Cephalosporins in clinical development

Bacterial resistance to established classes of antibiotics in clinical use is continuing to increase, making the need for new agents that can be used to treat the newly multi-drug resistant organisms steadily more urgent. Cephalosporins have been a successful group of antibiotics since they were first introduced to combat drug-resistant organisms, including staphylococci. The history of cephalosporins has emphasised an improvement of their stability towards beta-lactamases, thus expanding their spectrum of activity against important Gram-negative pathogens. New cephalosporins that have potent activity against multi-resistant Gram-positive bacteria, including methicillin-resistant staphylococci and penicillin-resistant pneumococci have recently entered clinical development. At least two of these, BAL-5788 and S-3578, also have Gram-negative activity, which is comparable to that of the third- and fourth-generation cephalosporins, making them broad-spectrum agents that could be used in hospital infections where methicillin-resistant staphylococci is likely to be present.