First-generation agents |
Cefadroxil (Duricef) | Kinetics allow once-daily or twice-daily dosing; convenience offset by significantly higher cost than other first-generation cephalosporins |
Cephalexin (Keflex) | Extensive clinical experience with its use; well tolerated; good pharmacokinetics |
Cephradine (Velosef) | Similar properties as cephalexin, but not as widely used |
Second-generation agents |
Cefaclor (Ceclor, Ceclor CD) | May cause serum sickness–like syndrome; absorption decreased by food; of second-generation cephalosporins, has highest incidence of Haemophilus influenzae resistance |
Cefprozil (Cefzil) | Absorption not affected by food |
Cefuroxime axetil (Ceftin) | Parenteral form available (cefuroxime sodium [Zinacef]); absorption enhanced by food; only second-generation agent labeled for the treatment of urinary tract infections |
Third-generation agents |
Cefixime (Suprax) | Oral suspension better absorbed than tablets (therefore, less likely to cause diarrhea); single oral dose indicated for the treatment of uncomplicated gonorrhea |
Cefpodoxime (Vantin) and cefdinir (Omnicef) | Of the third-generation agents, provide best coverage of penicillin-sensitive Pneumococcus and methicillin-sensitive Staphylococcus aureus |
Ceftibuten (Cedax) | Poor efficacy against Streptococcus pneumoniae, which limits its clinical usefulness |