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<script type="text/javascript" src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.boots.min.js"> </script><title>Cefuroxime - StatPearls - NCBI Bookshelf</title>
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<meta name="citation_title" content="Cefuroxime">
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<meta name="citation_date" content="2024/01/11">
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<meta name="citation_author" content="Adekunle E. Omole">
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<meta name="citation_author" content="Ayoola O. Awosika">
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<meta name="citation_author" content="Preeti Patel">
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<meta name="citation_pmid" content="38261689">
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<meta name="DC.Contributor" content="Adekunle E. Omole">
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<meta name="DC.Contributor" content="Ayoola O. Awosika">
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<meta name="DC.Contributor" content="Preeti Patel">
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<meta name="DC.Date" content="2024/01/11">
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<meta name="description" content="Cefuroxime belongs to the second generation of cephalosporin antibiotics and is classified as a β-lactam agent. Cefuroxime was approved by the U.S. Food and Drug Administration (FDA) in December 1987, and it exhibits broad-spectrum activity against both gram-positive and gram-negative organisms, making the drug effective for treating a wide range of bacterial infections. Cefuroxime is frequently utilized for empirical therapy in community-acquired infections, including upper and lower respiratory tract infections, genitourinary tract infections, skin and soft tissue infections, and Lyme disease.">
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<meta name="og:description" content="Cefuroxime belongs to the second generation of cephalosporin antibiotics and is classified as a β-lactam agent. Cefuroxime was approved by the U.S. Food and Drug Administration (FDA) in December 1987, and it exhibits broad-spectrum activity against both gram-positive and gram-negative organisms, making the drug effective for treating a wide range of bacterial infections. Cefuroxime is frequently utilized for empirical therapy in community-acquired infections, including upper and lower respiratory tract infections, genitourinary tract infections, skin and soft tissue infections, and Lyme disease.">
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</svg> Books</a></div><div class="jr-rhead f1 flexh"><div class="head"></div><div class="body"><div class="t">Cefuroxime</div><div class="j">StatPearls [Internet]</div></div><div class="tail"></div></div><div id="jr-tb2"><a id="jr-bkhelp-sw" class="btn wsprkl hidden" title="Help with NLM PubReader">?</a><a id="jr-help-sw" class="btn wsprkl hidden" title="Settings and typography in NLM PubReader"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512" preserveAspectRatio="none"><path d="M462,283.742v-55.485l-29.981-10.662c-11.431-4.065-20.628-12.794-25.274-24.001 c-0.002-0.004-0.004-0.009-0.006-0.013c-4.659-11.235-4.333-23.918,0.889-34.903l13.653-28.724l-39.234-39.234l-28.72,13.652 c-10.979,5.219-23.68,5.546-34.908,0.889c-0.005-0.002-0.01-0.003-0.014-0.005c-11.215-4.65-19.933-13.834-24-25.273L283.741,50 h-55.484l-10.662,29.981c-4.065,11.431-12.794,20.627-24.001,25.274c-0.005,0.002-0.009,0.004-0.014,0.005 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600" preserveAspectRatio="none"><path fill="none" stroke="#000" stroke-width="36" stroke-linecap="round" style="fill:#FFF" d="m320,350a153,153 0 1,0-2,2l170,170m-91-117 110,110-26,26-110-110"></path></svg></a><a id="jr-fip-done" class="wsprkl btn" title="Dismiss find">✘</a></nav><nav id="jr-fip-info-p"><a id="jr-fip-prev" class="wsprkl btn" title="Jump to previuos match">◀</a><button id="jr-fip-matches">no matches yet</button><a id="jr-fip-next" class="wsprkl btn" title="Jump to next match">▶</a></nav></nav></div><div id="jr-epub-interstitial" class="hidden"></div><div id="jr-content"><article data-type="main"><div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><div class="fm-sec"><h1 id="_NBK599503_"><span class="title" itemprop="name">Cefuroxime</span></h1><p class="contribs">Omole AE, Awosika AO, Patel P.</p><p class="fm-aai"><a href="#_NBK599503_pubdet_">Publication Details</a></p></div></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="article-159953.s1"><h2 id="_article-159953_s1_">Continuing Education Activity</h2><p>Cefuroxime belongs to the second generation of cephalosporin antibiotics and is classified as a β-lactam agent. Cefuroxime was approved by the U.S. Food and Drug Administration (FDA) in December 1987, and it exhibits broad-spectrum activity against both gram-positive and gram-negative organisms, making the drug effective for treating a wide range of bacterial infections. Cefuroxime is frequently utilized for empirical therapy in community-acquired infections, including upper and lower respiratory tract infections, genitourinary tract infections, skin and soft tissue infections, and Lyme disease.</p><p>This activity emphasizes the efficacy of cefuroxime in treating bacterial infections and highlights the importance of selecting the appropriate antibiotic. This activity also focuses on the mechanism of action, pathophysiology of resistance, pharmacokinetics, administration, adverse drug reactions, drug interactions, and medical toxicology of cefuroxime. Furthermore, this course highlights the critical roles of healthcare professionals in making informed decisions about patient therapy and preventing antibiotic resistance. By addressing critical aspects of cefuroxime treatment, healthcare professionals contribute to the overarching goal of antimicrobial stewardship and confirm the public health benefits that come with it.</p><p>
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<ul><li class="half_rhythm"><div>Identify the appropriate indications for cefuroxime, recognizing its role in treating various bacterial infections, including upper and lower respiratory tract infections, genitourinary tract infections, skin and soft tissue infections, and Lyme disease.</div></li><li class="half_rhythm"><div>Screen patients effectively to assess their suitability for cefuroxime therapy, considering factors such as allergies, renal function, and concurrent medications.</div></li><li class="half_rhythm"><div>Select cefuroxime as part of an antimicrobial stewardship program, emphasizing targeted therapy to combat antibiotic resistance.</div></li><li class="half_rhythm"><div>Collaborate with interdisciplinary healthcare team members to optimize patient outcomes and align cefuroxime therapy with broader treatment goals.</div></li></ul>
