Moderate-spectrum cephalosporins with anti-Haemophilus activity: cefuroxime and cefaclor

Cefuroxime and cefaclor have marginally broader gram-negative activity than cefalexin, cefalotin and cefazolin.

Cefuroxime has replaced cefaclor in these guidelines because cefaclor has inferior activity against Streptococcus pneumoniae and is more likely to cause serum sickness–like syndrome, particularly in children.

For oral treatment of respiratory tract infections, cefuroxime is preferred to cefalexin because of its superior activity against S. pneumoniae, Haemophilus influenzae and Moraxella catarrhalis.