Pharmacology for Dentistry

Beta Lactam Antibiotics 323

Adverse Reactions

Cephalosporins are generally well tol-
erated and various side effects include pain
at the site of injection and can also cause
thrombophlebitis. Allergic reactions include
skin rash, fever, serum sickness, eosino-
philia, neutropenia and rarely anaphylactic
reaction.

CNS side effects include nystagmus and
hallucinations and some of the newer
compounds can cause disulfiram like
reaction.

Larger doses can cause nephrotoxicity.

FIRST GENERATION CEPHALOSPORINS

Highly active against gram positive but
weaker against gram negative bacteria.

CEPHALEXIN

It is orally active first generation
cephalosporin and less active against
penicillinase producing staphylococci.

Adverse effects include skin rash,
urticaria, nausea, vomiting, diarrhoea and
neutropenia.

It is excreted unchanged in urine. It is
indicated in respiratory, genitourinary, skin
and soft tissue infections, bone and joint
infections, dental and ENT infections.

CEFAZOLIN

It is a semisynthetic potent cephalosporin
for parenteral administration. It can be
administered less frequently because of its
long half life. It is used in infections of
genitourinary tract, bone, joint and soft tissue
infections, septicaemia, endocarditis,
gonorrhoea, postoperative chest infections,
biliary tract infection and surgical prophylaxis.

CEFADROXIL

It has good tissue penetration. Excreted

unchanged in urine. Used in soft tissue and

skin infection caused by staphylococci or

streptococci, pharyngitis, tonsillitis, ENT

infections and urinary tract infections.

SECOND GENERATION CEPHALOSPORINS

CEFUROXIME

It is effective against a wide range of

gram positive and negative organisms. It is

indicated in:

• Lower respiratory tract infections e.g.,
  pneumonia, acute bronchitis and acute
  exacerbations of chronic bronchitis.


• ENT infections, such as otitis media,
  sinusitis, tonsillitis and pharyngitis.


• Genitourinary tract infections e.g.,
  pyelonephritis, cystitis and urethritis.


• Skin and soft tissue infections e.g.,
  furunculosis, pyoderma and impetigo.


• Enteric fever.


• Gonorrhoea, acute uncomplicated
  gonococcal urethritis, and cervicitis.
  Adverse reactions to cefuroxime have
  been generally mild and transient in nature.
  As with other cephalosporins there have
  been rare reports of erythema multiforme,
  Steven-Johnson syndrome, toxic epidermal
  necrolysis (exanthematic necrolysis) and
  hypersensitivity reactions including skin
  rashes, urticaria, pruritus, drug fever, serum
  sickness and very rarely anaphylaxis.

CEFACLOR

The antibacterial spectrum of cefaclor in-

cludes the following organisms: Staphylo-