The use of cephalosporins in an era of drug-resistantStreptococcus pneumoniae ‘is a major concern for paediatric physicians’,said Dr Richard Jacobs of Arkansas Children's Hospital in Little Rock at the 31st Annual ASHP*Midyear Meeting [New Orleans, Louisiana, US; December 1996] at a symposium entitled ‘Third Generation Cephalosporins: Patient Selection and Dosing Considerations’. Until the recent introduction of a vaccine,Haemophilus influenzaewas the primary cause of meningitis, bacteraemia, bacteraemic pneumonia, and septic arthritis in children aged < 2 years. In Dr Jacobs' clinical experience, the use of the vaccine has saved millions of dollars in treating meningitis cases. Until an effective vaccine forS. pneumoniaecan be made available, medical and paramedical professions need to provide the best possible treatment for patients infected with this pathogen.