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<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Cephalosporins, Oral - LiverTox - NCBI Bookshelf</title>
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<meta name="citation_inbook_title" content="LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]">
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<meta name="citation_title" content="Cephalosporins, Oral">
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yet</button><a id="jr-fip-next" class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK548358_"><span class="title" itemprop="name">Cephalosporins, Oral</span></h1><p class="fm-aai"><a href="#_NBK548358_pubdet_">Publication Details</a></p></div></div><div class="body-content whole_rhythm" itemprop="text"><div id="OralCephalosporins.OVERVIEW"><h2 id="_OralCephalosporins_OVERVIEW_">OVERVIEW</h2><div id="OralCephalosporins.Introduction"><h3>Introduction</h3><p>The orally available cephalosporins are widely used as broad spectrum antibiotics for mild-to-moderate infections with susceptible organisms. Despite their widescale use, cases of drug induced liver disease from the cephalosporins are very rare, with only isolated case reports having been published.</p></div><div id="OralCephalosporins.Background"><h3>Background</h3><p>The oral cephalosporins are available in both generic and trade formulations and include cefaclor (Ceclor, Raniclor: 2nd), cefadroxil (Duracef: 1st), cefdinir (Omnicef: 3rd), cefditoren (Spectracef: 3rd), cefixime (Suprax: 3rd), cefpodoxime (Vantin: 3rd), cefprozil (Cefzil: 2nd), ceftibuten (Cedax: 3rd), cephalexin (Keftab: Apo-Cephalex, Biocef, Keflex, NovoLexin, Nu-Cephalex: 1st), cefuroxime (Ceftin: 2nd), cephradine (Velosef: 1st), and loracarbef (Lorabid: 2nd). Cefuroxime and cephradine are also available in parenteral forms. The typical dose regimens for oral cephalosporins are 250 to 500 mg two to four times daily for 7 to 14 days. The oral cephalosporins are widely used in medicine for mild-to-moderate infections due to susceptible bacteria. The oral cephalosporins are generally well tolerated; adverse events can include diarrhea, nausea, abdominal pain, dyspepsia, headache, and rash. Rare but potentially severe adverse events include Clostridium difficile-associated diarrhea, hypersensitivity reactions, angioedema, anaphylaxis and Stevens Johnson syndrome/toxic epidermal necrolysis.</p></div><div id="OralCephalosporins.Hepatotoxicity"><h3>Hepatotoxicity</h3><p>Oral cephalosporins can be associated with minor elevations in serum aminotransferase and alkaline phosphatase values, but these are generally mild, transient and not associated with symptoms or development of more severe liver injury. The frequency of these elevations is reported to be as high as 11%, but varies depending upon the frequency of monitoring, duration of therapy, and nature and severity of the underlying illness. Clinically apparent liver injury from oral cephalosporin use is rare, only isolated case reports having been published, and not all of the formulations have been linked to cases of liver injury. The clinical pattern of injury suggests that hepatotoxicity is largely a class effect from the cephalosporins, even though it is idiosyncratic and rare. The typical latency period has been 1 to 4 weeks with an abrupt onset of liver injury. The pattern of serum enzyme elevations is usually cholestatic, but mixed and hepatocellular instances have been reported. Liver injury is often accompanied by fever, rash and eosinophilia or other signs and symptoms of hypersensitivity. A history of penicillin allergy is not common.</p><p>Likelihood score: B (cephalosporins as a class are very likely but rare causes of clinically apparent liver injury, the association having been made largely with the most frequently used agents, such as cefazolin, cephalexin and ceftriaxone).</p></div><div id="OralCephalosporins.Mechanism_of_Injury"><h3>Mechanism of Injury</h3><p>The mechanism of hepatic injury due to cephalosporins is unknown, but believed to be hypersensitivity and similar to that of other penicillins.</p></div><div id="OralCephalosporins.Outcome_and_Managemen"><h3>Outcome and Management</h3><p>In most case reports, recovery has been rapid within 4 to 8 weeks without residual injury or persistent serum enzyme elevations. Among the few cases reported, none have been fatal. It is unclear whether there is cross sensitivity to the hepatic injury induced by cephalosporins. In many published cases, patients have been switched to an alternative cephalosporin without recurrence of injury, but it is more judicious to switch to another class of agents. Similarly, patients with a history of penicillin allergy have a higher rate of hypersensitivity reactions to cephalosporins, and they should be avoided or started with careful supervision and monitoring.</p><p>References to oral cephalosporin induced liver injury are provided in the introductory overview chapter on Cephalosporins.