The role of fourth-generation cephalosporins in the treatment of serious infectious diseases in hospitalized patients.

For many years, the third-generation cephalosporins have been utilized in the treatment of a broad range of infections. The reduction in the efficacy of these antimicrobials in hospitals seen in recent years is a result of the development of resistance to these compounds. This resistance, caused in part by the production of beta-lactamases which can spread from species to species, has intensified the search for alternative agents. Compared with third-generation cephalosporins, fourth-generation cephalosporins possess enhanced activity against Gram-positive organisms, excellent penetration into Gram-negative bacilli, and are more stable against the activity of some beta-lactamases. Accordingly, fourth-generation cephalosporins are attractive candidates to replace third-generation cephalosporins for the treatment of many nosocomial infections.