Cefuroxime for Bacterial Infections: What to Know

Cefuroxime is a second-generation cephalosporin, which is one of the beta-lactams used for a wide range of bacterial infections. Cefuroxime is available in various forms, such as oral tablets, oral suspensions, and an injectable form to be given in a muscle or a vein. Continue reading to learn more about how this drug can help fight bacterial infections.

What are bacterial infections?

Bacterial infections are common, affecting individuals of all ages and backgrounds. These harmful bacteria invade the body and can cause a wide range of illnesses, from minor to severe. Common bacterial infections include urinary tract infections, respiratory tract infections, skin infections, and gastrointestinal infections.

When a healthcare provider chooses an antibiotic to treat an infection, in addition to a person’s demographics and medical history, the following factors are considered:

The type of infection
The bacteria that causes it based on the location of the infection and the presentation of the illness
The class of antibiotic that is supposed be effective against the bacteria
The specific antibiotic in the class is based on cost and whether it is an outpatient or inpatient (hospital, clinic) treatment — oral antibiotics can be prescribed to be taken at home, while injectable antibiotics are reserved for treatment in a hospital setting.

However, even when the appropriate antibiotic is chosen, there are instances when the treatment is rendered ineffective, and susceptibility is one of the reasons.

Susceptible bacteria

Susceptible bacteria are those that can be effectively targeted and eliminated by antibiotics like cefuroxime.

Drug-resistant bacteria

The misuse or overuse of antibiotics has led to the emergence of drug-resistant strains. These bacteria have developed mechanisms to withstand the effects of antibiotics, making infections caused by them harder to treat. This is why it is very important that you finish the entire course of antibiotics even if you feel better. Using leftover antibiotics from previous illnesses can also contribute to the emergence of drug-resistant bacteria.

The rise of drug-resistant bacteria highlights the need for antibiotic use and ongoing research to combat resistance.

Effectiveness of cefuroxime against bacteria

Cefuroxime is one of the broad-spectrum antibiotics and works against infections caused by gram-positive bacteria such as:

Streptococcus pneumoniae
Streptococcus pyogenes (Group A Streptococcus)
Staphylococcus aureus (susceptible strains)
Streptococcus agalactiae (Group B Streptococcus)

It also acts on gram-negative bacteria, including:

Escherichia coli (E. coli)
Klebsiella pneumoniae
Haemophilus influenzae
Neisseria gonorrhoeae (certain strains)
Moraxella catarrhalis
Borrelia burgdorferi
Salmonella
Shigella

How does Cefuroxime work?

Cefuroxime is a broad-spectrum, semisynthetic cephalosporin antibiotic. It works by killing the bacteria or stopping their growth. It is important to note that cefuroxime only works against bacteria and cannot treat viral infections such as the common cold or flu.

Therapeutic uses of cefuroxime

Cefuroxime is commonly used to treat bacterial infections, such as:

Respiratory Infections: Cefuroxime is used to treat upper respiratory tract infections, such as sinusitis, tonsillitis, and pharyngitis, as well as lower respiratory tract infections, including uncomplicated pneumonia and acute bronchitis.
Skin Infections: Cefuroxime can be used to treat several skin diseases, including cellulitis, impetigo, folliculitis, abscesses, and infected wounds.
Urinary Tract Infections (UTI): Your healthcare professional may prescribe this medication to treat uncomplicated urinary tract infections.
Lyme disease: Caused by Borrelia burgdorferi, Lyme disease is transmitted through the bite of infected ticks. The symptoms are fever, fatigue, joint pain, and a skin rash known as erythema migrans (a type of rash that appears as one of the first symptoms of Lyme disease). Cefuroxime can be prescribed for early Lyme disease.
Gonorrhea: Cefuroxime is used to treat uncomplicated gonorrhea.

Administration and dosage recommendations

Cefuroxime is available in various dosage forms

Cefuroxime tablets for oral administration

Cefuroxime (axetil) 250 milligrams (mg)
Cefuroxime (axetil) 500 mg

Cefuroxime suspension

Oral suspension: 125 mg/5 milliliters (mL); 250 mg/5 mL

It is important to know that cefuroxime axetil oral tablets and oral suspension are not substitutable on a milligram-per-milligram basis. Therefore, they are not interchangeable. This means that 250 mg of cefuroxime oral tablet is not equivalent to 250 mg of cefuroxime oral suspension.

Cefuroxime sodium — Parenteral forms for intravenous and intramuscular injection

Available cefuroxime injections:

Injection powder for solution: 750 mg/vial
Intravenous powder for solution: 1.5 grams (gm)/vial; 7.5 gm/vial

It is advisable to take this medicine according to your health care professional and finish the entire course of antibiotic treatment even when you start to feel better.