</p><p>Drug Class: Antiinfective Agents, <a href="/books/n/livertox/Cephalosporins/?report=reader">Cephalosporins</a></p></div></div><div id="OralCephalosporins.CASE_REPORT"><h2 id="_OralCephalosporins_CASE_REPORT_">CASE REPORT</h2><div id="OralCephalosporins.Case_1_Cholestatic_he"><h3>Case 1. Cholestatic hepatitis related to cefuroxime.(<a class="bibr" href="#OralCephalosporins.REF.1" rid="OralCephalosporins.REF.1">1</a>)</h3><p>A 52 year old man was given a 10-day course of oral cefuroxime for recurrent folliculitis, but developed worsening skin rash and itching, and was found to be jaundiced 7 weeks after starting the antibiotic. Laboratory testing showed prominent elevations in serum AST and alkaline phosphatase with a total bilirubin of 8.4 mg/dL (Table). Tests for autoantibodies and for serologic evidence of hepatitis A, B and C were negative. Imaging tests of the liver including ultrasound, MRI and MRCP were unremarkable. The patient had a complex past medical history of diabetes, hypertension, coronary artery disease, chronic back pain and asthma for which he took several medications chronically, none of which had been changed recently. He abused alcohol for many years, but had abstained for 4 years. He had no known allergies. His cholestasis and liver disease were prolonged, and ultimately he underwent liver biopsy which showed changes of chronic inflammation and intrahepatic cholestasis compatible with drug induced liver disease. The diagnosis of cephalosporin induced liver injury had not been fully appreciated and he received two 10-day courses of cephalexin during this period of jaundice. These exposures were not associated with appreciable changes in serum enzyme levels, but were followed by an increase in serum bilirubin levels and skin rash (Table). Because of persistent pruritus, he was treated with ursodiol, cholestyramine and several antihistaminics. Ultimately, his rash and itching resolved; serum bilirubin fell to normal, but there were minor elevations in ALT and alkaline phosphatase that did not fall into the completely normal range for more than a year after the initial presentation.</p><div id="OralCephalosporins.Key_Points"><h4>Key Points</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figOralCephalosporinsTc"><a href="/books/NBK548358/table/OralCephalosporins.Tc/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figOralCephalosporinsTc" rid-ob="figobOralCephalosporinsTc"><img class="small-thumb" src="/books/NBK548358/table/OralCephalosporins.Tc/?report=thumb" src-large="/books/NBK548358/table/OralCephalosporins.Tc/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="OralCephalosporins.Tc"><a href="/books/NBK548358/table/OralCephalosporins.Tc/?report=objectonly" target="object" rid-ob="figobOralCephalosporinsTc">Table</a></h4></div></div></div><div id="OralCephalosporins.Laboratory_Values"><h4>Laboratory Values</h4><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figOralCephalosporinsTd"><a href="/books/NBK548358/table/OralCephalosporins.Td/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figOralCephalosporinsTd" rid-ob="figobOralCephalosporinsTd"><img class="small-thumb" src="/books/NBK548358/table/OralCephalosporins.Td/?report=thumb" src-large="/books/NBK548358/table/OralCephalosporins.Td/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="OralCephalosporins.Td"><a href="/books/NBK548358/table/OralCephalosporins.Td/?report=objectonly" target="object" rid-ob="figobOralCephalosporinsTd">Table</a></h4></div></div></div><div id="OralCephalosporins.Comment"><h4>Comment</h4><p>The prolonged course of cholestasis with no obvious cause was most likely due to drug induced liver injury, and cefuroxime (a third generation, orally available cephalosporin) was the most likely cause. The long incubation period is unusual for cephalosporin related liver injury. Furthermore, rechallenge with cephalexin and then with cefuroxime appeared to worsen the course minimally, if at all, but may have been the reason for the delayed recovery. A year after the initial presentation, the patient was without symptoms, but serum enzymes were still mildly abnormal. Ultimately, however, even these mild biochemical abnormalities resolved.</p></div></div></div><div id="OralCephalosporins.PRODUCT_INFORMATION"><h2 id="_OralCephalosporins_PRODUCT_INFORMATION_">PRODUCT INFORMATION</h2><p>
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<b>REPRESENTATIVE TRADE NAMES</b>
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</p><p>Cefuroxime – Generic, Ceftin®</p><p>
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<b>DRUG CLASS</b>
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</p><p>Antiinfective Agents</p><p>
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<a href="https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=cefuroxime" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">COMPLETE LABELING</a>
