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Use of third-generation cephalosporins. Anaerobes

R L Nichols1, J W Smith

  • 1Department of Surgery, Tulane University School of Medicine, New Orleans.

Hospital Practice (Office Ed.)
|January 1, 1991
PubMed

Insights

Third-generation cephalosporins offer broad-spectrum activity, effective for mixed aerobic-anaerobic infections and prophylaxis. Clinical use shows they can replace combination therapy in polymicrobial infections.

Area of Science:

  • Pharmacology
  • Microbiology
  • Infectious Diseases

Background:

  • Third-generation cephalosporins exhibit enhanced activity against Gram-negative bacteria.
  • They possess moderate activity against anaerobic bacteria but reduced activity against Gram-positive bacteria compared to earlier generations.

Purpose of the Study:

  • To evaluate the clinical utility of third-generation cephalosporins for treating mixed aerobic-anaerobic infections.
  • To assess their role in prophylaxis for patients with expected mixed flora.
  • To analyze the correlation between in vitro susceptibility and clinical efficacy.

Main Methods:

  • In vitro testing of anaerobic bacteria susceptibility using various methods, including microtube broth dilution.
  • Review of clinical studies on the use of third-generation cephalosporins in polymicrobial infections and prophylaxis.

Main Results:

  • In vitro susceptibility of anaerobes is method-dependent, with regional variations observed.
  • The microtube broth dilution method demonstrated the best correlation with in vivo results.
  • Clinical efficacy does not always align with in vitro susceptibility or resistance patterns.

Conclusions:

  • Third-generation cephalosporins are suitable for monotherapy in mixed aerobic-anaerobic infections.
  • They can be used as prophylaxis when mixed microflora are anticipated.
  • These agents may serve as alternatives to combination therapy for polymicrobial infections.

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