Table of Contents
What is Cefuroxime?
Cefuroxime is a drug used for the treatment of tonsillitis, pharyngitis, sinusitis, otitis, bronchitis, cystitis, pyelonephritis and Lyme disease. The product ingredients are: Cefuroxime axetil, Cefuroxime sodium.
The brand names of Cefuroxime in the United States are: Ceftin, Zinacef and Kefurox.
Cefuroxime Mechanism of Action (MOA)
Bactericide. Inhibits bacterial cell wall synthesis by binding to target proteins, bacterial lysis.
Therapeutic indications, uses and benefits of Cefuroxime
- Treatment of acute strep throat and pharyngitis, acute bacterial sinusitis, acute otitis media, acute exacerbation of chronic bronchitis, community-acquired pneumonia, cystitis, pyelonephritis, uncomplicated skin and soft tissue infections, intra-abdominal infections.
- Treatment of the early stages of Lyme disease.
- Antibiotic prophylaxis in gastrointestinal (including esophageal), orthopedic, cardiovascular and gynecological surgery (including cesarean section).
Cefuroxime Dosage
– Oral dose (cefuroxime axetil)
Adults and children with body weight ≥ 40 kg: acute tonsillitis, pharyngitis, acute bacterial sinusitis, cystitis, pyelonephritis, uncomplicated skin and soft tissue infections: 250 mg/12 h.
Acute otitis media, exacerbation of chronic bronchitis, Lyme disease: 500 mg/12 h.
Children with body weight < 40 kg: acute tonsillitis, pharyngitis, acute bacterial sinusitis: 10 mg/kg, 2 times a day (max. 250 mg/day).
Cystitis, pyelonephritis, uncomplicated skin and soft tissue infections, Lyme disease, children ≥ 2 years with otitis media or in case of more serious infections: 15 mg/kg, 2 times a day (max. 500 mg/day).
Normal duration of treatment: 5-10 days (in Lyme disease 10-21 days).
Renal insufficiency: Clcr 10 -29 ml/min, standard individual dose every 24 h, Clcr < 10 ml/min, individual dose every 48 h, haemodialysis: supplementary dose at the end of the session.
– Intravenous/Intramuscular (IV/IM) injection or intravenous perfusion (sodium cefuroxime)
Adults and children with body weight ≥ 40 kg: community-acquired pneumonia, acute exacerbation of chronic bronchitis, soft-tissue and intra-abdominal infections: 750 mg/8 h (via IM or IV). Complicated urinary tract infections: 1,500 mg/8 h (via IM or IV).
Severe infections: 750 mg/6 h or 1,500 mg/8 h (via IV); surgical prophylaxis for gastrointestinal and gynaecological surgery (including caesarean section).
Orthopedic operations: 1,500 mg with induction of anaesthesia (can be supplemented with 2 doses of 750 mg (via IM) at 8 and 16 h).
Surgical prophylaxis for cardiovascular and esophageal operations: 1,500 mg with induction of anaesthesia + 750 mg/8 h (via IM) for the following 24 h.
Children with body weight < 40 kg and > 3 weeks: community-acquired pneumonia, complicated urinary tract, soft tissue and intra-abdominal infections: 30-100 mg/kg/day (via IV), in 3-4 doses (sufficient 60 mg/kg/day for most infections);
Children with body weight < 40 kg and < 3 weeks: community-acquired pneumonia, complicated urinary tract, soft tissue and intra-abdominal infections: 30-100 mg/kg/day (via IV), in 2-3 doses. Renal insufficiency: Clcr 10-20 ml/min: 750 mg/12 h; Clcr < 10 ml/min: 750 mg/24 h.
Haemodialised: additional dose of 750 mg, at the end of the session; 250 mg/2 l can be incorporated into the peritoneal dialysis fluid.
Continuous arteriovenous haemodialysis or high flow haemofiltration in ICU: 750 mg, 2 times/day.
