The cephalosporin antibiotics (cefaclor [CECLOR], cefadroxil [DURICEF], cefixime [SUPRAX], cefpodoxime [VANTIN], cefuroxime [CEFTIN] )are used in the treatment of infections caused by bacteria. They work by killing bacteria or preventing their growth. These drugs are used to treat infections in many different parts of the body. They are sometimes given with other antibiotics. Some cephalosporins given by injection are also used to prevent infections before, during, and after surgery. However, cephalosporins will not work for colds, flu or other virus infections.

Before beginning therapy with a cephalosporin antibiotic, careful inquiry should be made to determine whether the patient has had previous hypersensitivity reactions to cephalosporin, penicillin or other drugs.  This product should be given cautiously to penicillin-sensitive patients.

These antibiotics may cause stomach or abdominal cramps and pain; abdominal tenderness; watery diarrhea that may also be bloody; and fever. These drugs may also cause skin reactions, seizures, decrease in urine output, joint pain, loss of appetite, nausea or vomiting, and a low platelet count (thrombocytopenia).

Hypersensitivity reactions, including anaphylactic/anaphylactoid reactions (including shock and fatalities), angioedema (hive-like swelling beneath the skin, especially around the eyes and mouth) and facial edema (swelling) have been reported with the use of cefixime (Suprax).

Amoxil (Amoxycillin) is used to treat certain infections caused by bacteria, such as ear, sinus, and bladder infections. It is also prescribed for bronchitis in people with chronic lung disease and for gonorrhea. A second drug, clavulanate, is sometimes combined with Amoxil. It helps Amoxil work better by preventing bacteria from resisting the drug. Amoxil will not help a cold or the flu.

A study conducted to determine if antibiotics are beneficial in treating patients with sinusitis complaints and with pus in the nasal cavity, facial pressure, or nasal discharge lasting longer than 7 days, found that Amoxil did not provide any significant benefits over placebo. Although, in retrospect, there were patients whose symptoms did improve while on Amoxil, identifying these patients in advance and treating them with antibiotics may be difficult in a clinical setting. Treating patients unnecessarily with antibiotics may result in potential harm to the patient.

If you have kidney disease, you may need to take less than the usual adult dose of Amoxil. The excretion of crystals (small irregular solids) in the urine (crystalluria) producing urine irritation has been reported.

In rare instances, liver injury has been reported in patients taking the combination of Amoxil and clavulanate. The estimated risk of damage to the liver (hepatotoxicity), presumably due to this combination increases from 3 to 17 per 100,000 prescriptions. It was found that patients who are on prolonged or repeated courses of treatment and men over the age of 50 taking this combination are at an increased risk of developing hepatotoxicity.

Although most patients recover with supportive care, hepatitis often does not occur until after the drug is stopped. Two cases of severe hepatotoxicity that rapidly progressed to life-threating acute liver failure have been reported with the use of Amoxil/clavulanate.

Tooth discoloration has also been reported with Amoxil use.

Ampicillin is an older form of Amoxil. Many people who take ampicillin develop a slight skin rash. This may or may not be a sign that you are allergic to the drug. If you get a skin rash, call your doctor. Some of ampicillin’s adverse effects can appear as much as a month after you stop taking it.

Colds and Bronchitis

Two recently published studies ("Antibiotic prescribing for adults with colds, upper respiratory tract infections, and bronchitis by ambulatory care physicians." and "Antibiotic prescribing for children with colds, upper respiratory tract infections, and bronchitis." from Journal of the American Medical Association by Gonzales R, Steiner JF, Sande MA.), based on nationwide data from office visits for children and adults, have decisively documented the expensive and dangerous massive overprescribing of antibiotics for conditions that, because of their viral origin, do not respond to these drugs. Forty-four percent of children under 18 years old were given antibiotics for treatment of a cold and 75% for treatment of bronchitis. Similarly, 51% of people 18 or older were treated with antibiotics for colds and 66% for bronchitis. Despite the lack of evidence of any benefit for most people from these treatments, more than 23 million prescriptions a year were written for colds, bronchitis, and upper respiratory infections. This accounted for approximately one-fifth of all prescriptions for antibiotics written for children or adults.

Sore Throats

Sore throats are one of the leading causes of visits to doctors, with more than 10 million such visits a year. The only kind of sore throat that merits treatment with an antibiotic is a bacterial sore throat caused by group A beta-hemolytic streptococci, the so-called strep throat. Although only approximately 10% of adults seen by a doctor for a sore throat actually have a strep throat, 75% of patients with sore throats seen by doctors are prescribed an antibiotic. Though the likelihood that a sore throat in a child is a strep throat is somewhat higher, perhaps 25%, the majority of children are also treated with antibiotics.

Bladder Infections

In a recent study of more than 13,000 women going to a doctor because of a bladder infection, more than 95% of whom had an acute bladder infection, not a recurrent one, only 37% were prescribed the preferred treatment for this condition, the combination antibiotic trimethoprim/sulfamethoxazole (sometimes prescribed by the brand name Bactrim or Septra. Almost as many (32%) were prescribed one of the heavily promoted fluoroquinolones such as ciprofloxacin (CIPRO), which are not the first-choice drug for bladder infections. Using such drugs when there is a better alternative contributes to the rapidly increasing and health-threatening problem of resistance to antibiotics, whereby when the fluoroquinolones are actually needed, people may be infected with bacteria that are resistant to them (see below). The recommended duration of treatment for an acute bladder infection is three days of the antibiotic, and yet less than 10% of the prescriptions were for three days. The most common duration of treatment was 10 days, followed by seven and five days. Thus, in addition to using the wrong antibiotic most of the time, the duration of therapy was too long most of the time.

Antibiotics (drugs used to treat bacterial infections) are overwhelmingly misprescribed in the United States.  Despite congressional hearings and numerous academic studies on this issue, it has become the general consensus that 40 to 60% of all antibiotics in this country are misprescribed. New studies continue to confirm the fact that a large proportion of antibiotic prescribing for both children and adults continues to be inappropriate. To put it simply, a large proportion of antibiotics are prescribed in situations in which the infection cannot be treated by any antibiotic, or another, more effective and appropriate antibiotic should be used instead. This should be a major concern, since the misprescribing of antibiotics poses some real dangers to the population at large, as well as to the individuals taking them, especially older adults.