Cephalosporins: Broad Spectrum Antibiotics-An Updated Review for Healthcare Professionals.

Background: Cephalosporins are cornerstone β-lactam antibiotics arranged into five generations that progressively expand gram-negative activity while preserving gram-positive coverage across common and severe infections.Aim: To synthesize practice-oriented guidance on spectrum, mechanisms, pharmacokinetics, indications, safety, contraindications, monitoring, and toxicity.Methods: Narrative review of the supplied article integrating generational profiles, cefiderocol approvals, population-specific dosing, adverse effects, and stewardship themes.Results: First generation targets staphylococci/streptococci; second adds respiratory gram-negatives and anaerobes; third broadens Enterobacteriaceae with CNS penetration (ceftazidime provides antipseudomonal activity); fourth-generation cefepime adds β-lactamase stability and antipseudomonal activity; fifth-generation ceftaroline uniquely covers MRSA. Cefiderocol, a siderophore cephalosporin, is FDA-approved for complicated UTI and ventilator-associated pneumonia due to resistant gram-negative bacilli. Safety issues include hypersensitivity, drug-induced immune hemolytic anemia, N-methyl-thiotetrazole–associated hypoprothrombinemia and disulfiram-like reactions, and antibiotic-associated Clostridioides difficile colitis. Contraindications include cephalosporin allergy, anaphylaxis to β-lactams, and neonatal ceftriaxone in hyperbilirubinemia or with calcium. Monitoring focuses on renal function, PT/INR, and hemolysis labs; cefepime neurotoxicity is the hallmark of overdose, and careful dose adjustment in renal impairment is essential.Conclusion: Cephalosporins remain versatile and effective; optimal outcomes require tailored selection and stewardship, while cefiderocol extends options against carbapenem-resistant gram-negatives