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<a href="https://www.statpearls.com/account/trialuserreg/?articleid=159953&utm_source=pubmed&utm_campaign=reviews&utm_content=159953" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Access free multiple choice questions on this topic.</a>
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</p></div><div id="article-159953.s2"><h2 id="_article-159953_s2_">Indications</h2><p>Cefuroxime belongs to the second generation of cephalosporin antibiotics and is classified as a β-lactam agent. Cefuroxime was approved by the U.S. Food and Drug Administration (FDA) in December 1987, and it exhibits broad-spectrum activity against both gram-positive and gram-negative organisms, making the drug effective for treating a wide range of bacterial infections.<a class="bibr" href="#article-159953.r1" rid="article-159953.r1">[1]</a><a class="bibr" href="#article-159953.r2" rid="article-159953.r2">[2]</a> Cefuroxime is frequently utilized for empirical therapy in community-acquired infections, including upper and lower respiratory tract infections, genitourinary tract infections, skin and soft tissue infections (SSTIs), and Lyme disease.</p><p>
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<b>FDA-Approved Indications of Parenteral Cefuroxime</b>
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</p><p>
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<b>Lower respiratory tract infections:</b> Cefuroxime is recommended for treating lower respiratory tract infections caused by <i>Streptococcus pneumonia</i>, <i>S pyogenes</i>, <i>Haemophilus influenzae</i> (including ampicillin-resistant strains), <i>Staphylococcus aureus</i> (including penicillinase- and non-penicillinase–producing strains), and <i>Klebsiella</i> spp. The guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) endorse the use of cefuroxime for community-acquired pneumonia.<a class="bibr" href="#article-159953.r3" rid="article-159953.r3">[3]</a></p><p>
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<b>Urinary tract infections:</b> Cefuroxime is indicated for treating urinary tract infections (UTIs) caused by susceptible strains of <i>Klebsiella </i>spp<i>.</i> and <i>Escherichia coli</i>.</p><p>
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<b>Skin and skin structure infections:</b> Cefuroxime is indicated for treating SSTIs caused by <i>S pyogenes</i>, <i>S aureus</i> (including penicillinase- and non-penicillinase-producing strains), <i>E coli, Klebsiella</i> spp., and <i>Enterobacter</i> spp.</p><p>
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<b>Septicemia:</b> Cefuroxime is indicated for the treatment of septicemia caused by susceptible strains of <i>H influenzae</i> (including ampicillin-resistant strains), <i>S aureus</i> (including penicillinase- and non-penicillinase–producing strains), <i>E coli, S pneumoniae, </i>and <i>Klebsiella </i>spp<i>.</i></p><p>
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<b>Meningitis:</b> Cefuroxime is effective for treating meningitis caused by <i>Neisseria meningitidis, S pneumoniae, H influenzae</i> (including ampicillin-resistant strains), and <i>S aureus</i> (including penicillinase- and non-penicillinase–producing strains).</p><p>
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<b>Uncomplicated and disseminated gonococcal infections:</b> Cefuroxime may be considered for treating susceptible strains of Neisseria gonorrhoeae (including penicillinase- and non-penicillinase–producing bacteria). Notably, ceftriaxone is the preferred agent due to resistance.<a class="bibr" href="#article-159953.r4" rid="article-159953.r4">[4]</a></p><p>
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<b>Bone and joint infections:</b> Cefuroxime is effective against susceptible strains of <i>S aureus</i> (including penicillinase- and non-penicillinase-producing strains).</p><p>
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<b>FDA-Approved Indications of Oral Cefuroxime</b>
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</p><p>
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<b>Pharyngitis or tonsillitis:</b> Cefuroxime is indicated for the treatment of mild-to-moderate pharyngitis or tonsillitis in adult and pediatric patients aged 13 or older caused by susceptible strains of<i> S pyogenes. </i>Notably, the efficacy of cefuroxime in preventing rheumatic fever has not been established in clinical trials. In addition, the effectiveness of cefuroxime in treating penicillin-resistant <i>S pyogenes</i> has not been demonstrated.<a class="bibr" href="#article-159953.r5" rid="article-159953.r5">[5]</a></p><p>
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<b>Acute bacterial otitis media:</b> Cefuroxime is indicated for the treatment of acute bacterial otitis media due to susceptible strains of <i>H influenzae</i> (including β-lactamase–producing strains), <i>S pneumoniae</i>,<i> S pyogenes</i> or <i>Moraxella catarrhalis</i> (including β-lactamase–producing strains).<a class="bibr" href="#article-159953.r6" rid="article-159953.r6">[6]</a></p><p>
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<b>Acute bacterial maxillary sinusitis:</b> Cefuroxime is effective for treating mild-to-moderate acute bacterial maxillary sinusitis in adult and pediatric patients aged 13 or older due to susceptible strains of <i>H influenzae</i> (non-β-lactamase-producing strains only) or <i>S pneumonia</i>. The effectiveness of cefuroxime for sinusitis due to <i>H influenzae</i> (including β–lactamase–producing strains) or <i>M catarrhalis</i> in acute bacterial maxillary sinusitis has not been proven.</p><p>
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<b>Acute bacterial exacerbations of chronic bronchitis:</b> Cefuroxime is indicated for the treatment of mild-to-moderate acute exacerbations of chronic bronchitis in adult and pediatric patients aged 13 or older. This drug is effective against strains of <i>H influenzae</i> (β-lactamase–negative strains), <i>S pneumoniae</i>, and <i>H</i> <i>parainfluenzae</i> (β-lactamase–negative strains).<a class="bibr" href="#article-159953.r7" rid="article-159953.r7">[7]</a></p><p>
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<b>Uncomplicated UTIs:</b> Cefuroxime is indicated for the treatment of uncomplicated UTIs in adult and pediatric patients aged 13 or older caused by susceptible strains of <i>E coli</i> or<i> Klebsiella pneumonia</i>.<a class="bibr" href="#article-159953.r8" rid="article-159953.r8">[8]</a></p><p>
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<b>Uncomplicated SSTIs:</b> Cefuroxime is indicated for the treatment of uncomplicated SSTIs in adult and pediatric patients aged 13 or older, which is caused by susceptible strains of <i>S aureus</i> (including β-lactamase-producing strains) or <i>S pyogenes</i>.</p><p>
