At treatment of nosocomial infections (urinary tract infections, sepsis and pneumonia) I generation cephalosporins are useful only in combination with other antibacterial agents active against Gram-negative organisms (aminoglycosides, fluoroquinolones). Drugs in this group is not active against H. influenzae, therefore, inappropriate to their destination in infections in which large etiological role of this microorganism (bronchitis, community-acquired pneumonia, sinusitis, otitis media). I generation cephalosporins are currently considered an effective means for prevention of infectious complications in surgical operations on the biliary tract, stomach and small intestine, pelvic organs, in traumatology and orthopedics, vascular and cardiac surgery. The optimal preparation is cefazolin, as it has the greatest half-life and can be administered in a single dose (1 g for 30 min before anesthesia). II generation cephalosporins have enhanced activity against gram-negative bacteria and a broad spectrum of activity compared with the drugs I generation. Preparations are stable to beta-lactamase produced by H.
Influenzae, M. catarrhalis, E. coli, P. mirabilis. In action on gram-positive cocci are similar to those of cephalosporins I generation. Some drugs (cefoxitin, tsefmetazol, tsefotetan) have activity against anaerobic bacteria, including B. fragilis. This group includes drugs for parenteral use (cefuroxime, Tsefamandol, cefoxitin, tsefotetan, tsefmetazol) and oral (cefuroxime aksetil, cefaclor).
Drugs in this group have close the half-life (50 – 80 min), except tsefotetan that has a higher rate (about 4 h), are distinguished mainly by the kidney, is not metabolized in the body (except cefoxitin). Cephalosporins II generation is widely used in clinical practice to treat infections of different localization (non-hospital – as a single agent, hospital – usually in combination with aminoglycosides). Cefuroxime and cefaclor aksetil are means first-line treatment of various respiratory tract infections in ambulatory practice: sinusitis, otitis media, acute exacerbations of chronic bronchitis, pneumonia (with the exception of Mycoplasma and Chlamydia), as alternative means are used to treat tonsillitis / pharyngitis, acute and chronic urinary tract infections, skin and soft tissue.