Symposium on antimicrobial therapy. IV. The cephalosporins.

Hopefully this review has brought some cephalosporin contentment to replace cephalosporin confusion. From the classification of these antibiotics in Table 1, we have made some significant reductions. One should know how to use cefazolin for staphylococcal/streptococcal infections and for surgical prophylaxis. One should know that cephalexin is massively overused, and really now not all that useful an agent. Cefuroxime is a useful agent for beta-lactamase producing H. influenzae infections. Cefotetan has a role in surgical prophylaxis in ob/gyn and represents the best antianaerobic activity of the cephalosporins; although no cephalosporin is a primary drug for anaerobic infections. Cefuroxime axetil or cefprozil can be useful for comparatively minor infections due to beta-lactamase producing H. influenzae. A third generation cephalosporin represents a reasonable alternative, in certain situations, to aminoglycoside therapy for infections due to multiply drug-resistant Gram-negative bacilli. Ceftazidime is an alternative antipseudomonal beta-lactam antibiotic. Despite the lack of indications for use of cephalosporins as drugs of choice, rational use of these agents can provide safe, effective, and efficient therapy for a variety of infectious diseases. They will likely remain an important part of the physicians' antimicrobial armamentarium for the foreseeable future.