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<b>Early Lyme disease (erythema migrans):</b> Cefuroxime is FDA-approved for the treatment of early Lyme disease in adults and pediatric patients aged 13 or older, which is caused by susceptible strains of Borrelia burgdorferi. The joint guidelines by the IDSA, American Academy of Neurology (AAN), and American College of Radiology (ACR) recommend cefuroxime for erythema migrans. Other preferred agents recommended in these guidelines include doxycycline or amoxicillin.<a class="bibr" href="#article-159953.r9" rid="article-159953.r9">[9]</a></p><p>
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<b>Off-Label Uses</b>
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</p><p>Cefuroxime is utilized off-label for intraabdominal infections,<a class="bibr" href="#article-159953.r10" rid="article-159953.r10">[10]</a> antimicrobial prophylaxis in surgery, <a class="bibr" href="#article-159953.r11" rid="article-159953.r11">[11]</a> and odontogenic infections.<a class="bibr" href="#article-159953.r12" rid="article-159953.r12">[12]</a></p><p>
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<b>Antimicrobial Stewardship</b>
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</p><p>Although the list of bacterial susceptibility should guide the selection of appropriate antibiotics, it is crucial to incorporate clinical judgment and consider antimicrobial resistance. To prevent the development of drug-resistant bacteria and ensure the effectiveness of cefuroxime and other antibacterial drugs, one should only use them for treating or preventing infections caused by susceptible bacteria. Healthcare professionals should use available culture and susceptibility data to guide treatment selection. According to IDSA, facility-specific guidelines can standardize prescribing practices based on local epidemiology. In instances where such data are unavailable, susceptibility patterns may aid in selecting the appropriate therapy. Antimicrobial stewardship programs promote the proper use of oral antibiotics and facilitate a timely transition from intravenous (IV) to oral antibiotics.<a class="bibr" href="#article-159953.r13" rid="article-159953.r13">[13]</a></p></div><div id="article-159953.s3"><h2 id="_article-159953_s3_">Mechanism of Action</h2><p>Bacterial cell walls are strengthened by cross-linking peptidoglycan units through the action of penicillin-binding proteins (PBPs), specifically peptidoglycan transpeptidase.<a class="bibr" href="#article-159953.r14" rid="article-159953.r14">[14]</a> The peptidoglycan layer protects the cell wall from lysis. As a bactericidal agent, cefuroxime binds to PBPs via β-lactam rings. This binding inhibits the transpeptidation or cross-linking in the peptidoglycan cell wall synthesis of susceptible bacterial organisms.<a class="bibr" href="#article-159953.r2" rid="article-159953.r2">[2]</a><a class="bibr" href="#article-159953.r15" rid="article-159953.r15">[15]</a> Although PBP3 is the primary target of cefuroxime, it can also inhibit PBP 1a and PBP 1b.<a class="bibr" href="#article-159953.r16" rid="article-159953.r16">[16]</a><a class="bibr" href="#article-159953.r17" rid="article-159953.r17">[17]</a> This inhibition of the bacteria's ability to form a functional cell wall leads to death through osmotic lysis.<a class="bibr" href="#article-159953.r18" rid="article-159953.r18">[18]</a></p><p>
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<b>Susceptible Organisms</b>
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</p><p>
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<b>Gram-positive aerobic bacteria: </b>These bacteria include <i>S aureus</i>, <i>S epidermidis</i>, <i>S pneumonia</i>,<a class="bibr" href="#article-159953.r19" rid="article-159953.r19">[19]</a><i> </i>and<i> S pyogenes.</i></p><p>Notably, cefuroxime is generally ineffective against most strains of enterococci (eg, <i>Enterococcus faecalis</i>). In addition, the medication does not effectively target methicillin-resistant <i>Staphylococcus</i> <i>aureus</i> (MRSA) and <i>Listeria monocytogenes</i>.</p><p>
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<b>Gram-negative aerobic bacteria:</b> These bacteria include <i>Citrobacter </i>spp<i>., </i><i>Enterobacter </i>spp<i>., </i><i>E coli</i>,<i> H influenzae</i> (including methicillin-resistant strains),<a class="bibr" href="#article-159953.r20" rid="article-159953.r20">[20]</a><a class="bibr" href="#article-159953.r21" rid="article-159953.r21">[21]</a><i> H parainfluenza</i>, <i>Klebsiella </i>spp<i>.</i> (including <i>K pneumonia</i>), <i>M catarrhalis </i>(including ampicillin- and cephalothin-resistant strains), <i>Morganella morganii</i>, <i>N gonorrhoeae</i> (including penicillinase- and non-penicillinase-producing strains),<a class="bibr" href="#article-159953.r22" rid="article-159953.r22">[22]</a><i> N meningitidis</i>,<i> Proteus mirabilis</i>,<i> Providencia rettgeri</i>,<i> Salmonella </i>spp<i>.</i>, and <i>Shigella </i>spp<i>.</i></p><p>Notably, in vitro tests have indicated resistance to cefuroxime in some strains of <i>M morganii, Enterobacter cloacae, </i>and<i> Citrobacter </i>spp. Furthermore, cefuroxime is generally ineffective against <i>Pseudomonas</i> and <i>Campylobacter</i> spp., <i>Acinetobacter</i>
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<i>calcoaceticus</i>, and the majority of strains from <i>Serratia </i>spp<i>.</i> and <i>P</i> <i>vulgaris</i>.<a class="bibr" href="#article-159953.r23" rid="article-159953.r23">[23]</a><a class="bibr" href="#article-159953.r24" rid="article-159953.r24">[24]</a><a class="bibr" href="#article-159953.r25" rid="article-159953.r25">[25]</a></p><p>
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<b>Anaerobic bacteria:</b> These bacteria include <i>Bacteroides</i>, <i>Clostridium</i>, <i>Fusobacterium</i>, <i>Peptococcus</i><i>,</i> and <i>Peptostreptococcus </i>species<i>.</i></p><p>Notably, <i>Clostridium difficile</i> and most strains of<i> Bacteroides fragilis</i> are resistant to cefuroxime.</p><p>
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<b>Resistance</b>
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</p><p>The global challenge of developing resistance to antibacterial agents is substantial. Bacteria primarily acquire resistance to cefuroxime through various mechanisms, as listed below.</p><p>
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<b>Drug inactivation or modification:</b> Certain bacteria can produce β-lactamases, which can cause hydrolysis of the β-lactam ring of cefuroxime, thus hindering its bactericidal effects. Despite its susceptibility, cefuroxime exhibits high stability in the presence of most β-lactamase strains.<a class="bibr" href="#article-159953.r2" rid="article-159953.r2">[2]</a></p><p>
