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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 typ-

ically 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 pre-

scribed 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).

CEPHALOSPORINS AND

DRUG-DRUG INTERACTIONS

Alcohol should be avoided when taking certain cephalosporins (cefamandole,

cefoperazone, or moxalactam) because patients might experience adverse side

effects that include:

• Stomach pain


• Nausea


• Vomiting


• Headaches

(^216) CHAPTER 13 Antimicrobials—Fighting Infection