What are the fifth generation cephalosporins (antibiotics)?

From the Guidelines

Ceftaroline and ceftobiprole are considered fifth-generation cephalosporins due to their bactericidal activity against gram-positive and negative pathogens, including MRSA and DRSP, as reported in a study published in 2021 1.

Key Characteristics of Fifth-Generation Cephalosporins

• Ceftaroline has bactericidal activity against gram-positive and negative pathogens, including MRSA and DRSP
• Ceftobiprole has extended spectrum activity against gram-positive pathogens, including MSSA, methicillin-resistant coagulase-negative staphylococci, penicillin and ceftriaxone-resistant S. pneumoniae, and gram-negative pathogens, such as P. aeruginosa and Enterobacteriaceae

Clinical Use of Fifth-Generation Cephalosporins

• Ceftaroline has been shown to be superior to ceftriaxone in patients with severe pneumonia, with an odds ratio of 1.66 (95% CI 1.34,2.06) for clinical cure 1
• Ceftobiprole has been shown to be non-inferior to ceftriaxone as monotherapy or combined with linezolid in patients with CAP, with similar microbiological cure rates 1

Important Considerations

• The use of fifth-generation cephalosporins should be reserved for patients with resistant pathogens or severe infections, due to the potential for increased resistance and side effects
• The classification of ceftaroline and ceftobiprole as fifth-generation cephalosporins is not universally accepted, and they are more commonly considered advanced-generation or MRSA-active cephalosporins 1

From the FDA Drug Label

ZEVTERA is a cephalosporin antibacterial Teflaro is a cephalosporin antibacterial The fifth generation cephalosporins are:

• Ceftaroline
• Ceftobiprole These are the only two fifth generation cephalosporins mentioned in the provided drug labels 2, 3, and 3.

From the Research

Fifth Generation Cephalosporins

• Ceftaroline 4, 5
• Ceftobiprole 6, 7, 8

Characteristics of Fifth Generation Cephalosporins

• Broad-spectrum activity against Gram-positive bacteria, including MRSA
• Activity against Gram-negative bacilli, including some resistant strains
• Low propensity for inducing resistance
• Good safety profile

Clinical Uses of Fifth Generation Cephalosporins

• Treatment of complicated skin and soft tissue infections (cSSTIs) 4, 5, 8
• Treatment of community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP) 7
• Treatment of diabetic foot infections 8