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<b>Alteration of target or binding site:</b> Modifications occur in the binding site of cefuroxime's PBPs, rendering it ineffective against MRSA and penicillin-resistant strains of <i>S pneumoniae</i>. MRSA possesses a resistant gene, <i>mecA</i>, encoding PBP 2a. PBP 2a differs from other PBPs, as its active site does not bind to methicillin or other β-lactam antibiotics. Consequently, acquiring <i>mecA</i> confers resistance to methicillin and β-lactam antibiotics, as their β-lactam ring cannot interact with PBP 2a.<a class="bibr" href="#article-159953.r26" rid="article-159953.r26">[26]</a></p><p>
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<b>Alteration in cell membrane penetration:</b> This phenomenon is predominantly observed in gram-negative bacteria due to the impermeable outer membrane of their cell wall. The diminished penetration of the antibiotic through the outer membrane of the bacteria prevents the drug from reaching the target PBPs. <i>Pseudomonas aeruginosa</i> provides an illustrative example of this mechanism.<a class="bibr" href="#article-159953.r27" rid="article-159953.r27">[27]</a><a class="bibr" href="#article-159953.r28" rid="article-159953.r28">[28]</a></p><p>
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<b>Pharmacokinetics</b>
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</p><p>Understanding the pharmacokinetic profile of cefuroxime is necessary for appropriate dosing, monitoring, and optimizing therapeutic outcomes. The fundamental aspects of cefuroxime's pharmacokinetics are mentioned below.<a class="bibr" href="#article-159953.r29" rid="article-159953.r29">[29]</a></p><p>
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<b>Absorption:</b> Cefuroxime can be administered orally or parenterally. The parent molecule, cefuroxime, exhibits poor absorption after oral administration. Cefuroxime axetil, the ester prodrug form of cefuroxime, is effectively absorbed from the intestines and promptly converted to cefuroxime through hydrolysis by esterases in the mucosal cells of the gastrointestinal tract. Subsequently, it is released into the systemic circulation, significantly enhancing absorption in the presence of food. </p><p>The bioavailability of cefuroxime axetil tablets is about 37% on an empty stomach and increases to around 52% if taken after food. Following oral administration, adults typically reach peak serum concentration of cefuroxime in about 2 to 3 hours, while in children, it takes approximately 3 to 4 hours.<a class="bibr" href="#article-159953.r22" rid="article-159953.r22">[22]</a> Cefuroxime is rapidly absorbed into the bloodstream after intramuscular (IM) or IV injection, with the peak serum concentration achieved in about 2 to 3 minutes after IV administration.</p><p>
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<b>Distribution:</b> Cefuroxime exhibits a relatively small volume of distribution of 0.25 to 0.3 L/kg, with approximately 33% to 50% of the drug binding to plasma proteins. Cefuroxime effectively penetrates various tissues, including tonsils, sinus tissues, lungs, bronchial mucosa, aqueous humor of the eye, and middle ear effusion. Notably, cefuroxime demonstrates good penetration into bone tissue—a valuable attribute in treating odontogenic infections.<a class="bibr" href="#article-159953.r30" rid="article-159953.r30">[30]</a></p><p>
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<b>Metabolism:</b> The active parent compound cefuroxime is produced from its ester prodrug.<a class="bibr" href="#article-159953.r31" rid="article-159953.r31">[31]</a></p><p>
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<b>Elimination</b>: Cefuroxime is excreted by the kidney as an unchanged drug, resulting in a high urinary concentration.<a class="bibr" href="#article-159953.r32" rid="article-159953.r32">[32]</a> Approximately 50% of the dose can be recovered in the urine within 12 hours. The elimination half-life of cefuroxime is about 1 to 2 hours in adults and 1.4 to 1.9 hours in children. The pharmacokinetics of cefuroxime is influenced by its renal excretion, with decreasing renal function increasing its half-life.<a class="bibr" href="#article-159953.r33" rid="article-159953.r33">[33]</a></p></div><div id="article-159953.s4"><h2 id="_article-159953_s4_">Administration</h2><p>
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<b>Available Dosage Forms and Strengths</b>
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</p><p>Cefuroxime is available in various formulations, including oral tablets, oral suspension, and powder for injections. The oral tablet cefuroxime axetil is available in strengths of 250 mg and 500 mg. The oral suspensions are available in concentrations of 125 mg/5 mL and 250 mg/5 mL. The powder for injection form is supplied in vials containing 750 mg, 1.5 g, and 7.5 g of cefuroxime as cefuroxime sodium. Administration of the powder for injection can be done either via IM or IV route.</p><p>
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<b>Adult Dosage</b>
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</p><p>Cefuroxime is administered twice or thrice daily, depending on the severity of the infection.<a class="bibr" href="#article-159953.r34" rid="article-159953.r34">[34]</a> The tablets and oral suspension demonstrate non-bioequivalence, making them non-substitutable on a milligram-to-milligram basis.</p><p>
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<b>Pharyngitis or tonsillitis:</b> The recommended dosage of cefuroxime is 250 mg PO every 12 hours for 10 days.</p><p>
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<b>Acute bacterial maxillary sinusitis:</b> The recommended dosage of cefuroxime is 250 mg PO every 12 hours for 10 days.</p><p>
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<b>Acute bacterial exacerbations of chronic bronchitis:</b> The recommended dosage of cefuroxime is 250 to 500 mg PO every 12 hours for 10 days. Alternatively, the suggested dosage for IV administration is 500 to 750 mg every 8 hours, with a switch to oral cefuroxime as soon as clinically possible.</p><p>
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<b>Uncomplicated pneumonia:</b> The recommended dosage of cefuroxime is 750 mg administered IV or IM every 8 hours.</p><p>
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<b>Uncomplicated skin and skin structure infections:</b> The recommended dosage of cefuroxime is 250 to 500 mg PO every 12 hours for 10 days. Alternatively, the suggested dosage for IV or IM administration is 750 mg every 8 hours, with a switch to oral cefuroxime as soon as clinically possible.</p><p>
