Cephalosporins include

Cephalosporins/beta-lactamase inhibitors:

• Avibactam/ceftazidime (Avycaz)
• Ceftolozane/tazobactam (Zerbaxa)

First generation cephalosporins:

• Cefadroxil (Duricef)
• Cephradine (Velosef)
• Cefazolin (Kefzol and Ancef)
• Cephalexin (Keflex and Panixine)

Second generation cephalosporins:

• Cefotetan (Cefotan)
• Cefoxitin (Mefoxin)
• Cefaclor (Raniclor)
• Cefprozil (Cefzil)
• Cefuroxime (Ceftin oral, Kefurox injection, and Zinacef injection)
• Loracarbef (Lorabid Pulvules)

Third generation cephalosporins:

• Ceftibuten (Cedax)
• Ceftriaxone (Rocephin)
• Cefotaxime (Claforan)
• Cefpodoxime (Vantin)
• Cefdinir (Omnicef and Omnicef Omni-Pac)
• Cefixime (Suprax)
• Cefditoren (Spectracef)
• Ceftizoxime (Cefizox)
• Cefoperazone (Cefobid)
• Ceftazidime (Ceptaz, Fortaz, and Tazicef)

Fourth generation cephalosporins:

• Cefepime (Maxipime)

Probiotics

Taking cephalosporins may deplete good bacteria.

There are many types of good bacteria that live in your intestine. They help keep your digestive system healthy. Two of these bacteria are Lactobacillus acidophilus and Bifidobacterium bifidum.

Good bacteria help you to:

• Fight against infections and diseases
• Digest food
• Detoxification
• Maintenance of intestinal health

Use of some medicines may deplete good bacteria. If you do not have enough probiotics in your gut, you may have:

• Gas
• Stomach problems
• Diarrhea
• More serious infections in your intestine
• Increased risk of allergies

Some foods called probiotics contain good bacteria, and can help return your gut to normal.

Vitamin K

Taking cephalosporins may deplete vitamin K.

The major symptom of vitamin K deficiency is that your blood does not clot as it should. Low levels of vitamin K may cause:

• Easy bruising
• Bleeding even on minor injury
• Bleeding gums
• Nosebleeds
• Women may have heavy periods

Lack of vitamin K may also cause internal bleeding. This can be life threatening.

Calcium

Taking cefdinir or cefepime may deplete calcium.

Calcium, along with vitamin D, keeps your bones strong and healthy.

Low levels of calcium may cause:

• Muscle cramps
• Numbness or tingling in toes and feet
• Irregular heartbeat
• Depression
• Bone pain
• Spinal problems
• Seizures

Magnesium

Taking ceftolozane/tazobactam may deplete magnesium.

Magnesium deficiency affects calcium and vitamin D levels in the body. This may cause:

• Muscle cramps
• Muscle weakness
• Irregular heartbeat
• Numbness and tingling in feet and toes
• Seizures
• Insomnia
• High blood pressure

Potassium

Taking avibactam/ceftazidime, ceftaroline, or ceftolozane/tazobactam may deplete potassium.

Symptoms of potassium deficiency include:

• Nausea and vomiting
• Tiredness
• Drowsiness
• Feeling of apprehension
• Weakness
• Muscle pain and weakness (mostly in the legs)
• Muscle cramps
• Strong, rapid, or irregular heartbeat

Phosphorous

Taking ceftolozane/tazobactam, cefdinir, or cefepime may deplete phosphorus.

Phosphorus deficiency is rare, but low levels can cause:

• Muscle pain and weakness
• Bone pain
• Confusion
• Numbness and tingling in feet and toes
• Loss of appetite
• Increased risk of infections
• Trouble breathing
• Seizures
• Irregular heartbeat

The information presented here covers some of the nutrients that may be affected when you take certain medicines. If you have any of these signs and symptoms, it does not always mean you have low levels of these nutrients.

Factors that affect the level of nutrients are:

• Your medical history
• Diet
• Lifestyle
• How long you have been taking the medicine

Please talk to your health care provider. They can best address your health care needs and see if you are at risk for low levels of any nutrients.

Asiedu DK. Vitamin deficiency (Hypovitaminosis). In: Ferri FF, ed. Ferri's Clinical Advisor 2017. Philadelphia, PA: Elsevier; 2017:1359-1360.

Elsevier BV. First Consult: Hypomagnesemia, 2013. Updated February 19, 2013. www.clinicalkey.com/#!/content/medical_topic/21-s2.0-2001655. Accessed July 20, 2016.

Gold Standard Drug Database: Drug Monograph: Cefaclor, 2015. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-96. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Cefadroxil, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-97. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Cefazolin, 2015. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-98. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Cefdinir, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-688. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Cefditoren, 2015. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-2494. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Cefepime 2015. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-99. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Cefixime, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-100. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Cefoperazone 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-101. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Cefotaxime, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-102. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Cefotetan, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-103. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Cefoxitin, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-104. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Cefpodoxime, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-1239. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Cefprozil, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-105. Accessed July7, 2016.

Gold Standard Drug Database: Drug Monograph: Cefprozil, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-355. Accessed July7, 2016.

Gold Standard Drug Database: Drug Monograph: Ceftaroline 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-3708. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Ceftazidime 2015. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-106. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Ceftazidime; Avibactam, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-3987. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Ceftibuten, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-1240. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Ceftizoxime, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-1241. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Ceftolozane; Tazobactam, 2015. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-3971. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Ceftriaxone, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-107. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Cefuroxime, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-108. Accessed July7, 2016.

Gold Standard Drug Database: Drug Monograph: Cephradine, 2015. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-1245. Accessed July 19, 2016.

Gold Standard Drug Database: Drug Monograph: Cephalexin, 2016. www.clinicalkey.com/#!/content/drug_monograph/6-s2.0-109. Accessed July 19, 2016.

Greenbaum LA. Vitamin K deficiency. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 53.

Harrison GJ. Probiotics. In: Cherry JD, Demmler-Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ, eds. Feigin and Cherry's Textbook of Pediatric Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 242.

James WD, Berger TG, Elston DM. Nutritional diseases. In: James WD, Berger TG, Elston DM, eds. Andrews' Diseases of the Skin. 12th ed. Philadelphia, PA: Elsevier; 2016:chap 22.

Leone KA. Calcium, magnesium, and phosphorus. In: Adams JG, ed. Emergency Medicine. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 166.

Osborn MB. Potassium. In: Adams JG, ed. Emergency Medicine. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 165.

Shenkin A, Roberts NB. Vitamins and trace elements. In: Burtis CA, Ashwood ER, Bruns DE, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 5th ed. St. Louis, MO: Elsevier Saunders; 2012:chap 31.

Smogorzewski MJ, Stubbs JR, Yu ASL. Disorders of calcium, magnesium, and phosphate balance. In: Skorecki K, Chertow GM, Marsden PA, Taal MW, Yu ASL, eds. Brenner and Rector's The Kidney. 10th ed. Philadelphia, PA: Elsevier; 2016:chap 19.

Yu ASL. Disorders of magnesium and phosphorus. In: Lee G, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier; 2016:chap 119.