Cefuroxime: 7 things you should know

Medically reviewed by Carmen Pope, BPharm. Last updated on Feb 12, 2024.

1. How it works

• Cefuroxime is an antibiotic that is used to treat infections caused by susceptible strains of bacteria.
• Cefuroxime belongs to the class of antibiotics known as cephalosporins. Cefuroxime is a second-generation cephalosporin. Second-generation cephalosporins have enhanced activity against gram-negative bacteria compared with first-generation cephalosporins but still retain some activity against gram-positive bacteria. They are also more resistant to beta-lactamase.
• Cephalosporins are bactericidal (kill bacteria) and work in a similar way to penicillins. They bind to and block the activity of enzymes responsible for making peptidoglycan, an important component of the bacterial cell wall. They are called broad-spectrum antibiotics because they are effective against a wide range of bacteria.

2. Upsides

• Treats a wide range of infections such as those occurring in the respiratory tract, ear, skin, genitourinary area, and bone.
• Cefuroxime may be used to treat tonsillitis in adults and children aged 13 years and over with mild-to-moderate infection caused by susceptible strains of Streptococcus pyogenes. Research has not established if cefuroxime is effective at preventing rheumatic fever or if it is effective at treating penicillin-resistant strains of S. pyrogenes.
• Other examples of infections that may be treated with cefuroxime include acute bacterial otitis media or maxillary sinusitis, acute exacerbations of chronic bronchitis, and uncomplicated gonorrhea.
• Also used for the early treatment of Lyme disease caused by susceptible strains of Borrelia burgdorferi in adults and children over the age of 13 years.
• Cefuroxime has excellent activity against gram-positive streptococci and gram-negative aerobes including susceptible isolates of Staphylococcus aureus (methicillin-susceptible isolates only), Streptococcus pneumoniae, S. pyrogens, Escherichia coli, Haemophilus influenzae, Klebsiella pneumoniae, Haemophilus parainfluenzae, Moraxella catarrhalis, and Neisseria gonorrhoeae. Most extended-spectrum β-lactamase (ESBL)-producing and carbapenemase-producing isolates are resistant to cefuroxime.
• Available as oral tablets, an oral suspension, and in an injectable form.
• May be given twice or three times daily depending on the severity of the infection.
• May be given with or without food.
• Has been used in children as young as 3 months for acute bacterial maxillary sinusitis.
• Generic cefuroxime is available.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Diarrhea, nausea, or vomiting have been reported. May alter some laboratory tests. Rarely, may cause seizures (the risk is higher with overdosage).
• A very small percentage of people who are allergic to penicillin are also allergic to cephalosporins. Tell your doctor if you have ever had an allergy to antibiotics.
• The dosage of cefuroxime may need to be reduced in severe renal impairment.
• Severe diarrhea, caused by an overgrowth of a bacteria called Clostridium difficile, is a potential side effect of almost all antibacterial agents, including cefuroxime. Symptoms include persistent, watery, and sometimes bloody diarrhea.
• May not be suitable for some people including those allergic to penicillin or other cephalosporins.
• May interact with some drugs including oral contraceptives, drugs that reduce gastric acidity (such as antacids, omeprazole), probenecid, and some urine glucose tests.
• The use of antibiotics, including cefuroxime, has been associated with the development of drug-resistant bacteria. Cefuroxime should only be used to treat infections caused by bacteria that are susceptible to it.
• Research has suggested cefuroxime is NOT associated with an increased risk of major birth defects or miscarriage during pregnancy. Cefuroxime has been shown to distribute into human breast milk, but at a rate that is less than 1% of the adult dose.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

• Cefuroxime is a second-generation cephalosporin-type antibiotic that may be used for the treatment of bacterial infections caused by susceptible strains of bacteria. It is mainly effective against Streptococci, beta-lactamase-producing bacteria, and gram-negative aerobes.

5. Tips

• Can be taken with or without food.
• Take exactly as directed and for the duration intended. Usually dosed every 12 hours.
• Only use when prescribed by a doctor to treat infections caused by susceptible bacteria as improper use increases the chance of resistant bacteria developing. Cefuroxime will not treat viral infections such as the flu.
• Seek urgent advice if you develop any allergy-like symptoms while taking cefuroxime.
• Seek medical advice if chronic diarrhea develops during or following a course of cefuroxime.
• Children or adults should be given the suspension if they cannot swallow tablets because cefuroxime tablets taste bitter when crushed.
• If you take antacids, do not take them at the same time as cefuroxime because they may affect the absorption of cefuroxime. Take either an hour afterward or at least two hours before the cefuroxime.
• Talk to your doctor if you develop any worrying side effects after taking cefuroxime such as abdominal pain, excessive bruising or bleeding, or a rash.
• Tell your doctor if you are pregnant, intending to become pregnant, or breastfeeding before taking cefuroxime. They will discuss the risks versus benefits with you.

6. Response and effectiveness

• Peak concentrations are reached one hour after dosing; however, it may take up to 48 hours before infection-related symptoms start to abate.
• Cefuroxime tablets and cefuroxime suspension are not equivalent in terms of dosage on a mg per mg basis.

7. Interactions

Medicines that interact with cefuroxime may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with cefuroxime. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed. Common medications that may interact with cefuroxime include:

• antacids such as aluminum hydroxide, calcium carbonate, magnesium hydroxide, or sodium bicarbonate, which may affect the absorption of cefuroxime
• BCG intravesical (eg, Theracrys)
• gout medications, such as probenecid
• immunosuppressants, such as mycophenolate mofetil or mycophenolic acid
• indigestion and reflux medications such as cimetidine, dexlansoprazole, famotidine, nizatidine, rabeprazole, ranitidine, which may affect the absorption of cefuroxime
• typhoid vaccine (Vivotif).

Avoid eating grapefruit and drinking grapefruit juice while taking cefuroxime. Cefuroxime may cause a false-positive reaction for glucose in the urine with copper reduction tests (eg, Benedict's or Fehling's solution), but not with enzyme-based tests.

Note that this list is not all-inclusive and includes only common medications that may interact with cefuroxime. You should refer to the prescribing information for cefuroxime for a complete list of interactions.

References

• Cefuroxime (oral/injection). Revised 10/2023. Cerner Multum. https://www.drugs.com/mtm/cefuroxime-oral-injection.html

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use cefuroxime only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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