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<b>Uncomplicated UTIs:</b> The recommended dosage of cefuroxime is 125 to 250 mg PO every 12 hours for 7 to 10 days. Alternatively, the suggested dosage for IV or IM administration is 750 mg every 8 hours, with a switch to oral cefuroxime as soon as clinically possible.</p><p>
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<b>Gonorrhea:</b> Cefuroxime is not the preferred choice due to bacterial resistance. The reference dosage per the product label for uncomplicated gonococcal infection is 1.5 g administered IM as a single dose at 2 anatomical sites and 1 g of oral probenecid.</p><p>
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<b>Early Lyme disease:</b> The recommended dosage is 500 mg PO every 12 hours for 20 days as per AAN/IDSA/ACR guidelines. Treatment for erythema migrans may be sufficient with a 14-day course, but carditis and arthritis may necessitate prolonged treatment.<a class="bibr" href="#article-159953.r9" rid="article-159953.r9">[9]</a></p><p>
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<b>Pediatric Dosage </b>
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</p><p>
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<b>Pharyngitis or tonsillitis:</b> The recommended dosage for children aged 3 months to 12 years is 20 mg/kg/d PO every 12 hours for 10 days, with a maximum daily dosage of 500 mg/d. Alternatively, for IV or IM administration, the dosage is 75 to 150 mg/kg/d every 8 hours for 10 days, with a maximum daily dosage of 6 g/d. The suggested dosage for individuals aged 12 and older is 250 mg PO every 12 hours for 10 days.</p><p>
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<b>Acute bacterial maxillary sinusitis:</b> The recommended dosage for children aged 3 months to 12 years is 30 mg/kg/d of suspension PO every 12 hours for 10 days, with a maximum daily dosage of 1 g/d. Alternatively, for IV or IM administration, the dosage is 75 to 150 mg/kg/d every 8 hours for 10 days, with a maximum daily dosage of 6 g/d. The suggested dosage for individuals aged 12 or older is 250 mg PO every 12 hours for 10 days.</p><p>
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<b>Acute otitis media:</b> The recommended dosage for children aged 3 months to 12 years is 30 mg/kg/d of suspension PO every 12 hours for 10 days, with a maximum daily dosage of 1 g/d. Alternatively, for IV or IM administration, the dosage is 75 to 150 mg/kg/d every 8 hours for 10 days, with a maximum daily dosage of 6 g/d. The suggested dosage for individuals aged 12 or older is 250 mg PO every 12 hours for 10 days.</p><p>
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<b>Impetigo:</b> The recommended dosage for children aged 3 months to 12 years is 30 mg/kg/d of suspension PO every 12 hours for 10 days, with a maximum daily dosage of 1 g/d. Alternatively, for IV or IM administration, the dosage is 75 to 150 mg/kg/d every 8 hours for 10 days, with a maximum daily dosage of 6 g/d. The suggested dosage for individuals aged 12 or older is 250 mg PO every 12 hours for 10 days.</p><p>
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<b>Specific Patient Populations</b>
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</p><p>
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<b>Hepatic impairment:</b> Cefuroxime has not been extensively studied in patients with hepatic impairment, and as a result, there are no specific recommendations regarding its use in this population. As the metabolism of cefuroxime is not dependent on hepatic function, dosage adjustment is not necessary in patients with hepatic impairment.<a class="bibr" href="#article-159953.r35" rid="article-159953.r35">[35]</a></p><p>
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<b>Renal impairment:</b> The degree of the impairment determines the dosage adjustment of cefuroxime. In individuals with creatinine clearance (CrCl) levels ranging between 10 and 30 mL/min, the recommended frequency for standard individual dose administration is every 24 hours. In patients with CrCl levels below 10 mL/min, the recommended frequency is every 48 hours. Those undergoing hemodialysis should receive an additional standard dose after each dialysis session. For IV or IM injection, the dosage should be reduced to 750 mg twice daily if CrCl is 10 to 20 mL/min and 750 mg once daily if CrCl is less than 10 mL/min. Cefuroxime is effectively removed by dialysis, and an additional dose should be given at the end of dialysis.<a class="bibr" href="#article-159953.r36" rid="article-159953.r36">[36]</a></p><p>
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<b>Pregnancy considerations:</b> Cefuroxime is classified as an FDA pregnancy category B drug. The available data from published studies do not indicate any association between cefuroxime and major congenital disabilities, miscarriage, or adverse outcomes for the fetus or mother. Animal reproduction studies have revealed no evidence of fetal risk or impaired fertility. Although considered safe in pregnancy, cefuroxime use should be limited to situations where it is deemed necessary.<a class="bibr" href="#article-159953.r37" rid="article-159953.r37">[37]</a> The American College of Obstetricians and Gynecologists (ACOG) acknowledges cefuroxime as a viable off-label option for preventing infection during cesarean delivery.<a class="bibr" href="#article-159953.r38" rid="article-159953.r38">[38]</a></p><p>
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<b>Breastfeeding considerations:</b> As cefuroxime is excreted in human milk, caution is required in lactating mothers. Potential adverse effects, such as diarrhea or thrush, may occur in breastfed infants. The concentration of cefuroxime in breast milk is typically low and depends on maternal dose, administration timing, and the presence of mastitis. Although adverse effects are not generally severe, careful monitoring is advised to ensure the well-being of breastfed infants.</p><p>
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<b>Pediatric patients:</b> The safety and efficacy of cefuroxime have not been established in pediatric patients younger than 3 months. Currently, recommendations for treating infection with cefuroxime in this age group are absent.<a class="bibr" href="#article-159953.r2" rid="article-159953.r2">[2]</a> The dosage of cefuroxime for pediatric patients is based on body weight.<a class="bibr" href="#article-159953.r39" rid="article-159953.r39">[39]</a></p><p>
