cefuroxima

Cefuroxima, also known as cefuroxime in English, is a second-generation cephalosporin antibiotic used to treat a range of bacterial infections. As a beta-lactam antibiotic, it inhibits bacterial cell-wall synthesis by binding to penicillin-binding proteins, leading to lysis of susceptible organisms.

Its spectrum covers many Gram-positive cocci, including Streptococcus species and penicillin-susceptible Staphylococcus aureus, and a broad range of Gram-negative bacteria such as Haemophilus influenzae, Moraxella catarrhalis, Neisseria gonorrhoeae, and various Enterobacteriaceae. It is less active against Pseudomonas aeruginosa and beta-lactamase–producing strains.

Clinical uses include acute otitis media, sinusitis, community-acquired pneumonia, bronchitis, skin and soft-tissue infections, urinary tract infections, and some gynecologic or intra-abdominal infections. It is also used for surgical prophylaxis in certain procedures.

Formulations and pharmacokinetics: Cefuroxima is available as an oral prodrug, cefuroxime axetil, and as injectable cefuroxime sodium. After oral administration, the axetil is converted to active cefuroxime, with moderate bioavailability. The drug distributes widely and is mainly excreted by the kidneys; dosage may require adjustment in renal impairment.

Adverse effects and safety: Common adverse effects include diarrhea, nausea, rash, and hypersensitivity reactions. Superinfections and Clostridioides difficile infection can occur. Caution is advised in patients with a history of penicillin allergy due to possible cross-reactivity. Cefuroxima is generally considered compatible with pregnancy when indicated and is excreted in breast milk; use only if clearly needed.

Resistance and stewardship: Local resistance patterns influence usefulness; overuse can select beta-lactamase-producing organisms.