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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › OTHER BETA-LACTAM ANTIBACTERIALS › Second-generation cephalosporins
cefuroxime
J01DC02
Forms & Strengths
- Tablet: 250 mg, 500 mg (as cefuroxime axetil)
- Oral Suspension: 125 mg/5 mL, 250 mg/5 mL (as cefuroxime axetil)
- Injection, powder for reconstitution: 750 mg, 1.5 g (as cefuroxime sodium)
Adult Dosing
- Pharyngitis/Tonsillitis: 250 mg PO BID for 10 days
- Acute Bacterial Exacerbation of Chronic Bronchitis: 250-500 mg PO BID for 10 days
- Community-Acquired Pneumonia: 500 mg PO BID or 750-1500 mg IV q8h for 7-10 days
- Uncomplicated Urinary Tract Infection: 125-250 mg PO BID for 7-10 days
- Gonorrhea, uncomplicated: 1000 mg PO single dose
- Surgical Prophylaxis: 1.5 g IV single dose prior to surgery
Pediatric Dosing
- Ages 3 months to 12 years (Otitis Media, Sinusitis): 30 mg/kg/day divided BID (max 1000 mg/day)
- Ages 3 months to 12 years (Pharyngitis, Tonsillitis): 20 mg/kg/day divided BID (max 500 mg/day)
- Neonates and Infants < 3 months: Safety and efficacy not established for oral use; IV dosing ranges from 75-150 mg/kg/day divided q8h
Indications
- Lower respiratory tract infections (bronchitis, pneumonia)
- Upper respiratory tract infections (pharyngitis, tonsillitis, acute bacterial otitis media, acute maxillary sinusitis)
- Uncomplicated urinary tract infections
- Skin and skin structure infections
- Uncomplicated gonorrhea (urethral and endocervical)
- Early Lyme disease (erythema migrans)
- Perioperative prophylaxis
Mechanism of Action
- Second-generation cephalosporin beta-lactam antibiotic
- Inhibits bacterial cell wall synthesis by binding to one or more penicillin-binding proteins (PBPs)
- Bactericidal activity against susceptible gram-positive and gram-negative aerobic organisms
Contraindications
- Hypersensitivity to cefuroxime or other cephalosporin-class antibacterial drugs
- History of severe hypersensitivity reaction (e.g., anaphylaxis) to penicillins or other beta-lactam agents
Adverse Reactions
- Diarrhea / loose stools
- Nausea and vomiting
- Transient elevations in AST, ALT, and LDH
- Eosinophilia and transient neutropenia
- Injection site reactions (pain, thrombophlebitis)
- Clostridioides difficile-associated diarrhea
- Hypersensitivity reactions (rash, urticaria, pruritus, anaphylaxis)
Drug Interactions
- Antacids and H2-receptor antagonists: May decrease the absorption and bioavailability of oral cefuroxime axetil
- Probenecid: Decreases renal tubular secretion of cefuroxime, leading to increased and prolonged serum concentrations
- Oral anticoagulants (e.g., warfarin): May increase the risk of bleeding by suppressing vitamin K-producing gut flora
- Nephrotoxic drugs (e.g., aminoglycosides, loop diuretics): May increase the risk of nephrotoxicity
Curated Content: Needs Vetting Before Put to Clinical Use