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<b>Older patients:</b> Research indicates no significant disparities in safety and efficacy between older and younger patients. Given the substantial renal excretion of cefuroxime, caution is advised in dose selection for older patients due to their increased potential for decreased renal function.<a class="bibr" href="#article-159953.r2" rid="article-159953.r2">[2]</a><a class="bibr" href="#article-159953.r22" rid="article-159953.r22">[22]</a></p></div><div id="article-159953.s5"><h2 id="_article-159953_s5_">Adverse Effects</h2><p>Similar to penicillins and most β-lactam antibiotics, cefuroxime is generally well-tolerated. However, cefuroxime may potentially lead to adverse drug reactions in some patients, as seen with other medications. The most commonly reported adverse drug reactions are gastrointestinal disturbances, including nausea, vomiting, and diarrhea.<a class="bibr" href="#article-159953.r22" rid="article-159953.r22">[22]</a> Additional gastrointestinal adverse drug reactions include anorexia, abdominal pain, dizziness, and headache. In cases of parenteral administration, local reactions at the injection site, including thrombophlebitis, can occur.</p><p>Cefuroxime may elicit hypersensitivity reactions, including pruritis, urticaria, and skin rashes. In rare instances, severe reactions, such as anaphylaxis, drug fever, erythema multiforme, toxic epidermal necrolysis, and Stevens-Johnson syndrome, have been reported.<a class="bibr" href="#article-159953.r40" rid="article-159953.r40">[40]</a> Reports indicate decreased hemoglobin or hematocrit, eosinophilia, and prolonged prothrombin time associated with cefuroxime use.<a class="bibr" href="#article-159953.r41" rid="article-159953.r41">[41]</a><a class="bibr" href="#article-159953.r42" rid="article-159953.r42">[42]</a> Furthermore, elevations in bilirubin and liver enzymes, including aspartate transaminase, alanine transaminase, and alkaline phosphatase, have been observed.</p><p>Case reports have also documented instances of acute kidney injury attributed to cefuroxime.<a class="bibr" href="#article-159953.r43" rid="article-159953.r43">[43]</a> Furthermore, a post-marketing surveillance study identified a statistically significant elevated risk of delirium associated with several antibiotics, including cefuroxime.<a class="bibr" href="#article-159953.r44" rid="article-159953.r44">[44]</a> Similar to all broad-spectrum antibacterial agents, <i>C difficile–</i>associated diarrhea and<i> </i>pseudomembranous colitis have been noted during and after courses of cefuroxime.<a class="bibr" href="#article-159953.r2" rid="article-159953.r2">[2]</a></p><p>
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<b>Drug-Drug Interactions</b>
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</p><ul><li class="half_rhythm"><div>Cefuroxime may interact with drugs that serve as substrates, inhibitors, or inducers of renal tubular secretion, including probenecid, furosemide, or penicillins. These interactions can influence the renal clearance and serum levels of cefuroxime by competing for or modifying the activity of organic anion transporters in the kidney. Notably, probenecid can increase the concentration of cefuroxime in the blood.</div></li></ul><ul><li class="half_rhythm"><div>Drugs that decrease stomach acidity, such as proton pump inhibitors, H2-blockers, and antacids, may reduce the absorption of cefuroxime.<a class="bibr" href="#article-159953.r45" rid="article-159953.r45">[45]</a> Therefore, it is recommended to administer cefuroxime axetil at least 1 hour before or after the intake of these drugs.</div></li></ul><ul><li class="half_rhythm"><div>Cefuroxime may interact with highly protein-bound drugs, such as warfarin, phenytoin, or aspirin. These drugs can displace cefuroxime from its binding sites on plasma proteins, increasing its free fraction and potentially intensifying its antibacterial activity and adverse effects.</div></li></ul><ul><li class="half_rhythm"><div>Clinicians should exercise caution when concurrently using cefuroxime with nephrotoxic drugs, such as aminoglycosides and potent diuretics.<a class="bibr" href="#article-159953.r46" rid="article-159953.r46">[46]</a></div></li></ul></div><div id="article-159953.s6"><h2 id="_article-159953_s6_">Contraindications</h2><p>Cefuroxime is contraindicated in individuals with known or documented severe hypersensitivity or allergic/anaphylaxis reactions to penicillins, cephalosporins, or other drugs. Patients with a history of an anaphylactic response, Stevens-Johnson syndrome, or toxic epidermal necrolysis to penicillin should not receive cefuroxime or other cephalosporins.<a class="bibr" href="#article-159953.r47" rid="article-159953.r47">[47]</a> In patients with penicillin allergy, caution should be exercised when considering cefuroxime, and discontinuation of the medication is recommended if an allergic reaction occurs. Severe hypersensitivity reactions may require epinephrine and other emergency measures.<a class="bibr" href="#article-159953.r2" rid="article-159953.r2">[2]</a><a class="bibr" href="#article-159953.r22" rid="article-159953.r22">[22]</a></p><p>
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<b>Warnings and Precautions</b>
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</p><p>Caution should be exercised when administering cefuroxime to patients with prolonged prothrombin time or international normalized ratio, including those with poor nutritional status, renal disease, hepatic disease, prolonged antibiotic therapy, or those previously stabilized on anticoagulants. Administration of vitamin K may be necessary when warranted.</p><p>
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<b>Laboratory interference:</b> In patients taking cefuroxime, ferricyanide tests may lead to false-negative blood/plasma glucose results, while copper reduction tests may result in false-positive glucose readings in urine. It is recommended to use either the hexokinase or glucose oxidase method to determine plasma glucose levels in patients receiving cefuroxime.</p><p>
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<b>Pseudomembranous colitis and<i> C difficile</i> infection:</b> Broad-spectrum antibiotics, including cefuroxime, can disrupt the normal gastrointestinal flora, potentially leading to the development of pseudomembranous colitis. Healthcare practitioners are advised to use caution when prescribing cefuroxime, especially in patients with a history of pseudomembranous colitis or confirmed C<i> difficile</i>-associated disease.<a class="bibr" href="#article-159953.r2" rid="article-159953.r2">[2]</a><a class="bibr" href="#article-159953.r48" rid="article-159953.r48">[48]</a> If the diagnosis is confirmed, discontinuation of cefuroxime is recommended, and further management with fluid and electrolytes, along with antibiotic agents effective against <i>C difficile</i> (oral vancomycin or fidaxomicin), may be necessary.<a class="bibr" href="#article-159953.r49" rid="article-159953.r49">[49]</a></p></div><div id="article-159953.s7"><h2 id="_article-159953_s7_">Monitoring</h2><p>Cefuroxime administration and dosing necessitate adjustment in the geriatric population and individuals with poor renal function. Monitoring renal function is crucial, particularly in critically ill patients receiving higher doses and older patients. Clinicians should also monitor prothrombin time in at-risk patients and liver enzymes in individuals with hepatic dysfunction.<a class="bibr" href="#article-159953.r2" rid="article-159953.r2">[2]</a><a class="bibr" href="#article-159953.r22" rid="article-159953.r22">[22]</a></p></div><div id="article-159953.s8"><h2 id="_article-159953_s8_">Toxicity</h2><p>
