Cefuroxime Drug Profile

What is Cefuroxime?

Cefuroxime is a second-generation cephalosporin antibiotic used to treat various bacterial infections. As a member of the cephalosporin class of antibiotics, it works by disrupting bacterial cell wall formation, leading to bacterial death. Healthcare providers commonly prescribe cefuroxime for respiratory tract infections, skin infections, and urinary tract infections caused by susceptible bacteria.

Uses

Cefuroxime is approved for treating several types of bacterial infections:

• Respiratory tract infections: Including pneumonia, bronchitis, and sinusitis caused by susceptible bacteria such as Streptococcus pneumoniae and Haemophilus influenzae
• Skin and soft tissue infections: Treatment of cellulitis, wound infections, and other skin infections caused by Staphylococcus aureus and Streptococcus pyogenes
• Urinary tract infections: Both uncomplicated and complicated UTIs caused by E. coli and other susceptible gram-negative bacteria
• Bone and joint infections: Treatment of osteomyelitis and septic arthritis when caused by susceptible organisms
• Surgical prophylaxis: Prevention of infections during certain surgical procedures, particularly orthopedic and abdominal surgeries

How it works

Cefuroxime kills bacteria by interfering with the synthesis of peptidoglycan, an essential component of bacterial cell walls. The medication binds to penicillin-binding proteins within the bacterial cell wall, preventing the cross-linking of peptidoglycan chains. This disruption weakens the cell wall structure, causing the bacteria to burst and die due to osmotic pressure.

Side effects

Common side effects include:

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• Nausea and vomiting
• Diarrhea
• Abdominal pain or cramping
• Headache
• Dizziness
• Pain or irritation at injection site (for IV/IM forms)
• Skin rash or itching
• Vaginal yeast infections in women

Serious side effects requiring immediate medical attention:

• Severe allergic reactions including difficulty breathing, facial swelling, or severe skin reactions
• Clostridioides difficile-associated diarrhea (severe, persistent, or bloody diarrhea)
• Severe skin reactions such as Stevens-Johnson syndrome
• Signs of liver problems including yellowing of skin or eyes
• Seizures (rare but reported with high doses)

Warnings and precautions

• Allergy history: Patients with known allergies to penicillins or other cephalosporins should use cefuroxime with extreme caution due to potential cross-reactivity
• Kidney function: Dosage adjustments are necessary for patients with impaired kidney function, as the drug is primarily eliminated through the kidneys
• Pregnancy and breastfeeding: Cefuroxime is generally considered safe during pregnancy (FDA Pregnancy Category B) and small amounts pass into breast milk
• Gastrointestinal conditions: Patients with a history of colitis or inflammatory bowel disease may be at increased risk for antibiotic-associated diarrhea
• Complete treatment course: Patients must complete the entire prescribed course even if symptoms improve to prevent antibiotic resistance and treatment failure

Interactions

• Probenecid: Increases cefuroxime blood levels by blocking kidney elimination, potentially requiring dosage adjustment
• Loop diuretics (furosemide): May increase risk of kidney toxicity when used together, especially in patients with existing kidney problems
• Aminoglycosides: Concurrent use may increase risk of kidney damage and should be monitored closely
• Warfarin: Cefuroxime may enhance anticoagulant effects, requiring more frequent monitoring of blood clotting times
• Live vaccines: Antibiotics may reduce effectiveness of live bacterial vaccines such as typhoid vaccine
• Birth control pills: May reduce effectiveness of oral contraceptives, requiring additional contraceptive methods
• Antacids containing aluminum or magnesium: Can reduce absorption of oral cefuroxime when taken simultaneously
• H2 blockers and proton pump inhibitors: May decrease absorption of oral cefuroxime by reducing stomach acid

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Dosage

Typical adult dosages vary depending on the type and severity of infection. For oral tablets, the usual range is 250-500 mg twice daily for 7-10 days. For intravenous or intramuscular administration, doses typically range from 750 mg to 1.5 g every 8 hours, with severe infections potentially requiring up to 3 g daily in divided doses. Dosage adjustments are necessary for patients with kidney impairment. The duration of treatment generally ranges from 5-14 days depending on the infection type and patient response. All dosing decisions should be made by a qualified healthcare provider based on individual patient factors including infection severity, kidney function, and treatment response.

Sources: FDA DailyMed drug labels (public domain), BNF, WHO Essential Medicines List. This article is for informational purposes only and does not constitute medical advice. Always consult your healthcare provider before starting or stopping any medication.

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