BACKGROUND:Antimicrobial resistance (AMR) is one of the most pressing global health problems, resulting from the misuse and overuse of antibiotics across various sectors, which has led to the emergence and spread of resistant microorganisms. AMR occurs when microorganisms no longer respond to antibiotics. In Italy alone, AMR is responsible for over 10,000 deaths each year, exceeding 40% of all AMR, attributable deaths in the EU/EEA. This alarming trend highlights the urgent need to preserve effective treatment options and to re-evaluate the role of well-established oral antibiotics with a favourable pharmacological and microbiological profile. SUMMARY:Ceftibuten is an oral third-generation cephalosporin with potent activity against many Gram-negative and some Gram-positive pathogens, including several Gram-negative pathogens. It is approved for the treatment of respiratory and urinary tract infections, both uncomplicated and complicated, in adults as well as in children. This review discusses clinical and pharmacological data supporting ceftibuten's efficacy, safety, pharmacokinetics, and microbiological spectrum. Moreover, the paper discusses its potential role in contemporary clinical practice, especially considering recent supply interruptions and increasing resistance patterns. KEY MESSAGES:Ceftibuten represents an oral treatment option for respiratory and urinary tract infections, particularly where resistance to other agents limits therapeutic choices. Its favourable pharmacokinetic profile, safety both in paediatric and adult populations, and efficacy against key resistant pathogens support use within approved indications. Finally, this antibiotic offers a favourable safety profile for both patients allergic to penicillin and cephalosporins, particularly third- and fourth-generation cephalosporins. Ensuring continued access to this antibiotic may contribute to appropriate management of infections in both community and hospital settings.
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