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<b>Signs and Symptoms of Overdose</b>
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</p><p>Cefuroxime toxicity may present with a range of clinical signs and symptoms. Overdose of cefuroxime can induce cerebral irritation, potentially resulting in seizures.<a class="bibr" href="#article-159953.r22" rid="article-159953.r22">[22]</a> The risk of toxicity is elevated in individuals with impaired renal function. Caution is advised when administering cefuroxime to patients with a history of seizures, particularly those with poor renal function.</p><p>
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<b>Management of Overdose</b>
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</p><p>Prompt recognition and management of cefuroxime toxicity are crucial for mitigating potential risks. Immediate discontinuation of the drug is imperative in cases of suspected overdose or adverse reactions. Supportive care, including fluid resuscitation and electrolyte repletion, may be necessary to address fluid and electrolyte imbalances. In severe cases, particularly those involving neurological manifestations or anaphylactic reactions, advanced life support measures, including airway management and the administration of epinephrine, may be warranted.<a class="bibr" href="#article-159953.r47" rid="article-159953.r47">[47]</a> In instances of hematologic toxicity, close monitoring of blood counts and, if necessary, hematopoietic growth factors or transfusion therapy may be indicated. Hemodialysis may be considered in cases of severe overdose or in patients with renal impairment to enhance drug clearance and alleviate potential toxicity.</p></div><div id="article-159953.s9"><h2 id="_article-159953_s9_">Enhancing Healthcare Team Outcomes </h2><p>Effective management of a patient's condition when administering cefuroxime involves collaboration among various disciplines. Patients with bacterial infections benefit from interprofessional teamwork, requiring coordination, communication, and collaboration among clinicians, nurses, pharmacists, and other healthcare professionals. The shared goal of management is to optimize patient outcomes while ensuring the safe use of cefuroxime. Healthcare professionals can provide comprehensive care, monitor for potential adverse drug effects, and adjust the treatment plan through effective teamwork to achieve the best possible outcome for their patients.</p><p>Primary care clinicians, internists, and infectious disease (ID) specialists are critical in accurately diagnosing a bacterial infection, ensuring the administration of cefuroxime, and determining the appropriate indication, dosage, and duration of therapy. They also monitor for potential adverse drug effects and evaluate the response to treatment. Nurse practitioners and physician assistants can closely monitor patients for possible adverse drug reactions. Clinical pharmacists contribute by educating patients on medication details, administration, possible side effects, and potential drug interactions. Patients actively participate in their management by regularly updating clinicians and nurses about their experiences and overall well-being during the course of treatment. This collaborative approach ensures comprehensive care and optimal outcomes. </p><p>A prospective 4-year study conducted from 2006 to 2009 evaluated 1444 adult ID specialists' consultations. The main specialties seeking consultations included cardiology, orthopedics, general medicine, hematology-oncology, gastroenterology, and pulmonary or critical care. The primary reason for seeking consultations was to select antibiotics, which accounted for 75% of cases. The study found that consultations with ID specialists significantly reduced inappropriate antimicrobial therapy and dual therapy use, emphasizing the crucial role of ID physicians in optimizing treatment plans.<a class="bibr" href="#article-159953.r50" rid="article-159953.r50">[50]</a> The implementation of antimicrobial stewardship programs is essential to reduce inappropriate antibiotic use, including cephalosporins such as cefuroxime.<a class="bibr" href="#article-159953.r13" rid="article-159953.r13">[13]</a> However, emergency department care for severe bacterial infections should not be withheld. When a bacterial infection is suspected, it is advisable to begin treatment with broad-spectrum antibiotics. Subsequently, based on clinical improvement and microbiological results, antibiotic therapy can be refined to a more targeted or narrower spectrum.<a class="bibr" href="#article-159953.r51" rid="article-159953.r51">[51]</a></p><p>Effective interprofessional teamwork among healthcare professionals is characterized by open communication and shared decision-making, which is crucial for enhancing patient outcomes associated with cefuroxime therapy. Optimal outcomes related to cefuroxime therapy necessitate open communication and an interprofessional team approach involving clinicians (MDs, DOs, NPs, and PAs), specialists, pharmacists, infection control, and clinical microbiologists.</p></div><div id="article-159953.s10"><h2 id="_article-159953_s10_">Review Questions</h2><ul><li class="half_rhythm"><div>
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</div></li></ul></div><div id="article-159953.s11"><h2 id="_article-159953_s11_">References</h2><dl class="temp-labeled-list"><dl class="bkr_refwrap"><dt>1.</dt><dd><div class="bk_ref" id="article-159953.r1">O'Callaghan CH, Sykes RB, Griffiths A, Thornton JE. Cefuroxime, a new cephalosporin antibiotic: activity in vitro. <span><span class="ref-journal">Antimicrob Agents Chemother. </span>1976 Mar;<span class="ref-vol">9</span>(3):511-9.</span> [<a href="/pmc/articles/PMC429562/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC429562</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/1259407" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 1259407</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>2.</dt><dd><div class="bk_ref" id="article-159953.r2">Scott LJ, Ormrod D, Goa KL. Cefuroxime axetil: an updated review of its use in the management of bacterial infections. <span><span class="ref-journal">Drugs. </span>2001;<span class="ref-vol">61</span>(10):1455-500.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/11558834" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 11558834</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>3.