Cefuroxime

Cefuroxime is a cephalosporin antibiotic available in oral tablet and injectable forms, each approved for specific infections depending on the product and route used.

• Cefuroxime Axetil tablets (oral): Pharyngitis/tonsillitis (adults and patients 13+); acute bacterial otitis media (ear infection) in pediatric patients who can swallow tablets whole; acute bacterial maxillary sinusitis (adults and patients 13+, and younger children who can swallow tablets); acute bacterial exacerbations of chronic bronchitis (adults and patients 13+); uncomplicated skin and skin-structure infections (adults and patients 13+); uncomplicated urinary tract infections (adults and patients 13+); uncomplicated gonorrhea (adults and patients 13+); early Lyme disease (adults and patients 13+)
• Cefuroxime and Cefuroxime sodium injections (IV/IM): Lower respiratory tract infections, including pneumonia; urinary tract infections; skin and skin-structure infections; septicemia (bloodstream infection); meningitis; gonorrhea (uncomplicated and disseminated); bone and joint infections
• Cefuroxime and Cefuroxime sodium injections (surgical prevention): Reducing the risk of postoperative infections in certain clean-contaminated or potentially contaminated surgical procedures, including vaginal hysterectomy and open heart surgery

Cefuroxime is a beta-lactam cephalosporin antibiotic. It works by attacking the bacteria's cell wall — specifically by binding to proteins the bacteria need to build and maintain their outer wall. Without an intact cell wall, the bacteria can't survive. This makes cefuroxime effective against a wide range of bacteria that cause infections in the lungs, urinary tract, skin, blood, joints, and elsewhere.

Like all antibiotics, cefuroxime only works against bacterial infections — it has no effect on viral illnesses such as colds or flu. Using it only when truly needed helps preserve its effectiveness and reduces the risk of antibiotic-resistant bacteria developing.

Cefuroxime Axetil tablets are taken by mouth, typically twice a day (every 12 hours). They can be taken with or without food, but absorption is meaningfully better after a meal, so taking them with food is a good habit. The injectable forms — Cefuroxime and Cefuroxime sodium — are given by a healthcare provider intravenously or intramuscularly, generally every 6 to 8 hours for most infections, with the exact schedule depending on the severity and type of infection.

• Always finish the full course your prescriber recommends, even if you feel better before it's done
• Cefuroxime Axetil tablets and oral suspension are NOT interchangeable milligram-for-milligram — do not switch between them without your doctor's guidance
• Dose reduction is needed for patients with significant kidney impairment — tell your prescriber about any kidney issues

The most common side effects with cefuroxime axetil tablets include:

• Diarrhea
• Nausea or vomiting
• Abdominal pain or cramps
• Headache
• Rash or itching
• Vaginitis (vaginal irritation or discharge)
• Temporary elevations in liver enzymes (detected on blood tests)
• Jarisch-Herxheimer reaction — a temporary flu-like flare that can occur when treating early Lyme disease

Seek immediate medical help if you experience signs of a serious allergic reaction (difficulty breathing, swelling of the face or throat, hives), persistent or bloody diarrhea, yellowing of the skin or eyes, seizures, or severe skin blistering or peeling — these are rare but serious reactions that need prompt attention.

• Serious allergic reactions (anaphylaxis): Rare but potentially life-threatening. Most likely in people with a prior allergy to penicillins or cephalosporins. Symptoms include hives, facial swelling, difficulty breathing, and rapid heartbeat. Seek emergency care immediately if this occurs.
• C. difficile-associated diarrhea (CDAD): Cefuroxime, like most antibiotics, can disrupt gut bacteria and allow C. difficile to overgrow, causing diarrhea that can become severe colitis. This can occur even 2 months after finishing the antibiotic. Report persistent or worsening diarrhea to your doctor promptly.
• Serious skin reactions: Rare but severe skin conditions including Stevens-Johnson syndrome and toxic epidermal necrolysis have been reported. Stop the medication and get medical help if you develop spreading rash, blistering, or peeling skin.
• Risk of drug-resistant bacteria: Using cefuroxime when it is not needed increases the chance of bacteria becoming resistant to treatment. Use it only as prescribed.
• Blood and liver effects: Rare blood disorders (low platelets, low white cells) and liver problems including hepatitis and jaundice have been reported. Report unusual bruising, bleeding, or yellowing of skin to your doctor.

Cefuroxime axetil tablets can interact with several medications and affect certain lab tests:

• Antacids, H2 blockers (e.g., famotidine, ranitidine), and proton pump inhibitors (e.g., omeprazole): These reduce stomach acid and can lower how much cefuroxime axetil your body absorbs. Avoid them if possible, or take cefuroxime axetil at least 1 hour before or 2 hours after a short-acting antacid.
• Probenecid (used for gout): Increases cefuroxime levels in the blood — co-administration with cefuroxime axetil tablets is not recommended.
• Oral contraceptives (combined estrogen/progesterone pills): Cefuroxime may reduce the effectiveness of hormonal birth control by affecting gut bacteria that help process estrogen. Use a backup non-hormonal method during treatment.
• Urine glucose tests: Cefuroxime can cause falsely positive results on copper-reduction urine glucose tests (such as Benedict's or Fehling's solution). Use an enzyme-based test for accurate results. It may also cause false-negative results on ferricyanide blood glucose tests.

This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.

• Penicillin or cephalosporin allergy: Cefuroxime is contraindicated if you have had a serious allergic reaction (such as anaphylaxis) to any penicillin or cephalosporin antibiotic. Tell your doctor about any prior antibiotic reactions.
• Kidney disease: Cefuroxime is cleared mainly through the kidneys — dose adjustment is required for patients with severe kidney impairment.
• Older adults: Elderly patients are more likely to have reduced kidney function, which can increase the risk of side effects. Careful dose selection and kidney monitoring are recommended.
• Pregnancy: Available human data have not shown a clear risk of birth defects or pregnancy complications from cefuroxime, but your doctor will weigh the benefits and risks for your situation.
• Breastfeeding: Cefuroxime passes into breast milk in small amounts. Discuss with your doctor whether to continue breastfeeding during treatment.
• Children: Cefuroxime Axetil tablets are approved for certain infections in children as young as 3 months (for sinusitis, based on adult data) and for ear infections in children who can swallow tablets whole. Younger children or those who cannot swallow tablets whole should use the appropriate formulation as directed by their doctor.

Taking too much cefuroxime can irritate the brain and nervous system, potentially causing seizures (convulsions) or encephalopathy (brain dysfunction). If an overdose is suspected, seek emergency medical care immediately. Blood levels of cefuroxime can be reduced with hemodialysis or peritoneal dialysis if needed.

When Cefuroxime Axetil tablets are swallowed, the drug is absorbed from the gut and quickly converted by enzymes in the gut lining and blood into active cefuroxime. Absorption is meaningfully better when the tablet is taken after a meal — bioavailability rises from about 37% fasted to about 52% fed. Once in the bloodstream, about half of cefuroxime is bound to proteins, and it distributes throughout the body's extracellular (outside-cell) fluids. Cefuroxime is not significantly broken down by the body — roughly half of the dose is excreted unchanged in the urine within 12 hours, making kidney function an important factor in how the drug is cleared and how doses should be adjusted.

Store at 20° to 25°C (68° to 77°F); excursions permitted to 15° to 30°C (59° to 86°F) .