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Third generation cephalosporins

Written by C. Fookes, BPharm on July 27, 2018.

What are Third generation cephalosporins?

Cephalosporins are a large group of antibiotics derived from the mold Acremonium (previously called Cephalosporium). Cephalosporins are bactericidal (kill bacteria) and work in a similar way to penicillins. They bind to and block the activity of enzymes responsible for making peptidoglycan, an important component of the bacterial cell wall. They are called broad-spectrum antibiotics because they are effective against a wide range of bacteria.

Since the first cephalosporin was discovered in 1945, scientists have been improving the structure of cephalosporins to make them more effective against a wider range of bacteria. Each time the structure changes, a new "generation" of cephalosporins are made. So far there are five generations of cephalosporins. Third generation cephalosporins were the third generation of cephalosporins to be developed.

What are third-generation cephalosporins used for?

Third generation cephalosporins may be used to treat the following types of infections when caused by susceptible strains of bacteria:

  • Bacteremia/septicemia
  • Bone and joint infections
  • Central nervous system infections
  • Gynecological infections
  • Intra-abdominal infections
  • Lower respiratory tract infections
  • Skin and skin structure infections
  • Urinary tract infections.

Cephalosporins are not usually used as a first-choice antibiotic. They tend to be reserved for use when other antibiotics (often penicillins) cannot be used.

What are the differences between third-generation cephalosporins?

There are differences between third-generation cephalosporins with regards to the bacteria they are effective against. No one third-generation cephalosporin treats all infectious disease scenarios.

Cefotaxime and ceftizoxime (discontinued) offer the best gram-positive coverage out of all the third-generation agents; ceftazidime and cefoperazone (discontinued) are unique in that they provide antipseudomonal coverage.

Ceftriaxone has a long half-life which allows for once daily dosing and may be used for the treatment of gonorrhea, pelvic inflammatory disease, and epididymo-orchitis. It is also an alternative to penicillins for suspected meningitis.

All the third-generation cephalosporins except for cefoperazone (discontinued) penetrate cerebrospinal fluid.

Generic name Brand name examples
cefdinir Omnicef
cefditoren Spectracef
cefixime Suprax
cefoperazone Discontinued
cefotaxime Claforan
cefpodoxime Generic
ceftazidime Fortaz, Tazicef
ceftibuten Cedax
ceftriaxone Generic

Are third generation cephalosporins safe?

Third generation cephalosporins are generally safe, with low toxicity and good efficacy against susceptible bacteria.

Allergic reactions have been reported with all cephalosporins including third generation cephalosporins and symptoms may include a rash, hives (urticaria), swelling, or rarely, anaphylaxis. Up to 10% of people with a history of penicillin allergy will also be allergic to cephalosporins.

Drug-induced hemolytic anemia has been associated with use of some cephalosporins, including third generation cephalosporins; suspect and investigate further if anemia develops during or after treatment.

Rarely, some people may develop a super-infection due to overgrowth of a naturally occurring bacterium called Clostridium difficile, following use of any antibiotic, including cephalosporins. Symptoms may include severe diarrhea.

Rarely, seizures have been reported with cephalosporins; the risk may be greatest in those with kidney disease.

Cephalosporin should be given exactly as directed. Potentially life-threatening arrhythmias have been reported following rapid bolus administration of cefotaxime, a third generation cephalosporin.

For a complete list of severe side effects, please refer to the individual drug monographs.

What are the side effects of third generation cephalosporins?

Third generation cephalosporins generally cause few side effects. The most common side effects reported include:

Transient increases in liver enzymes have also been reported.

For a complete list of side effects, please refer to the individual drug monographs.

List of Third generation cephalosporins

View by  Brand | Generic
Drug Name Avg. Rating Reviews
Rocephin (Pro)
Generic name: ceftriaxone
121 reviews
Omnicef (Pro)
Generic name: cefdinir
50 reviews
Suprax (Pro)
Generic name: cefixime
8 reviews
Vantin (Pro)
Generic name: cefpodoxime
6 reviews
Generic name: cefditoren
3 reviews
Generic name: ceftibuten
3 reviews
Omnicef Omni-Pac
Generic name: cefdinir
2 reviews
Tazicef (Pro)
Generic name: ceftazidime
No reviews
Fortaz (Pro)
Generic name: ceftazidime
No reviews
Generic name: cefotaxime
No reviews
Generic name: ceftazidime
No reviews
Generic name: cefoperazone
No reviews
Generic name: ceftizoxime
No reviews
For ratings, users were asked how effective they found the medicine while considering positive/adverse effects and ease of use (1 = not effective, 10 = most effective).

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.