What is Cefuroxime?
Cefuroxime, known by the brand name Ceftin (though discontinued), is a second-generation cephalosporin antibiotic used to treat a wide variety of bacterial infections. The drug is available in oral forms, such as tablets and liquid suspensions, as well as an injectable form for more severe infections. As a cephalosporin, cefuroxime is chemically similar to penicillin, meaning patients with a history of penicillin allergies should discuss this with their doctor due to a potential risk of cross-sensitivity.
How Cefuroxime Works
Cefuroxime works by interfering with the synthesis of the bacterial cell wall. Specifically, it binds to one or more of the penicillin-binding proteins (PBPs) located inside the bacterial cell wall, which are essential for its formation. By inhibiting this process, the antibiotic causes the bacterial cell to lyse and die. This bactericidal action is why it is effective against many susceptible bacteria.
Indications and Therapeutic Uses
Cefuroxime is prescribed to treat various bacterial infections throughout the body, including those of the ears, nose, throat, lungs, urinary tract, and skin.
Commonly treated conditions include:
- Respiratory Tract Infections: This includes tonsillitis, pharyngitis, acute sinusitis, and acute exacerbations of chronic bronchitis.
- Urinary Tract Infections (UTIs): Cefuroxime is effective against uncomplicated UTIs.
- Skin and Skin Structure Infections: It is used for uncomplicated infections of the skin caused by susceptible organisms.
- Lyme Disease: For early localized or disseminated Lyme disease, cefuroxime is an approved treatment option.
- Gonorrhea: Though other medications like ceftriaxone are often preferred due to resistance concerns, cefuroxime can be used for uncomplicated cases.
- Surgical Prophylaxis: The injectable form of cefuroxime is sometimes used to prevent infections before or after surgery.
Potential Side Effects and Warnings
Like all antibiotics, cefuroxime can cause side effects. Most are mild and manageable, but some serious ones can occur. Common side effects include:
- Diarrhea
- Nausea and vomiting
- Headache
- Vaginal yeast infections
- Stomach cramps
- Diaper rash (in infants taking the suspension)
Serious Side Effects and Warnings
- Serious Allergic Reactions: Severe allergic reactions, including anaphylaxis, can occur, particularly in individuals with a known penicillin allergy. Symptoms may include hives, difficulty breathing, and swelling of the face, tongue, or throat. If these occur, seek emergency medical care immediately.
- Clostridioides difficile Infection (CDAD): Cefuroxime can disrupt the balance of normal bacteria in the gut, leading to an overgrowth of C. diff bacteria. This can cause severe, watery, or bloody diarrhea and may occur weeks or months after treatment.
- Impact on Blood Sugar Tests: For diabetic patients testing their urine for sugar, cefuroxime can cause false-positive results with certain tests. Enzyme-based tests should be used instead.
- Infection Resistance: Inappropriate use of antibiotics, such as for viral infections, can lead to the development of antibiotic-resistant bacteria. Always complete the full course of treatment as prescribed.
Cefuroxime vs. Amoxicillin Comparison
When considering antibiotics for various infections, cefuroxime is sometimes compared to amoxicillin. While both are used for similar conditions, there are key differences related to their class, spectrum of activity, and side effects.
| Feature | Cefuroxime | Amoxicillin |
|---|---|---|
| Drug Class | Second-generation cephalosporin | Penicillin |
| Mechanism | Inhibits bacterial cell wall synthesis | Inhibits bacterial cell wall synthesis |
| Spectrum | Broad spectrum, effective against many gram-positive and gram-negative bacteria, and stable in the presence of many beta-lactamases | Broad spectrum, effective against many gram-positive and some gram-negative bacteria |
| Key Use Case | Used for certain respiratory, skin, and urinary tract infections, as well as early Lyme disease | Used for a variety of bacterial infections, including ear, nose, throat, and skin infections |
| Side Effect Profile | May have a lower incidence of gastrointestinal side effects compared to amoxicillin/clavulanate | GI side effects like diarrhea are common |
| Penicillin Allergy | Potential for cross-reactivity | Direct allergy risk |
Important Drug Interactions
Before starting cefuroxime, it is important to inform your doctor of all other medications, vitamins, and herbal products you are taking. Significant interactions include:
- Antacids, H2 Blockers, and PPIs: Medications that reduce stomach acidity, such as aluminum/magnesium antacids, cimetidine, and omeprazole, can decrease the absorption of oral cefuroxime. It is recommended to separate administration times.
- Probenecid: This medication can increase cefuroxime levels in the blood and should be used with caution.
- Oral Contraceptives: Cefuroxime can decrease the effectiveness of some oral contraceptives, and an alternative form of birth control should be used.
- Warfarin: Cefuroxime can increase the risk of bleeding in patients on warfarin.
Administration and Storage
- Dosage: The dosage depends on the infection being treated, its severity, and the patient's age and weight. It is typically taken twice daily for a set number of days. Always complete the full course even if symptoms improve.
- Tablets vs. Suspension: Oral tablets should be swallowed whole, as crushing them results in a bitter taste. The oral suspension is used for children or those who cannot swallow tablets and must be taken with food to improve absorption.
- Storage: Store oral tablets at room temperature, away from moisture and heat. The oral suspension must be refrigerated after mixing and should be discarded after 10 days.
Conclusion
Cefuroxime is a valuable second-generation cephalosporin antibiotic for treating a range of bacterial infections. Its mechanism of action, which involves disrupting bacterial cell wall synthesis, provides an effective means of combating susceptible bacteria. However, like any medication, its use requires careful consideration of potential side effects, including the risk of C. diff infection and severe allergic reactions, as well as important drug interactions. As with all prescription medications, it is crucial to follow the guidance of a healthcare professional for correct usage and to promote proper antimicrobial stewardship.
