Cephalexin: Pharmacology and Side Effects
Oct 23,2024
General Description
Cephalexin is an FDA-approved first-generation cephalosporin antibiotic that can be used to treat a variety of bacterial infections, such as pneumonia and other chest infections, skin infections, urinary tract infections (UTIs), respiratory tract infections, and otitis media. It can also be used to treat bone infections caused by Staphylococcus aureus or Proteus mirabilis.
Figure 1. Cephalexin
Pharmacology
Cephalexin is a β-lactam antibiotic that is structurally characterized by a β-lactam ring. Within bacterial cells, peptidoglycan provides mechanical stability to the cell wall. Cephalexin, along with other β-lactam antibiotics, utilizes its β-lactam ring to inhibit peptidoglycan synthesis, a key process in the formation of bacterial cell walls. Its β-lactam ring binds to penicillin-binding proteins (PBPs), which effectively blocks the final stage of peptidoglycan synthesis, called the transpeptidation reaction. This reaction is essential for the cross-linking of bacterial peptidoglycan. By inhibiting this process, cephalexin undermines cell viability and ultimately leads to bacterial cell death.
Despite this, bacteria can develop resistance to cephalexin through various mechanisms, including the following pathways:
(1) Bacteria express "β-lactamases" to degrade β-lactam antibiotics.
(2) Bacteria modify PBP proteins to change the binding affinity of cephalexin to its target site.
(3) Bacteria synthesize efflux pumps to expel drugs from the cells.
Side Effects
Common side effects of Cephalexin include:
Gastrointestinal reactions (abdominal pain, diarrhea, indigestion, nausea, vomiting, gastritis)
Redness, blistering, peeling or loosening of the skin
Abnormal vaginal discharge, itching or odor
Rare side effects include:
Muscle or joint pain
Blood in the stool
Immunogenic hemolytic anemia
Toxic tendinopathy
Acute generalized exanthematous pustulosis
Serious side effects include:
Severe stomach pain, watery or bloody diarrhea
Unexplained bruises on the skin
Yellowing of the skin and dark urine (may be a liver problem)
Serious allergic reactions (trouble breathing, swelling of the face, lips, tongue or throat, hives)
If any of the above serious adverse reactions occur, please contact your doctor immediately.
References:
[1] GRIFFITH R S. The pharmacology of cephalexin.[J]. Postgraduate Medical Journal, 1983, 59 Suppl 5.
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