Can I take intravenous drip to reduce inflammation if I take cephalexin which damages my liver?

Cefuroxime is actually an anti-inflammatory drug. Many people will use cephalexin if they have inflammation in their bodies. But some friends asked: Is it okay to have intravenous drip for anti-inflammatory treatment if taking cephalexin damages the liver? In fact, it cannot be said that it is not possible, but cephalexin itself is an anti-inflammatory drug. If you don't want to damage your liver, you can actually change to another medication for treatment and stop taking cephalosporins.

Cephalosporins have the characteristics of broad antibacterial spectrum, strong antibacterial effect, penicillinase resistance, high efficacy, low toxicity and few allergic reactions. It can not only destroy the cell walls of bacteria, but also kill bacteria during their reproduction period, while its toxicity to the body is relatively low. It is only effective against bacterial infections, but has no therapeutic effect on infections caused by viruses, mycoplasma, chlamydia, fungi, etc.

Precautions when using cephalosporins

1. Allergic reaction

Symptoms include rash, itching, drug fever, etc. In severe cases, anaphylactic shock or even death may occur. This is also the main and most serious adverse reaction. Before use, you should ask about the allergy history and do a skin test. After injection, observe for 30 minutes and be prepared to rescue anaphylactic shock.

2. Disulfiram-like reaction

Research reports show that antibiotics such as cefoperazone, cefradine, and ceftriaxone, as well as drugs such as metronidazole, tinidazole, ornidazole, and furazolidone can stop ethanol metabolism at the stage of acetaldehyde formation, causing acetaldehyde to accumulate in the body and causing alcohol withdrawal-like reactions;

Symptoms include facial flushing, blurred vision, headache, nausea and vomiting, chest tightness, and even coma.

Therefore, when using cephalosporins and metronidazole or within 3 days of stopping cephalosporins, you should avoid drinking alcohol or taking foods and medicines containing ethanol.

3. Combination of hepatotoxic and nephrotoxic drugs

Hepatic excretion: Cefoperazone is excreted through the liver and has a significant therapeutic effect on biliary and intestinal bacterial infections. It should not be used in cases of abnormal liver function and bile duct obstruction. It often affects the survival of normal intestinal bacteria, leading to reduced absorption of vitamin B and vitamin K and intestinal flora disorders, causing diarrhea. Care should be taken to prevent this when using the drug.

Renal excretion: Ceftazidime is excreted through the kidneys and urine, and has a strong therapeutic effect on urinary tract bacterial infections; it causes certain damage to the kidneys, especially the first-generation cephalosporins, so it should be used with caution or in reduced dosage in patients with renal insufficiency.

Liver damage is generally mild and reversible. Most cephalosporins are excreted by the kidneys, which may occasionally cause increased blood urea nitrogen, blood creatinine, oliguria, proteinuria, etc. The dose should be adjusted appropriately for patients with renal insufficiency. From generation one to generation five, the nephrotoxicity becomes lower with each generation.

Strong diuretics such as furosemide can hinder the excretion of cephalosporins from the kidneys, increase the concentration of cephalosporins in serum and tissues, and cause toxicity to the kidneys. Therefore, the dose of antibiotics should be reduced when they must be used in combination. Mannitol can reduce the blood concentration of cefazolin sodium and aggravate its nephrotoxicity.

Aminoglycosides and cephalosporins can produce a synergistic effect when used together, but their nephrotoxicity will also be aggravated. Therefore, they should be used with caution or not at all in patients with impaired renal function. If they need to be used, the patient's renal function should be monitored.

The combined use of cyclosporine and ceftazidime has certain nephrotoxicity, but no adverse reactions have been reported for other cephalosporins. Ceftriaxone, ceftriaxone, etc. are excreted through both the liver and kidneys, and are relatively safe for clinical use.

4. Impact on digestion and blood system

Cephalosporins may occasionally cause leukopenia, thrombocytopenia or thrombocytopenia. When cefoperazone is used in large doses, it can severely inhibit the bacteria that synthesize vitamin K in the intestine, resulting in hypoprothrombinemia and prolonged coagulation time, which may cause bleeding. Try not to use it in combination with anticoagulants, but consider using vitamin K drugs in combination to prevent bleeding. Cephalosporins can cause nausea, vomiting, loss of appetite and other reactions. Long-term use can lead to dysbacteriosis, mainly superinfection and pseudomembranous enterocolitis caused by enterococci or Candida.

5. Drugs with enhanced effects

Coumarin anticoagulants: Cephalosporins can reduce the intestinal absorption of vitamin K and enhance the effect of anticoagulants.

Probenecid: It can reduce the renal clearance rate of cephalosporins, causing their concentrations to continue to increase and increase renal damage. If combined use of these drugs is necessary, the dosage of antibiotics should be appropriately reduced based on the condition.

Nonsteroidal anti-inflammatory drugs: may increase the risk of gastrointestinal bleeding and may increase the cumulative platelet inhibition when used in combination with cephalosporin antibiotics.

6. Antagonism

Lincomycin: One of the main effects of lincomycin and cephalosporins is against Gram-positive bacteria, and combined use can produce antagonistic effects.

Macrolides such as acetylspiramycin: their rapid antibacterial effect can significantly inhibit the rapid bactericidal efficacy of cefazolin sodium.

7. Skin test issues

There is some cross-allergic reaction between penicillin and cephalosporin;

Cephalosporins are contraindicated in patients with a history of penicillin anaphylactic shock;

Those with a positive penicillin skin test or rash can be treated with a skin test, and if negative, cephalosporin can be used;

Penicillin should be used with caution or contraindicated in patients allergic to cephalosporins.

8. Standardized use of cephalosporins

Only when bacterial infection is clinically confirmed;

Medication used ≥2 times daily, except for ceftriaxone;

When using intravenous drip, a small amount of liquid should be used to dissolve the drug (cephalosporin is a bactericidal drug during the reproductive period, which needs to enter the body quickly and form a higher blood concentration in a short period of time, so that its antibacterial effect can be more effectively exerted);

Prepare the solution and use it as soon as possible (room temperature <5 hours, refrigerator at 4°C for 12-24 hours);

The two types of cephalosporins should not be used at the same time or in combination with penicillin.

For oral administration, it is best to take the drug on an empty stomach 0.5-1.0 hours before meals for better absorption. If taken after meals, food will interfere with absorption and reduce efficacy.

9. Cephalosporin resistance

Bacterial resistance to cephalosporins is mainly related to the production of β-lactamase by bacteria, which can destroy the β-lactam ring of β-lactam antibiotics and inactivate them. Currently commonly used β-lactamase inhibitors include clavulanic acid, clavulanic acid, and sulbactam (penicillin sulfone). They have weak antibacterial properties themselves, but because they can inhibit a variety of β-lactamases and protect β-lactam antibiotics, enhancing the latter's antibacterial effects, they have been made into compound preparations with some β-lactam antibiotics for clinical use.