Cefuroxime
antibiotic · cephalosporin
Third-party optionBy the Layer Nutrition editorial team · How the atlas classifies the 664 molecules
What this medicine is for
Pharmacologically, Cefuroxime relates to the category “antibiotic (cephalosporin)”. Antibiotics treat infections caused by bacteria. They are taken as a course, over a set duration, until the end of the prescription.
In the case of Cefuroxime, this means: Treats a bacterial infection. Its use is generally limited in time, adjusted to the situation.
Under which brands it is found
Cefuroxime is found in about 6 presentations listed in France. It comes under various trade names and in generic form.
- Aprokam
- Cefuroxime Arrow
- Cefuroxime Panpharma
- Cefuroxime Viatris
- Iceca
- Zinnat
Original brand-name products and generics deliver the same active substance; the choice between them is made with your doctor or pharmacist.
On your plate: potassium
The diarrhea and vomiting that can occur with cefuroxime cause a loss of water and electrolytes. These digestive losses are among the recognized causes of a drop in blood potassium. Diet remains the simplest way to replenish it.
Potassium is found in many everyday foods. Among vegetables and starches: potatoes with the skin, sweet potatoes, tomatoes, beans and lentils. Among fruits: bananas, citrus such as the orange, and apricots, keeping in mind that dried apricots contain more than fresh ones.
Dairy products such as milk and yogurt, nuts, as well as fatty meats and fish such as salmon and sardines also provide it. Spreading these foods across meals helps make up for the losses, in addition to your treatment.
How cefuroxime works
Cefuroxime is a bactericidal antibiotic in the cephalosporin family, which itself belongs to the beta-lactams. Its action targets the bacterial wall directly. It binds to the penicillin-binding proteins, enzymes called transpeptidases that assemble the mesh of peptidoglycan, the rigid network surrounding the bacterial cell. By blocking these enzymes, it prevents the cross-linking of the peptidoglycan units.
Deprived of a functional wall, the bacterium can no longer resist and dies: this is the bactericidal effect. Bacteria can escape it in several ways, by producing beta-lactamases that hydrolyze the molecule, by modifying their penicillin-binding proteins, by reducing their permeability or by expelling it through efflux pumps. Cefuroxime nonetheless retains activity in the presence of some of these enzymes, the penicillinases and the cephalosporinases.
Why it is prescribed
Cefuroxime treats specific bacterial infections, when a susceptible bacterium is involved. It is prescribed for pharyngitis and tonsillitis, acute otitis media, acute maxillary sinusitis, acute exacerbations of chronic bronchitis, certain uncomplicated skin infections and uncomplicated urinary tract infections. It also covers uncomplicated gonorrhea and early Lyme disease, at the erythema migrans stage.
The choice of this antibiotic depends on the targeted bacterium and its susceptibility. It has no action on viral infections, such as a cold or the flu. The duration of treatment is set by the doctor according to the infection, and following it is part of the treatment.
How to take it day to day
The cefuroxime axetil tablet is taken with a meal. Food increases its absorption: the absolute bioavailability rises from 37% on an empty stomach to 52% after a meal. Taking the tablet while eating therefore improves the amount of drug that reaches the blood.
The elimination half-life is short, 1.2 to 1.3 hours, which calls for a regular rhythm: the tablet is usually taken every 12 hours, for 5 to 20 days depending on the infection. Spacing the doses evenly maintains an effective concentration. You should not stop as soon as you feel better, because interrupting too early lets the least susceptible bacteria survive and encourages relapses and resistance.
The effects to know about
The most frequent adverse effects involve the digestive tract. In the multiple-dose regimens covering 912 subjects, diarrhea affects 4% of people and nausea or vomiting 3%. Transient elevations appear in laboratory tests: AST 2%, ALT 2%, eosinophilia 1%, and LDH 1%. In the treatment of early Lyme disease, over 20 days, diarrhea reaches 10.6%, a Jarisch-Herxheimer reaction occurs in 5.6% and vaginitis in 5.4%.