Typical cefuroxime dosing

Adults and children 13 years and older

The typical dose for most infections is 250 mg by mouth twice daily for the duration of 7 to 10 days. Certain infections would require a higher dosing of 500 mg twice daily. Examples include chronic bronchitis and skin infections.
Early Lyme disease: the typical dose is 500 mg by mouth every 12 hours for 20 days.
Uncomplicated gonorrhea: the typical dose is 1,000 mg or 1 g as a one-time dose.

Children younger than 13 years old

Sinus infection and otitis media (ear infection): the typical dose is 250 mg by mouth every 12 hours for 10 days.

In case of overdose

In case of an overdose, call your doctor immediately or seek emergency medical help at the nearest hospital or urgent care. You can also call your local poison control center or the national poison control center at 1-800-222-1222.

Storage guidelines

Keep medicines out of reach of children and pets.
Store at room temperature.
Never use drugs after the expiration date.
Protect from moisture and sunlight and keep it in its original packaging.

Possible Side Effects

Common side effects of cefuroxime include:

Mild diarrhea to severe diarrhea in higher doses
Nausea and vomiting

Other side effects:

Chills
Mild to severe stomach pain
Headache
Rash
Bad or unusual taste
Vaginal itching and yeast infection

These symptoms typically improve with time as the body adjusts to the medication. However, if symptoms persist, tell your medical doctor immediately.

Serious side effects

While cefuroxime is generally well-tolerated, there are other more severe effects that are rarely experienced. You should seek immediate medical attention if you experience any of the following symptoms:

Severe allergic reaction: hives, purple skin rash, blisters, swelling of lips, and tongue, sore throat, and difficulty in breathing.
Infectious diarrhea: this is caused by a bacteria called Clostridium difficile or C.Diff. Typical symptoms include foul-smelling diarrhea with fever, abdominal pain, and frequent bowel movements that can be up to 15 times per day.

Below are other precautions to be aware of while taking cefuroxime. Tell your doctors right away or seek medical care if you experience the following signs or symptoms:

Interfering with prothrombin, a protein that is essential for blood to clot — watch for unusual or unexplained bruising, bleeding that won’t stop
Kidney disease — problems with urination or reduced urine amount, fatigue, weakness
Convulsions or seizures
Hearing loss

Possible drug Interactions

Certain medications can cause low absorption, thus, reducing the effectiveness of cefuroxime, while other drugs can increase the blood levels and increase the risks for side effects of cefuroxime. To prevent harmful drug interactions, tell your healthcare professional about all medications you’re taking, including prescription medications, over-the-counter products, vitamins, and herbal supplements.

Below are examples of medications that can interact with:

Acid reflux medications:
- Antacids: Aluminum hydroxide, calcium carbonate
Proton pump inhibitors (PPIs): pantoprazole, omeprazole
- H2 -receptor blockers: famotidine, cimetidine
Oral contraceptives
Gout treatment: probenecid
Bacillus Calmette-Guérin (BCG) intravesical
Immunosuppressant medications such as mycophenolate

Considerations while taking the Medication

Some special considerations should be taken into account while taking cefuroxime as an antibiotic.

Tell your doctor if you have kidney disease, liver disease, or if you are allergic to cefuroxime or other antibiotics in the past.

Cefuroxime can interfere with certain lab tests, causing inaccurate results; you should inform healthcare providers and laboratory personnel that you are taking cefuroxime.

Proper Check-up

Administering any antibiotics without medical input can cause unpleasant side effects and increase your resistance to antibiotics. That means that your body can't longer respond to antibiotics, causing difficulty in treatment.

Dosage and Timing

Cefuroxime should be taken as prescribed. Take the entire course of medication even if you start to feel better before completing it. In case of a missed dose, take the next dose according to your dosing schedule.

Swallowing difficulty

Cefuroxime has a bitter taste and can't be crushed or chewed. Talk to your doctor if you struggle to swallow the whole tablet.

Interactions with food and other drugs

While other antibiotics are taken on an empty stomach, cefuroxime should be taken with food.

Give your doctor or pharmacist a complete list of your medications, including prescription drugs, over-the-counter medications, dietary supplements, and herbal products.

Tell your doctor if you have a history of kidney disease.

Follow-Up

Keep any follow-up appointments with your doctor while taking this medication.

Pregnancy

Cefuroxime is typically classified as a Pregnancy Category B drug by the FDA. Let your doctor know if you are pregnant or planning to get pregnant. Cefuroxime should only be used during pregnancy when the benefits outweigh the risks.

Breastfeeding mothers

Tell your doctor if you are breastfeeding before taking this drug, as it can be passed to the baby through human milk.

Pediatric use

It is not safe to give this medicine to pediatric patients below 3 months of age.

When to seek medical attention

Consult your doctor immediately if you experience adverse effects, such as:

Allergic reactions (Hives, rash, itching, swelling (especially of the face, lips, or tongue), or difficulty breathing).
Severe stomach pain or persistent diarrhea.
Changes in urine output, unusual bleeding or bruising, yellowing of the skin or eyes (jaundice), or signs of a new infection.

References