Cephalosporins are a multi-generational group of beta-lactam antibiotics. Selective use of cephalosporins allows the treatment of infections from Gram-positives to multi-resistant Gram-negative bacteria and can also be used for broad spectrum coverage. Cephalosporins are relatively safe, well tolerated and effective, with few interactions. There is risk of cross-over reactivity with penicillin allergic patients. Urologically, cephalosporins are used to treat urinary tract infections such as pyelonephritis, uncomplicated urinary tract infection (UTI) and urosepsis. Increasing antibiotic resistance and multi resistant organisms such as extended-spectrum beta-lactamase (ESBL) producing E. coli are reducing the efficacy of cephalosporins.