Cefuroxime

Oral Antibiotics

Drug class: Second-Generation Cephalosporin Antibiotic; Beta-lactam antibiotic class, specifically categorized as a Second-generation broad-spectrum cephalosporin.

Cefuroxime (ZINNAT) (中文：頭孢呋辛)

Pronunciation

Cefuroxime 250mg

Common Strengths of Cefuroxime

Cefuroxime is available in various strengths, including:

• Tablets: 125 mg, 250 mg and 500 mg
• Oral Suspension: 125 mg/5 mL
• Injectable Form: 250 mg, 750 mg, and 1.5 g

Drug Trade Names

Cefuroxime is marketed under several trade names, including:

• Zinacef
• Zinnat

Drug Usage

Cefuroxime is used to treat various bacterial infection:

• Pharyngitis (sore throat)
• Acute bacterial otitis media (ear infections)
• Sinusitis
• Bronchitis
• Urinary tract infections (TUTIs)
• Gonorrhea
• Lyme disease
• Skin infections

Mechanism of Action

Cefuroxime inhibits bacterial cell wall peptidoglycan synthesis, leading to bacterial cell death. It binds to specific proteins (penicillin-binding proteins) in the bacterial cell wall, disrupting its integrity and function.

Route of Administration

Cefuroxime can be administered via:

• Oral (tablets and suspension)
• Intravenous (IV) or Intramuscular (IM) injection

Dosages

• The standard dosing for adults is typically:
  • For most infections: 250 mg to 500 mg orally every 12 hours for 7 to 10 days.
  • For gonorrhea: 1 g orally as a single dose.
  • For early Lyme disease: 500 mg orally every 12 hours for 20 days.

• Renal Dosing
  • In patients with renal impairment, the dose should be adjusted based on the estimated glomerular filtration rate (eGFR):
    • eGFR >30 mL/min: No dose adjustment needed.
    • eGFR 10-30 mL/min: Reduce the dose by 50%.

Side Effects

Frequency	Adverse reactions
Common Side Effects	Diarrhea
	Nausea
	Vomiting
	Rash
Serious Side Effects	Allergic reactions (hives, difficulty breathing, swelling of the face or throat)
	Severe diarrhea (potentially caused by Clostridium difficile)
	Liver function abnormalities
	Renal impairment

Pharmacokinetics

• Onset of Action: Oral cefuroxime typically take a few hours to show effects, while IV administration can show effects within 15 minutes.
• Duration of action:
  • The half-life of cefuroxime is approximately 70-80 minutes
  • After IV administration of a 1.5 g dose, therapeutic serum concentrations are maintained for over 8 hours, while lower doses (750 mg) maintain effective concentration for about 5.3 hours
  • Following IM administrations, cefuroxime maintain effective serum level for several hour but may require repeated dosing every 8 hours for sustained efficacy against certain infections.

Drug Precautions

Pregnancy

It should only be used during pregnancy if the benefits outweigh the risks

Breastfeeding

Cefuroxime is excreted in breast milk; consult a healthcare provider before use while breastfeeding.

Children and Elderly

• Children: Not recommended for those under 3 months of age.
• Elderly: May require dose adjustments due to potential renal impairment.

Monitoring Items

Patients on cefuroxime should be monitored for:

• Signs of allergic reactions
• Liver and renal function tests
• Symptoms of antibiotic-associated diarrhea

Drug Interactions

There are significant enough that the combination should generally be avoided due to the risk outweighing any benefit:

• Antacids (e.g. aluminum hydroxide, calcium carbonate): These can reduce the absorption of cefuroxime. It is recommended to take cefuroxime at least one hour before or two after antacids.
• Proton Pump Inhibitors and H₂ Blockers (e.g. omeprazole, famotidine): Similar to antacids, these medications can also decrease cefuroxime's absorption.
• Probenecid: This gout medication can increase cefuroxime levels in the blood by reducing its renal clearance, potentially enhancing its effects and side effects.
• Warfarin and other anticoagulants: Cefuroxime may displace these drugs from plasma proteins, increasing their free fraction and potentially leading to enhanced anticoagulant effects.
• Nephrotoxic drugs: Caution is advised when using cefuroxime with other nephrotoxic agents such as aminoglycosides and potent diuretics, as this combination may increase the risk of kidney damage.

FAQ

How Should I Take the cefaclor?

Take cefuroxime tablets with food to enhance absorption and reduce stomach upset. Swallow the tablets whole; do not crush or chew.

What Should I Avoid While Taking?

Avoid alcohol as it may increase the risk of side effects and reduce the effectiveness of the antibiotic. Additionally, avoid taking antacids containing aluminum, magnesium, or calcium within two hours of taking cefuroxime, as they can interfere with its absorption.

What Happens if I Miss a Dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose.