Drug	Generation	Gram+ coverage	Gram- coverage	Pseudomonas	Key Notes
Cephalexin	1	Excellent
Cefuroxime	2
Ceftriaxone	3				Can cause biliary sludge and pseudolithiasis.
Ceftazidime	3	Poor	Excellent	Yes	Does not cover Strep pneumo and other Gram positive organisms well.
Cefipime	4	Similar as CTX against pneumococci and MSSA.	Excellent. Greater activity against AmpC ESBL.	Yes	Risk of superinfection particularly with Enterococcus/Candida. Neurotoxicity: increased risk of NCSE particularly in renal failure.
Ceftaroline	5	Similar spectrum as CTX with improved Gram+ coverage including MRSA, VISA, intermediate Strep pneumo. No activity against enterococci, ESBL		No
Ceftobiprole	5	Covers MRSA, pen-resistant Strep pneumo. Covers Enterococcus.