Against the backdrop of the comprehensive promotion of the policy of centralized bulk procurement of drugs (referred to as "centralized procurement"), this study aims to systematically review and integrate relevant evidence on the effectiveness, safety, and cost-effectiveness of cephalosporin injectables under centralized procurement as presented in real-world studies, and compare their clinical performance with that of original research drugs/imported generic drugs. The goal is to provide an evidence-based basis for the rational use, clinical evaluation, and policy optimization of selected generic drugs in centralized procurement.

Retrieval of real-world research literature on centralized collection cephalosporin injections published from April 2021 to February 2026, comprehensive analysis was conducted from the dimensions of clinical efficacy, safety, and economy, and QATSM-RWS was used to evaluate the quality of the included studies.

After screening, a total of 17 studies were included. The investigated medications primarily comprised cefuroxime, ceftriaxone, and cefoperazone-sulbactam sodium, covering diverse infectious populations in both adults and children, as well as two key clinical scenarios: perioperative infection prevention and therapeutic anti-infective treatment. The results demonstrated that, in terms of efficacy, most studies indicated comparable overall effectiveness between centrally procured cephalosporin injections and original/imported generic drugs for perioperative infection prevention and therapeutic anti-infective therapy, with only individual studies showing differences in secondary endpoints. Regarding safety, no significant differences were observed between the two groups for perioperative prophylaxis; in therapeutic applications, most studies confirmed equivalent safety profiles across both groups, with only certain safety indicators differing in specific studies. In terms of economy, centrally procured medications significantly reduced treatment-related expenses, demonstrating notable economic advantages.

Overall, centrally procured cephalosporin injections are basically consistent with original drugs/imported generic drugs in terms of clinical effectiveness and safety, while also offering superior cost-effectiveness, which can reduce patients’ medical burden. Limited by factors such as the limited coverage of included research varieties, mostly single-center studies, and small sample sizes, relevant research evidence still needs to be improved. Large-sample, multi-center clinical studies need to be conducted in the future to further consolidate the evidence-based basis.