Cephalosporins.

The cephalosporins have had a great effect on the prevention and treatment of many obstetric and gynecologic infections. Broader spectra and greater activity often allow for effective single-agent usage. Improved pharmacokinetics have permitted the number of doses to be decreased. Excellent activity against several gram-negative organisms sometimes permits substitution of the safer cephalosporins for the aminoglycosides, thus avoiding potential renal and otic toxicities. However, these advantages come with costs of their own, such as superinfection, induction of resistance, and the potential for clinical bleeding. Nevertheless, these adverse effects fortunately are infrequent and, with careful monitoring, they can be readily avoided or controlled. Therefore, the increasing number and diversity of these helpful agents should be accompanied by greater knowledge of all these factors. This should result in increasing benefits for our patients, without sacrificing cost, safety, and future therapeutic success.