Antimicrobial stewardship

Background: Cephalosporins and sulfonylureas represent clinically important drug classes used in the management of bacterial infections and type 2 diabetes mellitus, respectively. Their distinct molecular targets, pharmacokinetic properties, therapeutic benefits, and adverse-effect profiles illustrate fundamental principles of pharmacological selectivity and rational drug utilisation. Objective: This review examines the pharmacodynamics, pharmacokinetics, classification, therapeutic applications, mechanisms of resistance or treatment failure, safety considerations, and contemporary clinical relevance of cephalosporins and sulfonylureas. Methods: A narrative literature review was undertaken using established pharmacology literature, biomedical review articles, and accessible clinical reference sources. Relevant evidence was synthesised to explain the mechanisms of action, therapeutic positioning, drug interactions, and limitations of both classes. Results: Cephalosporins inhibit bacterial cell-wall synthesis through interactions with penicillin-binding proteins. Their antibacterial spectrum varies with molecular structure, generation, susceptibility patterns, and resistance mechanisms, including β-lactamase production and altered target proteins. Sulfonylureas stimulate pancreatic β-cell insulin secretion by binding sulfonylurea receptors associated with ATP-sensitive potassium channels. Although effective glucose-lowering agents, they can cause hypoglycaemia and weight gain, with risks influenced by renal function, nutrition, age, and concomitant medicines. Both classes require individualised selection, appropriate dosing, monitoring, and consideration of patient-specific factors. Conclusion: Rational use of these pharmacologically distinct agents depends on understanding their molecular mechanisms, therapeutic indications, limitations, and safety profiles. Antimicrobial stewardship and individualised diabetes management are essential to optimise clinical outcomes and minimise preventable harm. Keywords Antimicrobial stewardship; β-lactam resistance; insulin secretion; hypoglycaemia; rational pharmacotherapy.