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</p><p>Product labeling at DailyMed, National Library of Medicine, NIH</p></div><div id="OralCephalosporins.CHEMICAL_FORMULA_AND"><h2 id="_OralCephalosporins_CHEMICAL_FORMULA_AND_">CHEMICAL FORMULA AND STRUCTURE</h2><div class="iconblock whole_rhythm clearfix ten_col table-wrap" id="figOralCephalosporinsTe"><a href="/books/NBK548358/table/OralCephalosporins.Te/?report=objectonly" target="object" title="Table" class="img_link icnblk_img figpopup" rid-figpopup="figOralCephalosporinsTe" rid-ob="figobOralCephalosporinsTe"><img class="small-thumb" src="/books/NBK548358/table/OralCephalosporins.Te/?report=thumb" src-large="/books/NBK548358/table/OralCephalosporins.Te/?report=previmg" alt="Image " /></a><div class="icnblk_cntnt"><h4 id="OralCephalosporins.Te"><a href="/books/NBK548358/table/OralCephalosporins.Te/?report=objectonly" target="object" rid-ob="figobOralCephalosporinsTe">Table</a></h4></div></div></div><div id="OralCephalosporins.CITED_REFERENCES"><h2 id="_OralCephalosporins_CITED_REFERENCES_">CITED REFERENCES</h2><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="OralCephalosporins.REF.1">Alqahtani SA, Kleiner DE, Ghabril M, Gu J, Hoofnagle JH, Rockey DC., Drug-Induced Liver Injury Network (DILIN) Study Investigators. Identification and characterization of cefazolin-induced liver injury. <span><span class="ref-journal">Clin Gastroenterol Hepatol. </span>2015;<span class="ref-vol">13</span>:1328–36.e2.</span> [<a href="/pmc/articles/PMC4472636/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4472636</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25528012" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25528012</span></a>]</div></dd></dl></dl></div><div id="OralCephalosporins.NOTE"><h2 id="_OralCephalosporins_NOTE_">NOTE</h2><p>References to both the oral and parenteral cephalosporins as well as review articles on the relative frequency of cephalosporin-related liver injury are given in the overview chapter on <a href="/books/n/livertox/Cephalosporins/?report=reader">Cephalosporins</a>.</p></div><div id="bk_toc_contnr"></div></div></div><div class="fm-sec"><h2 id="_NBK548358_pubdet_">Publication Details</h2><h3>Publication History</h3><p class="small">Last Update: <span itemprop="dateModified">December 20, 2021</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div></div><h3>Publisher</h3><p><a href="https://www.niddk.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Diabetes and Digestive and Kidney Diseases</a>, Bethesda (MD)</p><h3>NLM Citation</h3><p>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Cephalosporins, Oral. [Updated 2021 Dec 20].<span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"><a href="/books/n/livertox/Cephalosporins/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M75,30 c-80,60 -80,0 0,60 c-30,-60 -30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Prev</text></svg></a></div><div class="small-screen-next"><a href="/books/n/livertox/ParenteralCephalospo/?report=reader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 100 100" preserveAspectRatio="none"><path d="M25,30c80,60 80,0 0,60 c30,-60 30,0 0,-60"></path><text x="20" y="28" textLength="60" style="font-size:25px">Next</text></svg></a></div></article><article data-type="table-wrap" id="figobOralCephalosporinsTc"><div id="OralCephalosporins.Tc" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK548358/table/OralCephalosporins.Tc/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__OralCephalosporins.Tc_lrgtbl__"><table><tbody><tr><th id="hd_b_OralCephalosporins.Tc_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Medication:</th><td headers="hd_b_OralCephalosporins.Tc_1_1_1_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cefuroxime, 500 mg daily for 10 days</td></tr><tr><th id="hd_b_OralCephalosporins.Tc_1_1_2_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pattern:</th><td headers="hd_b_OralCephalosporins.Tc_1_1_2_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cholestatic (R=1.2)</td></tr><tr><th id="hd_b_OralCephalosporins.Tc_1_1_3_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Severity:</th><td headers="hd_b_OralCephalosporins.Tc_1_1_3_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">3+ (jaundice and hospitalization)</td></tr><tr><th id="hd_b_OralCephalosporins.Tc_1_1_4_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Latency:</th><td headers="hd_b_OralCephalosporins.Tc_1_1_4_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6 weeks</td></tr><tr><th id="hd_b_OralCephalosporins.Tc_1_1_5_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Recovery:</th><td headers="hd_b_OralCephalosporins.Tc_1_1_5_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">More than 6 months</td></tr><tr><th id="hd_b_OralCephalosporins.Tc_1_1_6_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Other medications:</th><td headers="hd_b_OralCephalosporins.Tc_1_1_6_1" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Fluticasone and salmeterol inhalant and albuterol (for asthma), insulin (diabetes), gabapentin (neuropathy), lisinopril and hydrochlorothiazide (hypertension), cyclobenzaprine and the combination of hydrocodone and acetaminophen (low back pain)</td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobOralCephalosporinsTd"><div id="OralCephalosporins.Td" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK548358/table/OralCephalosporins.Td/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__OralCephalosporins.Td_lrgtbl__"><table><thead><tr><th id="hd_h_OralCephalosporins.Td_1_1_1_1" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Time after<br />Starting</th><th id="hd_h_OralCephalosporins.Td_1_1_1_2" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Time after<br />Stopping</th><th id="hd_h_OralCephalosporins.Td_1_1_1_3" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">ALT<br />(U/L)</th><th id="hd_h_OralCephalosporins.Td_1_1_1_4" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Alk P<br />(U/L)</th><th id="hd_h_OralCephalosporins.Td_1_1_1_5" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Bilirubin<br />(mg/dL)</th><th id="hd_h_OralCephalosporins.Td_1_1_1_6" scope="col" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">Comment</th></tr></thead><tbody><tr><td headers="hd_h_OralCephalosporins.Td_1_1_1_1 hd_h_OralCephalosporins.Td_1_1_1_2 hd_h_OralCephalosporins.Td_1_1_1_3 hd_h_OralCephalosporins.Td_1_1_1_4 hd_h_OralCephalosporins.Td_1_1_1_5 hd_h_OralCephalosporins.Td_1_1_1_6" colspan="6" scope="col" rowspan="1" style="text-align:center;vertical-align:top;">Ten day course of cefuroxime: weeks 1-2</td></tr><tr><td headers="hd_h_OralCephalosporins.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8 weeks</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6 weeks</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">268</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">651</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">8.4</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Jaundice and pruritus</td></tr><tr><td headers="hd_h_OralCephalosporins.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">9 weeks</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8 weeks</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">264</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">595</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">7.1</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_OralCephalosporins.Td_1_1_1_1 hd_h_OralCephalosporins.Td_1_1_1_2 hd_h_OralCephalosporins.Td_1_1_1_3 hd_h_OralCephalosporins.Td_1_1_1_4 hd_h_OralCephalosporins.Td_1_1_1_5 hd_h_OralCephalosporins.Td_1_1_1_6" colspan="6" scope="col" rowspan="1" style="text-align:center;vertical-align:top;">Two courses of cephalexin: weeks 10-14</td></tr><tr><td headers="hd_h_OralCephalosporins.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15 weeks</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">14 weeks</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">284</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">720</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">11.8</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_OralCephalosporins.Td_1_1_1_1 hd_h_OralCephalosporins.Td_1_1_1_2 hd_h_OralCephalosporins.Td_1_1_1_3 hd_h_OralCephalosporins.Td_1_1_1_4 hd_h_OralCephalosporins.Td_1_1_1_5 hd_h_OralCephalosporins.Td_1_1_1_6" colspan="6" scope="col" rowspan="1" style="text-align:center;vertical-align:top;">Five day course of cefuroxime: week 19</td></tr><tr><td headers="hd_h_OralCephalosporins.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20 weeks</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">19 weeks</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">189</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">812</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">4.7</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Erythema</td></tr><tr><td headers="hd_h_OralCephalosporins.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21 weeks</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20 weeks</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">191</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">859</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">3.6</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_OralCephalosporins.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">22 weeks</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">21 weeks</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">176</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">717</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">2.1</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Pruritus</td></tr><tr><td headers="hd_h_OralCephalosporins.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6 months</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">6 months</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">111</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">428</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1.0</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_OralCephalosporins.