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July 1982

The Third-Generation Cephalosporins: A Plea for Restraint

Author Affiliations

University of Massachusetts Medical School Division of Infectious Disease Saint Vincent Hospital 25 Winthrop St Worcester, MA 01604; University of Massachusetts Medical School Worcester, MA 01605

Arch Intern Med. 1982;142(7):1267-1268. doi:10.1001/archinte.1982.00340200025004

Frantic competition exists among the members of the pharmaceutical industry to develop the "ultimate cephalosporin." A virtual plethora of third-generation cephalosporin antibiotics are undergoing elaborate, intensive clinical investigation. Cephalosporins are being evaluated so rapidly that even antibiotic aficionados seem overwhelmed.

During this last year, two new agents, cefotaxime sodium and moxalactam disodium, have been released by the Food and Drug Administration for clinical use. Although technically a semisynthetic oxa-β-lactam antibiotic, moxalactam will be considered a third-generation cephalosporin by physicians. Clinicians, currently completely confused as to the subtle differences between these two antibiotics, can anticipate further bewilderment with the introduction of additional cephalosporins.

Researchers have identified a number of major benefits that can be ascribed to the newest cephalosporins, cefotaxime and moxalactam. These compounds possess an extended spectrum of activity, as compared with the first- and second-generation cephalosporins, and often provide an acceptable alternative to the aminoglycosides for treatment of life-threatening