Except in the treatment of pyelonephritis, the first-generation cephalosporins are rarely the first line drug of choice for any suspected infection in obstetrics. Other antibiotics have a narrower spectrum of antimicrobial coverage and are cheaper. Unless culture dictates the use of cephalosporins for main-line therapy, the use of first-generation cephalosporins should be limited to the treatment of pyelonephritis in pregnancy and for prophylaxis at the time of surgery.