Cephalosporin antibiotics: molecules that respond to different needs

Since the introduction of cephalothin in 1964, there has been a large number of cephalosporins synthesized and used clinically. Modification of the beta-acyl side chain has yielded compounds with stability against attack by plasmid and chromosomal beta-lactamases. The presence of methoxy groups at C-7 of the bicyclic cephalosporin nucleus has provided excellent activity against many anaerobic species. Changes in structure have also provided agents with extended half-lives, permitting twice a day dosing or single-dose prophylaxis. Cephalosporins clearly have come of age as agents to meet many different infectious needs.