General information
The cephalosporins and as the main representative cefuroxime are a classical broad-spectrum antibiotic and, like the penicillins, belong to the group of beta-lactam antibiotics. They have a bactericidal effect, i.e. they kill bacteria by disrupting the cell wall synthesis of the bacteria.
Classification
The antibiotic cefuroxime belongs to the antibiotic group of cephalosporins, which are counted among the beta-lactam antibiotics. Cephalosporins are chemically derived from aminocephalosporanic acid. They are insensitive to an enzyme that is formed by various bacteria and attacks the beta-lactam ring compound (beta-lactamase).
The cephalosporins are not all equally insensitive to this enzyme. This property is taken advantage of when using this antibiotic group and cephalosporins with less sensitive beta-lactamase susceptibility are used to combat beta-lactamase producing bacteria. The cephalosporins are divided into four groups (1,2,3a,3b) Cefuroxime is included in the second group.
This group includes antibiotics which are used parenterally, i.e. by infusion. The main reason for this is, on the one hand, a faster action by this route and, on the other hand, the acid instability of this antibiotic. If an antibiotic is acid-stable, it can be given in tablet form via the stomach.
Its effect is then unfolded only after passage through the stomach. Acid-unstable antibiotics would immediately be dissolved in the stomach by the gastric acid and thus not be able to work properly. For this reason, an infusion directly via the patient’s venous blood system is necessary.
Cefuroxime is also known under the trade name ZinacefR. The group 2 of cephalosporins is also known as the cefuroxime group because this substance is representative of all antibiotics in the group. In addition to cefuroxime, cefotiam, known as Spicef Round Cefoxitin, would be mentioned under the trade name MefoxitinR.
A further division, other than into groups, is made into generations. Newly developed antibiotics are called antibiotics of the next generation. However, the effect is not necessarily better in the reverse case, and when choosing antibiotics, the mechanisms of action and the bacterium to be controlled are decisive. Previously, the cefuroxime group was referred to as intermediary cephalosporins or 2nd generation antibiotics.
Effect
Cefuroxime and all other antibiotics in this group have a bactericidal effect on fast growing germs (proliferating germs). All beta-lactam antibiotics have a so-called beta-lactam ring in their chemical structural formula. This interferes with the formation of the bacterial cell wall and thus destroys the bacteria. This ring is an approximately stop sign-shaped structure that is incorporated into the chemical structure of the antibiotic.
Side effects
Complaints of the gastrointestinal tract and allergic reactions must be feared. A simultaneous administration of penicillin should be avoided because of a possible cross-allergy. Especially patients with known penicillin allergy should not be given cephalosporins.
Damage to the surface of the red blood cells (erythrocytes) can be observed at times. As a result, a test which is mainly used for the diagnosis of blood diseases can turn out positive (direct Coombs test). If this test is positive, an autoimmune disease can be suspected, since it mainly detects antibodies on the surface of the red blood cells. In any case, if the test is positive, the patient should be asked whether appropriate antibiotics are being taken. All other side effects, such as alcohol intolerance or increased bleeding tendency, are more likely to be observed with other cephalosporins and not with cefuroxime.
