cefuroxime
Regulatory sources consulted
Approved indications
- Susceptible throat, sinus, middle-ear, bronchial, urinary, and skin infections and early Lyme disease.
Contraindications
Absolute
- Hypersensitivity to cefuroxime or cephalosporins, or a history of a severe immediate hypersensitivity reaction to another beta-lactam.
Clinical warnings
- Major warning · It may cause severe hypersensitivity or anaphylaxis. Review any history of immediate beta-lactam reactions before use and discontinue if an allergic reaction occurs. — DailyMed, set_id 76cec54f-d167-4298-951b-5411a3c47f4a
- Major warning · It may cause Clostridioides difficile-associated diarrhea during or after treatment; assess significant diarrhea and avoid antiperistaltic drugs if colitis is suspected. — DailyMed, set_id 76cec54f-d167-4298-951b-5411a3c47f4a
Drug interactions
- ModerateProbenecid
Mechanism: It reduces renal tubular secretion and may increase and prolong antibiotic exposure.
Recommendation: Avoid the combination unless deliberately indicated and monitor toxicity.
DailyMed, set_id 76cec54f-d167-4298-951b-5411a3c47f4a
- ModerateDrugs that reduce gastric acidity
Mechanism: They may reduce cefuroxime axetil bioavailability.
Recommendation: Avoid concomitant administration when possible and monitor response.
DailyMed, set_id 76cec54f-d167-4298-951b-5411a3c47f4a
- HighOral anticoagulants
Mechanism: The antibiotic and infection may increase INR or bleeding risk.
Recommendation: Monitor INR and bleeding during and shortly after treatment.
DailyMed, set_id 76cec54f-d167-4298-951b-5411a3c47f4a
- ModerateCombined oral contraceptives
Mechanism: Changes in gut flora may reduce estrogen reabsorption and contraceptive effectiveness.
Recommendation: Use an additional contraceptive method during treatment.
DailyMed, set_id 76cec54f-d167-4298-951b-5411a3c47f4a
Adverse events
Common (≥1%)
Nausea, diarrhea, and rash
Rare but serious
Anaphylaxis, C. difficile colitis, and severe cytopenias
Pregnancy and lactation
Use during pregnancy only when clearly indicated. Small amounts pass into milk; monitor the infant for diarrhea, candidiasis, or sensitization and assess continuation according to the product.
Recent literature (PubMed)
Age-related cataract, defined as progressive opacification or clouding of the eye's natural lens, is a leading cause of visual disability and blindness. Cataract surgery is one of the most commonly performed procedures in high-income countries. More than 3.5 million cataract operations are performed annually in the US. Older age is the primary risk factor for cataracts, with approximately two-thirds of the population older than 80 years affected. As the population ages, the number of people with cataracts in the US is expected to increase to 50 million by 2050. Additional risk factors for cataracts include a hereditary or genetic predisposition, certain medications (corticosteroids), ocular trauma, significant UV exposure or radiation therapy, and certain medical conditions such as uncontrolled diabetes, retinitis pigmentosa, Down syndrome, and congenital rubella. Painless, progressive blurring of vision and visual glare are common symptoms of cataracts. Cataracts are diagnosed during an eye examination by an ophthalmologist or optometrist. Surgery to remove the cataract and implant a permanent intraocular lens (IOL) is indicated if visual impairment impedes activities of daily living and is associated with lower rates of falls (>30%) and dementia (20%-30%). Most cataract operations are performed with topical anesthesia. Therefore, patients do not require preoperative general medical testing such as bloodwork or electrocardiogram, and do not need to discontinue anticoagulants for cataract surgery. Systemic α1-adrenergic antagonists for symptomatic benign prostatic hyperplasia, such as tamsulosin, increase the risk of surgical complications and some ophthalmologists temporarily discontinue the drug preoperatively. Intraocular antibiotics, such as moxifloxacin or cefuroxime, delivered intraoperatively have reduced the rates of sight-threatening postsurgical endophthalmitis from 0.07% to 0.02%. In addition to reversing and preventing progressive vision loss, cataract s
Antibiotics are thought to decelerate inflammation progression and reduce complications in acute uncomplicated appendicitis. The evidence of their effectiveness is insufficient, and treatment practices vary widely. To investigate the effect of preoperatively started antibiotic treatment on the rate of appendiceal perforation. This multicenter, noninferiority, open-label randomized clinical trial was conducted in 2 hospitals in Finland and 1 hospital in Norway between May 18, 2020, and January 22, 2023. Data analysis was performed from March 2023 to March 2024. Eligible patients were adults (aged >18 years) diagnosed with presumed uncomplicated acute appendicitis. Patients with allergies or other contraindications to study antibiotics, previously started antibiotic treatment, pregnancy, a suspicion of perforated appendicitis, or other reasons to perform prompt surgery were excluded. Patients were randomized 1:1 with a web-based service simultaneously as the laparoscopic appendectomy was scheduled. Antibiotic treatment started while waiting for surgery (cefuroxime, 1500 mg, and metronidazole, 500 mg, every 8 hours until the surgery) or waiting without antibiotic treatment. Patients in both groups received a single prophylactic dose of antibiotics in the induction of anesthesia. The primary outcome was perforated appendicitis diagnosed during surgery. The absolute difference in perforation rates was compared between the groups by an intention-to-treat analysis, and the predefined noninferiority margin was 5 percentage points. Secondary outcomes included surgical site infections within 30 days. A total of 1797 patients were randomly assigned to either the antibiotic group (n = 901) or no-antibiotic group (n = 896). Median (IQR) patient age was 35 (28-46) years, and 793 patients (45%) were female. After randomization, 23 patients (1.3%) were excluded, leaving 1774 patients for the intention-to-treat analyses. The difference between the appendiceal perforation rates met t