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7 months</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">7 months</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">69</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">174</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0.7</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_OralCephalosporins.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8 months</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">8 months</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">74</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">217</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">1.0</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Asymptomatic</td></tr><tr><td headers="hd_h_OralCephalosporins.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15 months</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">15 months</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">42</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">169</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0.7</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_OralCephalosporins.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18 months</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">18 months</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">32</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">131</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0.4</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_OralCephalosporins.Td_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20 months</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">20 months</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">35</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">119</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">0.4</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr><tr><td headers="hd_h_OralCephalosporins.Td_1_1_1_1 hd_h_OralCephalosporins.Td_1_1_1_2" colspan="2" scope="row" rowspan="1" style="text-align:center;vertical-align:top;">
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<b>Normal Values</b>
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</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_3" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<b><35</b>
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</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_4" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<b><130</b>
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</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_5" rowspan="1" colspan="1" style="text-align:center;vertical-align:top;">
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<b><1.2</b>
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</td><td headers="hd_h_OralCephalosporins.Td_1_1_1_6" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;"></td></tr></tbody></table></div></div></article><article data-type="table-wrap" id="figobOralCephalosporinsTe"><div id="OralCephalosporins.Te" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK548358/table/OralCephalosporins.Te/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__OralCephalosporins.Te_lrgtbl__"><table><thead><tr><th id="hd_h_OralCephalosporins.Te_1_1_1_1" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">DRUG</th><th id="hd_h_OralCephalosporins.Te_1_1_1_2" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">CAS REGISTRY NO</th><th id="hd_h_OralCephalosporins.Te_1_1_1_3" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">MOLECULAR FORMULA</th><th id="hd_h_OralCephalosporins.Te_1_1_1_4" scope="col" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">STRUCTURE</th></tr></thead><tbody><tr><td headers="hd_h_OralCephalosporins.Te_1_1_1_1" scope="row" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">Cefuroxime</td><td headers="hd_h_OralCephalosporins.Te_1_1_1_2" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<a href="https://pubchem.ncbi.nlm.nih.gov/substance/135002925" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem">55268-75-2</a>
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</td><td headers="hd_h_OralCephalosporins.Te_1_1_1_3" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">C16-H16-N4-O8-S</td><td headers="hd_h_OralCephalosporins.Te_1_1_1_4" rowspan="1" colspan="1" style="text-align:left;vertical-align:top;">
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<a href="https://pubchem.ncbi.nlm.nih.gov/substance/135002925" title="View this structure in PubChem" class="img_link" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem"><img src="https://pubchem.ncbi.nlm.nih.gov/image/imgsrv.fcgi?t=l&sid=135002925" alt="image 135002925 in the ncbi pubchem database" /></a>
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