Cefuroxime

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Cefuroxime Brand Names

Alti-Cefuroxime | Ceftin | Kefurox | Zinacef

What is Cefuroxime

Cefuroxime is an oral (cefuroxime axetil) and parenteral (cefuroxime sodium) second-generation cephalosporin.

Although the dosage forms differ, the bacterial spectrum and mechanism of action are the same.

Similar to other second-generation cephalosporins, cefuroxime is more active against gram-negative bacteria than the first-generation cephalosporins, but not as active as the third-generation cephalosporins.

Except for ceftriaxone, cefuroxime is more active against Haemophilus influenzae, including beta-lactamase-producing strains, than other cephalosporins.

Common clinical uses of cefuroxime include severe upper and lower respiratory tract infections, skin infections, otitis media, and surgical prophylaxis.

The oral tablets and suspension are not bioequivalent and are not substitutable on a milligram-per-milligram basis.

Indications

  1. bacteremia
  2. biliary tract infections
  3. bone and joint infections
  4. bronchitis
  5. cholecystitis
  6. Citrobacter sp.
  7. community-acquired pneumonia
  8. Enterobacter sp.
  9. erythema migrans
  10. Escherichia coli
  11. gonorrhea
  12. Haemophilus influenzae (beta-lactamase negative)
  13. Haemophilus influenzae (beta-lactamase positive)
  14. Haemophilus parainfluenzae
  15. impetigo
  16. intraabdominal infections
  17. Klebsiella sp.
  18. lower respiratory tract infections
  19. Lyme disease
  20. meningitis
  21. Moraxella catarrhalis
  22. Morganella morganii
  23. Neisseria gonorrhoeae
  24. Neisseria meningitidis
  25. otitis media
  26. pharyngitis
  27. pleural empyema
  28. pneumonia
  29. Proteus mirabilis
  30. Providencia rettgeri
  31. Salmonella sp.
  32. Shigella sp.
  33. sinusitis
  34. skin and skin structure infections
  35. Staphylococcus aureus (MSSA)
  36. Staphylococcus epidermidis
  37. Streptococcus pneumoniae
  38. Streptococcus pyogenes (group A beta-hemolytic streptococci)
  39. surgical infection prophylaxis
  40. tonsillitis
  41. urinary tract infection (UTI)

Side Effects

  1. abdominal pain
  2. acute generalized exanthematous pustulosis (AGEP)
  3. agranulocytosis
  4. anaphylactoid reactions
  5. anorexia
  6. aplastic anemia
  7. arthralgia
  8. azotemia
  9. bleeding
  10. candidiasis
  11. chest pain (unspecified)
  12. chills
  13. cholestasis
  14. colitis
  15. cough
  16. diaper dermatitis
  17. diarrhea
  18. dizziness
  19. drowsiness
  20. dyspepsia
  21. dyspnea
  22. dysuria
  23. elevated hepatic enzymes
  24. eosinophilia
  25. erythema
  26. erythema multiforme
  27. fever
  28. flatulence
  29. headache
  30. hemolytic anemia
  31. hepatitis
  32. hyperbilirubinemia
  33. hypoprothrombinemia
  34. infection
  35. injection site reaction
  36. interstitial nephritis
  37. Jarisch-Herxheimer reaction
  38. jaundice
  39. leukopenia
  40. leukorrhea
  41. muscle cramps
  42. nausea
  43. neutropenia
  44. oral ulceration
  45. pancytopenia
  46. phlebitis
  47. pruritus
  48. pseudomembranous colitis
  49. rash
  50. restlessness
  51. seizures
  52. serum sickness
  53. sinus tachycardia
  54. sinusitis
  55. Stevens-Johnson syndrome
  56. superinfection
  57. thrombocytopenia
  58. toxic epidermal necrolysis
  59. urticaria
  60. vaginitis
  61. vasculitis
  62. vomiting

Monitoring Parameters

  • serum creatinine/BUN

Contraindications

  • antimicrobial resistance
  • breast-feeding
  • cephalosporin hypersensitivity
  • colitis
  • diabetes mellitus
  • diarrhea
  • geriatric
  • GI disease
  • inflammatory bowel disease
  • penicillin hypersensitivity
  • phenylketonuria
  • pregnancy
  • pseudomembranous colitis
  • renal failure
  • renal impairment
  • sexually transmitted disease
  • ulcerative colitis
  • viral infection

Interactions

  • Amikacin
  • Aminoglycosides
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
  • Antacids
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Omeprazole
  • Calcium Carbonate
  • Calcium Carbonate; Magnesium Hydroxide
  • Calcium Carbonate; Risedronate
  • Calcium Carbonate; Simethicone
  • Cimetidine
  • Dexlansoprazole
  • Esomeprazole
  • Esomeprazole; Naproxen
  • Famotidine
  • Famotidine; Ibuprofen
  • Gentamicin
  • H2-blockers
  • Kanamycin
  • Lansoprazole
  • Lansoprazole; Naproxen
  • Lanthanum Carbonate
  • Loop diuretics
  • Mycophenolate
  • Nizatidine
  • Omeprazole
  • Omeprazole; Amoxicillin; Rifabutin
  • Omeprazole; Sodium Bicarbonate
  • Oral Contraceptives
  • Pantoprazole
  • Paromomycin
  • Plazomicin
  • Proton pump inhibitors
  • Rabeprazole
  • Ranitidine
  • Sodium Bicarbonate
  • Sodium picosulfate; Magnesium oxide; Anhydrous citric acid
  • Streptomycin
  • Tobramycin
  • Warfarin

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