title: Cephalosporins currently in early clinical trials for the treatment of bacterial infections.
abstract: BACKGROUND
  Healthcare-associated infections caused by multi-drug resistant bacteria remain a major cause of worldwide mortality. With the recent approval of agents such as hetero-resistant cocci (i.e., ceftaroline, ceftobiprole, telavancin) for the treatment of Gram-positive infections by and drugs like fidaxomicin for treating Clostridium difficile, present-day research on antibacterials has largely shifted to developing interventions for diseases caused by Gram-negative bacilli. Cephalosporins have gained significant interest as antipseudomonals to be used in hospitals for treating device- and procedure-associated infections. With extended-spectrum activity against many enterobacterial pathogens, the introduction of new antipseudomonal cephalosporin-based treatments will mark a significant advancement in the management of hospital-borne diseases.
  
  
  METHODS
  The following review examines the present-day status of investigational cephalosporins currently in preclinical, Phase I and Phase II stage development. The article focuses specifically on treatments used for healthcare-associated infections due to Gram-negative bacteria.
  
  
  CONCLUSIONS
  There is an urgent need for new antimicrobials to treat nosocomial infections due to multi-drug resistant Gram-negative bacteria. The impending approvals of antipseudomonal cephalosporins co-formulated with a β-lactamase inhibitor will allow clinicians to treat more hetero-resistant infections with cephalosporins, while avoiding the use of more toxic agents such as colistin. The growing interest in developing new β-lactamase inhibitor combinatorial treatments with approved β-lactam antibiotics is anticipated to decrease the number of novel cephalosporins entering clinical trials this decade.
authors: Marshall University, School of Pharmacy, Department Pharmaceutical Science & Research , Huntington, WV 25755, USA +1 304 696 7393 ; +1 304 696 7309 ; longt@marshall.edu.
authors: Timothy E
authors: TE
authors: Long
authors: Justin T
authors: JT
authors: Williams
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002511:Cephalosporins / Q000494:pharmacology / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology; D017277:Drug Approval; D015195:Drug Design; D024901:Drug Resistance, Multiple, Bacterial; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000302:isolation & purification; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins
keywords: Enterobacteriaceae; MRSA; Pseudomonas; antibacterial; ceftolozane; cephalosporin; β-lactam