Fields of application
Cefuroxime is good but weaker than the antibiotics from the cefazolin group against gram-positive bacteria. However, they are more effective than antibiotics from the cefazolin group against gram negative bacteria. The bacteria of the gram-negative range include enterobacteria such as E. coli, Klebsiellen, Proteus, Salmonella, Shigella and Haemophilus Influenza.
Gram-positive pathogens include staphylococci and streptococci A and B. Although cefuroxime is penicillinase-resistant against staphylococci and limited betalactamase-resistant against gram-negative bacteria, there is a so-called Pseudomonas enterococcal gap. This means that against these germs, insufficient control with cefuroxime is guaranteed.
For this reason, a combination with azlocillin and piperacillin is useful. Cefuroxime is mainly used in so-called calculated antibiotic therapy for urinary tract infections and hospital-acquired pneumonia (nosocomial), i.e. immediate antibiotic treatment without exact pathogen detection. Cefuroxime is also used in the treatment of prophylactic antibiotic treatment accompanying surgery, for severe soft-tissue infections and to combat the bacterium Haemophilus influenza.
Interactions
Antibiotics that have an inhibitory effect on bacteria and are taken at the same time can weaken the effect of cefuroxime. For this reason, no combination with tetracyclines, sulfonamides, erythromycin or chloramphenicol should be taken. If cefuroxime is taken together with aminoglycoside antibiotics or drainage drugs from the group of loop diuretics, there is a risk of kidney damage.
If cefuroxime is taken together with blood-thinning medications (anticoagulants), the blood-thinning effect is increased and there is a risk of increased bleeding tendency with skin bleeding. The agent Probenecid increases the cefuroxime effect when taken in parallel. By impairing the oestrogen circulation, cefuroxime can weaken the effectiveness of oral contraceptives (“pill”) and even cancel it out completely.
Contraindications
In case of an existing cephalosporin allergy and renal insufficiency cefuroxime should not be taken.