Cefuroxime

Cefuroxime is a second-generation cephalosporin antibiotic used to treat infections caused by susceptible bacteria. It is available as an oral prodrug, cefuroxime axetil, and as a parenteral form, cefuroxime sodium. The axetil prodrug is converted to active cefuroxime after absorption.

Cefuroxime works by inhibiting bacterial cell wall synthesis through binding to penicillin-binding proteins, which disrupts peptidoglycan cross-linking. It is bactericidal and generally active against a range of gram-positive cocci and many gram-negative bacilli, but not active against MRSA or Enterococcus species.

Spectrum and indications: Cefuroxime has good activity against Streptococcus species and other common respiratory pathogens; it is also active against Haemophilus influenzae, Moraxella catarrhalis, and some Enterobacteriaceae such as Escherichia coli and Klebsiella. It is used for respiratory tract infections, otitis media, sinusitis, bronchitis, urinary tract infections, and skin and soft tissue infections.

Administration and pharmacokinetics: The oral form has limited and variable bioavailability, which is increased when taken with food. Parenteral cefuroxime is given by intramuscular or intravenous injection. It is primarily excreted by the kidneys, and dose adjustments are needed in renal impairment. The half-life in adults is roughly 1–2 hours.

Adverse effects and safety: Cefuroxime is generally well tolerated. Common side effects include diarrhea, nausea, vomiting, and rash. Hypersensitivity reactions can occur, and rare cases of anaphylaxis have been reported. There is a risk of Clostridium difficile-associated diarrhea. Cross-reactivity with penicillin allergy exists, so caution is advised in patients with beta-lactam allergies.