Fourth Generation Cephalosporins in the Antimicrobial Chemotherapy of Surgical Infections

AbstractSurgical infections include a variety of entities such as secondary peritonitis, intra-abdominal abscesses, obstetric and gynecological infections as well as bone-joint and soft-tissue infections. By definition the term “surgical infection” implies that surgery itself plays the major role in therapy, while antimicrobial chemotherapy is only supplementary. Broad-spectrum empirical regimens employed include the combination of a 1st or 2nd generation cephalosporin plus clindamycin or metronidazole ± aminoglycoside (depending on the severity of the condition). Cefepime and cefpirome are new 4th generation parenteral cephalosporins with a spectrum of activity which makes them suitable for the treatment of infections caused by a wide variety of bacteria. They are active against both Gram-positive and Gram-negative organisms, including Staphylococcus aureus and Pseudomonas aeruginosa with activity comparable to or greater than that of cefotaxime or ceftazidime respectively. Cefepime in particular is also...