Like all broad-spectrum antibiotics, cefuroxime can upset the intestinal flora and open the way to Clostridioides difficile colitis. Loose or bloody stools, cramps or fever can appear during treatment or up to two months after it is stopped. These signs should prompt medical advice without delay.
Interactions to be aware of
Several drugs modify cefuroxime concentrations. Probenecid slows its renal elimination and increases its exposure, by about 50% for the area under the curve and 21% for the peak. Conversely, drugs that reduce stomach acidity, antacids, H2 blockers and proton pump inhibitors, decrease the tablet's bioavailability compared with taking it on an empty stomach.
Cefuroxime can also reduce the effectiveness of hormonal contraceptives, and an additional method of contraception may then be needed during treatment. Telling your doctor about all the medicines you take helps anticipate these interactions.
Monitoring and a distinctive feature of the molecule
Cefuroxime is eliminated by the kidneys, almost without transformation: about half the dose is found unchanged in the urine within 12 hours, and nearly half of the serum fraction circulates bound to proteins. Because elimination is renal, kidney function guides dose adjustment. Monitoring of cephalosporins also watches the PT/INR when there is a risk of hypoprothrombinemia and stays attentive to the onset of colitis.
Cefuroxime differs from certain other cephalosporins. Molecules carrying an N-methylthiotetrazole side chain, such as cefamandole, cefotetan, cefoperazone, cefmetazole or moxalactam, expose to a drop in prothrombin, to interference with vitamin K and to disulfiram-type reactions with alcohol. Cefuroxime does not have this side chain and is not associated with these complications.
Sources
Related molecules
To explore in the « Anti-infectives » family and its neighbours.
See the whole « Anti-infectives » family · Back to the atlas
Supplements to consider
Beyond the plate, a single isolated nutrient can be worth discussing, to confirm with your doctor or pharmacist. Here is which one and in which form.
Probiotics
Probiotics are live micro-organisms, mainly lactobacilli and bifidobacteria. The CFU count and the number of strains are among the selection criteria; gastro-resistant capsules protect the bacteria from stomach acidity.
Preferred form gastro-resistant capsules, several strains, CFU count stated
Frequently asked questions
What is cefuroxime used for?
Cefuroxime is an antibiotic in the cephalosporin family, used against certain bacterial infections, notably respiratory, ear-nose-throat or urinary. Its oral form is cefuroxime axetil. The choice of antibiotic and the length of treatment are up to your doctor: refer to the patient leaflet and follow the prescription.
What are the most common cefuroxime side effects?
The patient leaflet notably mentions digestive upset such as diarrhea, nausea or stomach pain, and sometimes skin reactions. This information is for guidance only: read the leaflet and report any bothersome effect to your doctor or pharmacist.
Can you drink alcohol while taking cefuroxime?
Unlike some other antibiotics, the cefuroxime patient leaflet does not describe a specific major interaction with alcohol, but caution is still advisable during an infection. For your specific situation, ask your doctor or pharmacist for advice and refer to the patient leaflet.
Cefuroxime during pregnancy or breastfeeding: what does the leaflet say?
Use during pregnancy or breastfeeding must be assessed case by case by a healthcare professional, who weighs the expected benefit. Do not decide on your own: talk it over with your doctor or pharmacist and read the patient leaflet before taking any.
What should you do if you miss a dose of cefuroxime?
As a general rule, a missed dose is made up as soon as possible, without doubling the next one, and it is important to complete the full course as prescribed. The exact instructions are in the patient leaflet: if in doubt, call your pharmacist or doctor.
Should you take probiotics for gut flora while on an antibiotic like cefuroxime?
Antibiotics also act on the bacteria of the gut microbiome, and studies link their use to a temporary imbalance of the flora, sometimes causing diarrhea. Research connects taking probiotics with better digestive comfort in this context: the active ingredient to consider is a documented strain, for example Saccharomyces boulardii or Lactobacillus rhamnosus, in the form of an identified live strain. Ask your doctor or pharmacist for advice before combining any with your treatment.
Ces réponses portent sur le volet nutritionnel. Pour toute question sur votre médicament, la notice et votre médecin ou pharmacien font foi.