Source: Health Products Regulatory Authority (ZA) Revision Year: 2015 Publisher: RANBAXY PHARMACEUTICALS (PTY) LTD, 14 Lautre Road, Stormill, Ext.1, Roodepoort, 1724, South Africa
Pharmacological classification: A 20.1.1 Broad and medium spectrum antibiotics
Cefuroxime is a bactericidal second-generation cephalosporin. The antibacterial action of cefuroxime results from inhibition of bacterial cell wall synthesis by binding to essential target proteins in bacterial cytoplasmic membranes. Cefuroxime has bactericidal activity against a wide range of bacterial organisms, including beta-lactamase producing strains.
The prevalence of acquired resistance may vary geographically and with time for selected species and local information on resistance is desirable, particularly when treating severe infections. As necessary, expert advice should be sought when the local prevalence of resistance is such that the utility of cefuroxime axetil in at least some types of infections is questionable.
Cefuroxime is usually active against the following microorganisms in vitro.
Gram-positive aerobes:
Streptococcus pneumonia
Gram-negative aerobes:
Citrobacter freundii
Enterobacter aerogenes
Enterobacter cloacae
Escherichia coli
Klebsiella pneumoniae
Proteus mirabilis
Proteus spp. (other than P. vulgaris)
Providencia spp.
Gram-positive anaerobes:
Peptostreptococcus spp.
Propionibacterium spp.
Gram-negative anaerobes:
Fusobacterium spp.
Bacteroides spp.
Inherently resistant microorganisms
Gram-positive aerobes:
Enterococcus faecalis
Enterococcus faecium
Gram-negative aerobes:
Acinetobacter spp.
Campylobacter spp.
Morganella morganii
Proteus vulgaris
Pseudomonas aeruginosa
Serratia marcescens
Gram-negative anaerobes:
Bacteroides fragilis
Others:
Chlamydia spp.
Mycoplasma spp.
Legionella spp.
* All methicillin-resistant S. aureus are resistant to cefuroxime.
Cefuroxime axetil is an oral prodrug of cefuroxime. After oral absorption, cefuroxime axetil is hydrolysed in the intestinal mucosa and blood to release cefuroxime into the plasma. Oral absorption is optimal when administered with food. Peak serum levels of cefuroxime occur approximately two to three hours after oral dosing when taken with food. Protein binding is approximately 33% to 50%. Cefuroxime is not metabolised and is excreted unchanged in the urine by glomerular filtration and tubular secretion. The elimination half-life is between 1 and 1,5 hours after oral dosing. The elimination half-life is prolonged with renal impairment and in neonates. Serum levels of cefuroxime are reduced by dialysis.
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