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Use of Third-Generation Cephalosporins for Treatment of Neonatal Infections

GEORGE H. McCRACKEN JR, MD
Am J Dis Child. 1985;139(11):1079-1080. doi:10.1001/archpedi.1985.02140130017019.
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The advent of the new third-generation cephalosporins (cefotaxime, ceftizoxime, cefoperazone, ceftriaxone, ceftazidime, and moxalactam) has piqued the interest of physicians who care for newborn infants. These new compounds are extraordinarily active against enteric gram-negative bacilli and the following important pathogens: Haemophilus influenzae, Streptococcus agalactiae (group B streptococci), Neisseria meningitidis, and Streptococcus pneumoniae. With the exception of cefuroxime, a recently approved second-generation drug, the older cephalosporins have not been used extensively by pediatricians, nor have they been recommended for initial empiric therapy of any infectious condition. The principal reasons for their limited use were relatively poor penetration into cerebrospinal fluid, lack of uniform activity against all strains of H influenzae, and inadequate activity against many strains of gram-negative enteric bacilli.1

The third-generation cephalosporins are different. They are not only active against the major bacterial pathogens of infants and children, but they also achieve excellent cerebrospinal fluid

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