Abstract Cefcapene pivoxil monohydrochloride monohydrate, a broad spectrum third- generation cephalosporin for oral administration, was prepared by reacting three centers of 7β-amino-3-(hydroxymethyl) cephalosporinic acid (7-HACA), derived from 7β- aminocephalosporanic acid. The coupling of 7-HACA and (Z)-2-[2-(Boc-amino) thiazol-4-yl] pent-2-enoic acid, followed by carbamylation with chlorosulfonyl isocyanate, and ...