Overview
Cefuroxime axetil is a second-generation cephalosporin antibiotic with broad-spectrum activity against many Gram-positive and Gram-negative bacteria. It is commonly used to treat various infections including respiratory tract infections, skin and soft tissue infections, and urinary tract infections. The drug works by inhibiting bacterial cell wall synthesis, leading to bacterial cell death.
Mechanism of Action
Cefuroxime axetil is a prodrug that is hydrolyzed to active cefuroxime after oral administration. Cefuroxime binds to penicillin-binding proteins (PBPs) on bacterial cell walls, inhibiting the final transpeptidation step of peptidoglycan synthesis. This disruption of cell wall formation leads to osmotic instability and bacterial cell lysis.
Indications
- Acute bacterial otitis media
- Pharyngitis and tonsillitis
- Acute bacterial sinusitis
- Acute bacterial exacerbations of chronic bronchitis
- Uncomplicated skin and skin structure infections
- Uncomplicated urinary tract infections
- Uncomplicated gonorrhea
Common Doses
- 250 mg
- 500 mg
Dosage
Typical adult dosage is 250-500 mg twice daily depending on infection severity and type. For children, dosage is based on body weight (10-15 mg/kg twice daily). Should be taken with food to enhance absorption. Duration typically ranges from 5-10 days depending on infection type.
Contraindications
- Known hypersensitivity to cefuroxime axetil
- Hypersensitivity to other β-lactam antibacterial drugs including penicillins and cephalosporins
- History of anaphylactic reactions to cephalosporins
Side Effects
- Diarrhea
- Nausea
- Vomiting
- Abdominal pain
- Headache
- Dizziness
- Rash
- Elevated liver enzymes
- Vaginal candidiasis
- Pseudomembranous colitis
- Anaphylactic reactions
Interactions
- Probenecid may increase cefuroxime serum concentrations
- Antacids and H2-receptor antagonists may reduce absorption
- Oral contraceptives may have reduced efficacy
- Warfarin monitoring recommended due to potential interaction
Counseling Points
- Take with food to improve absorption
- Complete full course of therapy even if symptoms improve
- Report severe diarrhea, rash, or signs of allergic reaction immediately
- May reduce effectiveness of oral contraceptives - use alternative contraception
- Store at room temperature away from moisture