What are the side effects of cephalosporins?

Generally, cephalosporins—commonly used antibiotics in clinical practice—may cause several side effects, including gastrointestinal reactions, allergic reactions, hematological abnormalities, neurological reactions, and superinfections. A detailed analysis is as follows:

1. Gastrointestinal reactions: This is the most common side effect of cephalosporins, manifesting as nausea, vomiting, diarrhea, abdominal pain, and loss of appetite. These symptoms are usually mild and result from direct irritation of the gastrointestinal mucosa or disruption of intestinal flora balance. Most patients recover spontaneously after discontinuing the drug.

2. Allergic reactions: Some individuals may develop allergic symptoms after using cephalosporins. Mild cases include rashes, itching, and drug-induced fever; the rash is typically maculopapular and appears on the trunk and limbs. Severe reactions may include life-threatening conditions such as anaphylactic shock and laryngeal edema. Therefore, it is essential to evaluate a patient's history of allergies before administration.

3. Hematological abnormalities: In rare cases, patients may experience decreased white blood cell count, reduced platelet count, or increased eosinophils. Leukopenia can lead to weakened immunity and increased susceptibility to infections, while thrombocytopenia may result in skin bruising or gingival bleeding. Regular monitoring of complete blood count (CBC) is recommended during treatment.

4. Neurological reactions: These are more commonly observed with high-dose use or in patients with renal insufficiency, presenting as headache, dizziness, insomnia, or restlessness. In some cases, severe manifestations such as seizures or altered consciousness may occur, especially when drug excretion is impaired. Dosage must be carefully controlled to minimize these risks.

5. Superinfection: Prolonged or broad-spectrum use of cephalosporins may disrupt the body’s normal microbial balance, leading to overgrowth of drug-resistant bacteria or fungi, thereby causing secondary infections such as candidiasis of the mouth or intestines. Symptoms include white patches on oral mucosa, increased frequency of diarrhea, and curd-like stools.

Cephalosporins should be used strictly according to medical instructions. Patients must not adjust the dosage or extend the duration of treatment on their own. Alcohol and alcohol-containing products should be avoided during treatment to prevent adverse reactions.