Cefpiramide is a third-generation cephalosporin antibiotic. Cefpiramide is a new parenteral cephalosporin mainly excreted in the bile. Cefpiramide is a new Pseudomonas-active cephalosporin with a broad spectrum of antibacterial activity. Like cefoperazone, cefpiramide was moderately susceptible to hydrolysis by a variety of beta-lactamases from Gram-negative bacilli. Tests with 6552 bacterial isolates in five separate medical centres documented cefpiramide's effectiveness against the more commonly encountered bacterial pathogens. Additional studies with 761 selected isolates, representing 35 species, demonstrated similarities between cefpiramide and cefoperazone; cefpiramide was more active against Acinetobacter spp. and Pseudomonas spp. Cefpiramide was marginally active against Streptococcus faecalis.