Products
Cefuroxime is commercially available as film-coated tablets, powder for suspension, and injectable (Zinat, Zinacef, Aprokam, generics). It has been approved in many countries since 1988.
Structure and properties
Cefuroxime (C16H15N4NaO8S, Mr = 446.4 g/mol) is present in peroral drugs in the form of the acetoxyethyl ester prodrug cefuroxime axetil, a white powder that is sparingly soluble in water. Cefuroxime axetil is hydrolyzed during and after absorption to the active ingredient cefuroxime. Parenteral dosage forms contain cefuroxime sodium, a white, slightly hygroscopic powder that is readily soluble in water. Cefuroxime is semisynthetically produced from a substance obtained by fermentation.
Effects
Cefuroxime (ATC J01DC02) is a bactericidal and betalactamase-resistant antibiotic. Its effects are based on inhibition of bacterial cell wall synthesis. Cefuroxime has a broad spectrum and is effective against some Gram-negative and Gram-positive pathogens.
Indications
For the treatment and, in some cases, prevention of bacterial infectious diseases. Cefuroxime is used for respiratory tract infections, urinary tract infections, skin infections, gonorrhea, and Lyme disease, among others.
Dosage
According to the drug label. Cefuroxime should be taken with meals and water. The German SmPC advises taking the drug shortly after a meal.
Contraindications
- Hypersensitivity, including to other cephalosporins and beta-lactam antibiotics.
For complete precautions, see the drug label.
Interactions
Cefuroxime is not metabolized and is excreted unchanged. Interactions are possible with aminoglycosides, diuretics, antacids and other acid blockers, probenecid, contraceptives, imipenem, and chloramphenicol.
Adverse effects
The most common possible adverse effects include candidemia; blood count abnormalities; headache; dizziness; digestive symptoms such as diarrhea, abdominal pain, and nausea; and elevation of liver enzymes. As with other cephalosporins and penicillins, hypersensitivity reactions (allergic reactions) may occur, often manifesting as itchy skin rashes. Because severe reactions are very rarely possible (severe allergic reaction, Stevens-Johnson syndrome, toxic epidermal necrolysis), the physician/doctor should be contacted if a rash develops.
