Cefprozil (Cefzil - Bristol-Myers Squibb), a new oral second-generation cephalosporin, was recently released in the USA for treatment of pharyngitis, bronchitis, otitis media, and skin and skin-structure infections.

Cefixime (Suprax - Lederle), an oral cephalosporin antibiotic, was recently approved for marketing by the US Food and Drug Administration. Claimed to be the first oral third-generation cephalosporin, the new drug is offered for once-a-day treatment of otitis media, pharyngitis, bronchitis and urinary tract infections.

Methicillin-resistant Staphylococcus aureus (MRSA), which was traditionally a nosocomially-acquired organism but now frequently occurs in the absence of healthcare exposure, is the predominant cause of suppurative skin and soft-tissue infections in many parts of the US. Community-associated MRSA usually causes furunculosis, purulent cellulitis, and abscesses, but necrotizing fasciitis, necrotizing pneumonia, and sepsis can also occur.

Pneumocystis carinii pneumonia (PCP) occurs in nearly 80% of patients with the acquired immune deficiency syndrome (AIDS) and is a common cause of morbidity and mortality. Oral trimethoprim-sulfamethoxazole (Bactrim; and others), intravenous isethionate (Pentam 300) and other systemic drugs have been used to prevent PCP, but in AIDS patients, all of these agents can occasionally cause severe adverse effects (Medical Letter, 30:94, 1988). Recently, the US Food and Drug Administration approved marketing of aerosolized pentamidine isethionate (NebuPent - LyphoMed) for this indication. Another...

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Ceftibuten (Cedax - Schering), an oral cephalosporin similar to cefixime (Suprax - Medical Letter, 31:73, 1989), has been approved by the US Food and Drug Administration (FDA) for treatment of acute otitis media, pharyngitis or tonsillitis, and for acute bacterial exacerbations of chronic bronchitis.

Cefdinir (Omnicef - Parke-Davis), a third-generation oral cephalosporin, has been approved by the FDA for treatment of acute sinusitis, otitis media, acute exacerbations of chronic bronchitis, pharyngitis, community-acquired pneumonia and skin infections. Other drugs available for these indications are reviewed in The Medical Letter Handbook of Antimicrobial Therapy, 1998.

Enoxacin (en ox' a sin; Penetrex - Rh ne-Poulenc Rorer), a fluoroquinolone antimicrobial for oral use, has now been marketed in the USA for treatment of urinary tract infections and uncomplicated urethral or cervical gonorrhea.

Cefpodoxime proxetil (Vantin - Upjohn), a new third-generation oral cephalosporin, has been approved for marketing by the US Food and Drug Administration. It is available for twice-daily treatment of pharyngitis, upper and lower respiratory infections, otitis media, urinary tract infections, skin and soft tissue infections, and for single-dose treatment of uncomplicated gonorrhea in men or women and anorectal gonorrhea in women.

Almost 300,000 cases of epidemic cholera have occurred in the Western Hemisphere in 1991, mostly in South and Central America (Morbid Mortal Weekly Rep, 40:562, Aug 16, 1991). The few US cases caused by the epidemic strain have been in returning travelers or associated with contaminated food they brought back illicitly, with no secondary spread to date.