Present and future of cephalosporins

The cephalosporins today, and particularly the third-generation cephalosporins, still possess an activity spectrum and microbiological potency such that several authors continue to regard them as the gold standard of beta-lactam antibiotic therapy. Comparison with the rapid onset of resistance to other extensively used drugs, such as the macrolides and quinolones, places the emphasis once again squarely on the great reliability of the antibacterial action of the cephalosporins and, particularly, on the validity of their targets at the bacterial cell level. The beneficial use of cephalosporins for a vast range of infectious diseases is amply confirmed by the most authoritative international guidelines and bears witness to the role of great importance that these drugs still play in all fields of antibiotic therapy, as a result of the variety of the compounds available, their broad spectrum of antibacterial activity, their multiple clinical potentialities and their excellent tolerability. The cephalosporins therefore continue to constitute a firm reference point in the overcrowded antibiotics scene and, if used appropriately, promise to conserve their leading role for a long time to come.