CephalosporinsComments
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