Cefuroxime

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Genes that may be involved
  • Inhibits
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Cefuroxim, Curocef, Zinnat; Belgium: Cefurim, Cefuroxim, Cefuroxime, Doccefuro, Kefurox, Zinacef, Zinnat; Bulgaria: Aksef, Axetine, Cefuroxim, Cefuroxime, Ceroxim, Xorimax, Zinacef, Zinnat; Cyprus: Axetine, Cefuroxime, Interbion, Zilisten, Zinacef, Zinnat; Czech Republic: Axetine, Cefuroxim, Medoxin, Xorimax, Zinacef, Zinnat, Zinoxime; Denmark: Cefuroxim, Zinacef, Zinnat; Estonia: Axetine, Cefuroxime, Ketocef, Xorimax, Zinacef, Zinnat; Finland: Cefuroxim, Cefuroxime, Zinacef, Zinnat; France: Cefuroxime, Cepazine, Zinnat; Germany: Cefaxetil, Cefudura, Cefufar, CefuHexal, Cefurax, Cefuro-Puren, Cefurox, Cefuroxim, Cefuroxime, CFAX-B Trockensaft, Elobact, Zinacef, Zinnat; Greece: Anaptivan, Cefuretil, Cefuroprol, Cefuroxime, Ceruxim, Cupax, Feacef, Fredyr, Foucacillin, Furaxil, Galemin, Interbion, Lyprovir, Medosen, Nelavocin, Nipogalin, Saxetil, Sedopan, Vekfazolim, Yokel, Zetagal, Zinadol, Zinacef; Hungary: Cefuroxim, Ceroxim, Xorim, Xorimax, Zinacef, Zinnat; Ireland: Ceftal, Cefuroxime, Zinacef, Zinnat; Italy: Cefoprim, Cefurin, Cefuroxima, Curoxim, Oraxim, Supero, Tilexim, Zinnat, Zinocep, Zoref; Latvia: Axetine, Xorimax, Zinacef, Zinnat; Luxembourg: Kefurox, Zinacef, Zinnat; Malta: Axetine, Cefuroxim, Nipogalin, Zetagal, Zilisten, Zinacef, Zinnat; Netherlands: Cefuroxim, Zinacef, Zinnat; Poland: Biofuroksym, Bioracef, CefuHexal, Cefuroxim, Ceroxim, Novocef, Plixym, Tarsime, Xorim, Xorimax, Zamur, Zinacef, Zinnat, Zinoxx; Portugal: Antibioxime, Cefuraxima, Curoxime, Zipos, Zoref; Romania: Axetine, Axycef, Cefuroxima, Ceroxim, Zinacef, Zinnat; Slovakia: Axetine, Cefurim, Cefuroxim, Ceroxim, Xorim, Xorimax, Zinnat; Slovenia: Zinacef, Zinnat; Spain: Cefuroxima, Curoxima, Defuroxima, Nivador, Zinnat; Sweden: Cefuroxim, Zinacef, Zinnat; UK: Cefuroxime, Zinacef, Zinnat.

North America

Canada: Ceftin, Cefuroxime; USA: Ceftin, Cefuroxime, Zinacef.

Latin America

Argentina: Cefurox, Cefuroxima; Brazil: Cefuroxima, Keroxime, Medcef, Zinacef, Zinnat; Mexico: Cefabiot, Cefagen, Cefuracet, Cefuroxima, Cetoxil, Froxal, Fucerox, Furobioxin, Magnaspor, Novador, Ximaken, Xorufec, Zinnat.

Asia

Japan: Oracef.

Drug combinations

Chemistry

Cefuroxime Axetil: C~20~H~22~N~4~O~10~S. Mw: 510.47. (1) 5-Thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid, 3-[[(aminocarbonyl)oxy]methyl]-7-[[2-furanyl(methoxyimino)acetyl]amino]-8-oxo-, 1-(acetyloxy)ethylester, [6R-[6α,7β(Z)]]-; (2)(R,S)-1-Hydroxyethyl (6R,7R)-7-[2-(2-furyl)glyoxylamido]-3-(hydroxymethyl)-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylate, 7^2^-(Z)-(O-methyloxime), 1-acetate 3-carbamate. CAS-64544-07-6; CAS-55268-75-2 (cefuroxime)(1983).

Cefuroxime Sodium: C~16~H~15~N~4~NaO~8~S. Mw: 446.37. Sodium (6R,7R)-7-[2-(2-furyl)glyoxylamido]-3-(hydroxymethyl)-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylate, 72-(Z)-(O-methyloxime), carbamate (ester). CAS-56238-63-2.

Pharmacologic Category

Antibacterials; Second Generation Cephalosporins. (ATC-Code: J01DC02).

Mechanism of action

Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding proteins. Active in vitro and in clinical infections against Gram-positive aerobic bacteria, such as Staphylococcus aureus, S. epidermidis, Streptococcus pneumoniae, S. pyogenes (group A β-hemolytic streptococci), and other streptococci. Active in vitro and in clinical infections against Gram-negative aerobic bacteria such as Citrobacter, Enterobacter, Escherichia coli, Haemophilus influenzae (including ampicillin-resistant strains; β-lactamase-negative, ampicillin-resistant strains of H. influenzae should be considered resistant to cefuroxime and cefuroxime axetil despite the fact that results of in vitro susceptibility tests may indicate that the organisms are susceptible to the drug), H. parainfluenzae, Klebsiella (including K. pneumoniae), Moraxella catarrhalis (including ampicillin-resistant strains), Morganella morganii, Neisseria gonorrhoeae, N. meningitidis, Proteus mirabilis, Providencia rettgeri, Salmonella, and Shigella. Some strains of Citrobacter, E. cloacae, and M. morganii are resistant. Acinetobacter calcoaceticus, Campylobacter, Pseudomonas, P. vulgaris, Serratia are usually resistant. Active in vitro against anaerobes such as Bacteroides (except B. fragilis), Clostridium (except C. difficile), Fusobacterium, Peptococcus, and Peptostreptococcus. Inactive against Chlamydia, fungi, and viruses.

Therapeutic use

Susceptible infections of the upper and lower respiratory tract, otitis media, urinary tract, uncomplicated skin and soft tissue, bone and joint, sepsis, uncomplicated gonorrhea, and early Lyme disease. Preoperative prophylaxis of susceptible infections.

Pregnancy and lactiation implications

Adverse events not observed in animal studies. Cefuroxime crosses the placenta and reaches the cord serum and amniotic fluid. Placental transfer is decreased in the presence of oligohydramnios. Enters breast milk (use caution).

Unlabeled use

Contraindications

Hypersensitivity to cefuroxime, any component of the formulation, or other cephalosporins.

Warnings and precautions

May be associated with increased INR, especially in nutritionally-deficient patients, prolonged treatment, hepatic or renal disease. Use with caution in history of penicillin allergy, especially IgE-mediated reactions (e.g. anaphylaxis, angioedema, urticaria). Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea and pseudomembranous colitis. Use with caution in renal impairment. Some products may contain phenylalanine. Tablets and oral suspension are not bioequivalent (do not substitute on a mg-per-mg basis). May cause positive direct Coombs’ test, false-positive urinary glucose test using cupric sulfate, false-negative may occur with ferricyanide test.

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