cephalosporins work?
Block bacterial cell wall synthesis. Later generations generally have more gram-negative coverage.
What are examples of cephalosporins?
Ceftriaxone, Cefazolin, Cephalexin, Cefuroxime, Cefepime and Ceftaroline.
What are the nursing considerations for cephalosporins?
Ask about allergies. Cross-reactivity with penicillin allergy is low, but a severe penicillin reaction needs the prescriber's review. Do not give ceftriaxone with calcium-containing IV solutions.