Mode of administration
Oral administration should be done right after meals.
Contraindications of Cefuroxime
Hypersensitivity to cefuroxime or other cephalosporinic antibiotic; history of severe hypersensitivity to any other beta-lactamic antibacterial (penicillins, monobactam and carbapenemas).
Warnings and precautions with Cefuroxime
Allergy to penicillins or other ß-lactam, if allergy appears, discontinue. Kidney failure, adjust dose; Liver failure.
Risk of overinfection by Candida and other non-sensitive microorganisms in prolonged treatment, of pseudomembranous colitis and nephrotoxicity associated with potent diuretic or aminoglycoside.
Jarisch-Herxheimer reaction observed after treatment for Lyme disease; not suitable for treatment of intra-abdominal infections caused by Gram-non-fermentation bacteria.
Injectable forms should only be used via IV/IM and not intracameral (severe cases of ocular reactions such as macular edema, retinal edema, retinal detachment, retinal toxicity, visual disturbances, reduced visual acuity, blurred vision, corneal opacity and corneal edema have been reported after intracameral use of sodium cefuroxime vials for which intracameral use is not approved).
No experience in children < 3 months.
Liver failure
Caution.
Kidney failure
Caution. Adjust dose. Oral (cefuroxime axetil): Renal failure: Clcr 10 -29 ml/min, standard individual dose every 24 h, Clcr < 10 ml/min, individual dose every 48 h,
Hemodialysis: supplementary dose at the end of the session.
Intravenous/intramuscular injection or intravenous perfusion (sodium cefuroxime): Clcr 10-20 ml/min: 750 mg/12 h; Clcr < 10 ml/min: 750 mg/24 h.
Hemodializados: additional dose of 750 mg, at the end of the session.
Can be incorporated into peritoneal dialysis fluid: 250 mg/2 l. Continuous arteriovenous haemodialysis or high flow haemofiltration in ICU: 750 mg, 2 times/day.
Interactions with Cefuroxime
- Nephrotoxicity with: aminoglycosides, furosemide; monitor renal function.
- Oral absorption decreased by: antacids.
- Renal tubular secretion reduced by: probenecid.
- Decreases reabsorption of: estrogens (less efficacy of oral contraceptives).
- Lab: false + in Coombs and glucosuria test by reduction method; false – of blood glucose with ferricianide method. Increased INR in concomitant treatment with: oral anticoagulants.
Pregnancy and Cefuroxime
Not enough information on pregnancy. Assess benefit/risk.
Breastfeeding
Cefuroxime is excreted through breast milk in small amounts. Adverse reactions to therapeutic doses are not to be expected, although the risk of diarrhoea and fungal infections in mucous membranes cannot be excluded.
Breastfeeding may have to be discontinued due to these effects. Sensitization should be considered. Cefuroxime should only be used during lactation after a benefit/risk assessment by the attending physician.
Effects on driving ability
No studies have been conducted on the effects on the ability to drive or use machinery. However, because cefuroxime can cause dizziness, patients should be warned to check if their ability is affected before driving or operating machinery.
Adverse reactions and side effects of Cefuroxime
Candida overgrowth; neutropenia, eosinophilia, Hb drop. Headache, dizziness; diarrhea, nausea, abdominal pain; increased liver enzymes; reaction instead of injection.
⭐⭐⭐⭐⭐ VIDEO OF CEFUROXIME/CEFTIN (DRUG)
Source: The content of this active ingredient has been written taking into account the clinical and molecular information of all medicines authorised and marketed in the United States under the Unique Ingredient Identifier (UNII) by the Substance Registration System (SRS) of the Food and Drug Administration (FDA) and the United States Pharmacopeia (USP).
In order to know in detail the information authorized by the FDA for each drug, you should consult the corresponding medication guide authorized by the FDA.
Resources:
UNII: O1R9FJ93ED
ChemIDplus
DrugPortal
PubChem CID: 5479529
NCI Thesaurus: C61669