</dt><dd><div class="bk_ref" id="article-159953.r3">Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, Cooley LA, Dean NC, Fine MJ, Flanders SA, Griffin MR, Metersky ML, Musher DM, Restrepo MI, Whitney CG. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. <span><span class="ref-journal">Am J Respir Crit Care Med. </span>2019 Oct 01;<span class="ref-vol">200</span>(7):e45-e67.</span> [<a href="/pmc/articles/PMC6812437/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6812437</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31573350" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31573350</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>4.</dt><dd><div class="bk_ref" id="article-159953.r4">Barbee LA, St Cyr SB. Management of Neisseria gonorrhoeae in the United States: Summary of Evidence From the Development of the 2020 Gonorrhea Treatment Recommendations and the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infection Treatment Guidelines. <span><span class="ref-journal">Clin Infect Dis. </span>2022 Apr 13;<span class="ref-vol">74</span>(Suppl_2):S95-S111.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/35416971" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35416971</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>5.</dt><dd><div class="bk_ref" id="article-159953.r5">van Driel ML, De Sutter AI, Thorning S, Christiaens T. Different antibiotic treatments for group A streptococcal pharyngitis. <span><span class="ref-journal">Cochrane Database Syst Rev. </span>2021 Mar 17;<span class="ref-vol">3</span>(3):CD004406.</span> [<a href="/pmc/articles/PMC8130996/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8130996</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33728634" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33728634</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>6.</dt><dd><div class="bk_ref" id="article-159953.r6">Dhuguru J, Zviagin E, Skouta R. FDA-Approved Oximes and Their Significance in Medicinal Chemistry. <span><span class="ref-journal">Pharmaceuticals (Basel). </span>2022 Jan 04;<span class="ref-vol">15</span>(1)</span> [<a href="/pmc/articles/PMC8779982/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8779982</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35056123" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35056123</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>7.</dt><dd><div class="bk_ref" id="article-159953.r7">Yoon HI, Lee CH, Kim DK, Park GM, Lee SM, Yim JJ, Kim JY, Lee JH, Lee CT, Chung HS, Kim YW, Han SK, Yoo CG. Efficacy of levofloxacin versus cefuroxime in treating acute exacerbations of chronic obstructive pulmonary disease. <span><span class="ref-journal">Int J Chron Obstruct Pulmon Dis. </span>2013;<span class="ref-vol">8</span>:329-34.</span> [<a href="/pmc/articles/PMC3711651/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3711651</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23874094" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23874094</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>8.</dt><dd><div class="bk_ref" id="article-159953.r8">Novelli A, Rosi E. Pharmacological properties of oral antibiotics for the treatment of uncomplicated urinary tract infections. <span><span class="ref-journal">J Chemother. </span>2017 Dec;<span class="ref-vol">29</span>(sup1):10-18.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/29271734" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29271734</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>9.</dt><dd><div class="bk_ref" id="article-159953.r9">Lantos PM, Rumbaugh J, Bockenstedt LK, Falck-Ytter YT, Aguero-Rosenfeld ME, Auwaerter PG, Baldwin K, Bannuru RR, Belani KK, Bowie WR, Branda JA, Clifford DB, DiMario FJ, Halperin JJ, Krause PJ, Lavergne V, Liang MH, Meissner HC, Nigrovic LE, Nocton JJJ, Osani MC, Pruitt AA, Rips J, Rosenfeld LE, Savoy ML, Sood SK, Steere AC, Strle F, Sundel R, Tsao J, Vaysbrot EE, Wormser GP, Zemel LS. Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease. <span><span class="ref-journal">Clin Infect Dis. </span>2021 Jan 23;<span class="ref-vol">72</span>(1):e1-e48.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/33417672" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33417672</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>10.</dt><dd><div class="bk_ref" id="article-159953.r10">Solomkin JS, Mazuski JE, Bradley JS, Rodvold KA, Goldstein EJ, Baron EJ, O'Neill PJ, Chow AW, Dellinger EP, Eachempati SR, Gorbach S, Hilfiker M, May AK, Nathens AB, Sawyer RG, Bartlett JG. Diagnosis and management of complicated intra-abdominal infection in adults and children: guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. <span><span class="ref-journal">Clin Infect Dis. </span>2010 Jan 15;<span class="ref-vol">50</span>(2):133-64.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/20034345" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20034345</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>11.</dt><dd><div class="bk_ref" id="article-159953.r11">Bratzler DW, Dellinger EP, Olsen KM, Perl TM, Auwaerter PG, Bolon MK, Fish DN, Napolitano LM, Sawyer RG, Slain D, Steinberg JP, Weinstein RA., American Society of Health-System Pharmacists. Infectious Disease Society of America. Surgical Infection Society. Society for Healthcare Epidemiology of America. Clinical practice guidelines for antimicrobial prophylaxis in surgery. <span><span class="ref-journal">Am J Health Syst Pharm. </span>2013 Feb 01;<span class="ref-vol">70</span>(3):195-283.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/23327981" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23327981</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>12.</dt><dd><div class="bk_ref" id="article-159953.r12">Zawiślak E, Nowak R. Odontogenic Head and Neck Region Infections Requiring Hospitalization: An 18-Month Retrospective Analysis. <span><span class="ref-journal">Biomed Res Int. </span>2021;<span class="ref-vol">2021</span>:7086763.</span> [<a href="/pmc/articles/PMC7834778/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7834778</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33532496" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33532496</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>13.</dt><dd><div class="bk_ref" id="article-159953.r13">Barlam TF, Cosgrove SE, Abbo LM, MacDougall C, Schuetz AN, Septimus EJ, Srinivasan A, Dellit TH, Falck-Ytter YT, Fishman NO, Hamilton CW, Jenkins TC, Lipsett PA, Malani PN, May LS, Moran GJ, Neuhauser MM, Newland JG, Ohl CA, Samore MH, Seo SK, Trivedi KK. Implementing an Antibiotic Stewardship Program: Guidelines by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America. <span><span class="ref-journal">Clin Infect Dis. </span>2016 May 15;<span class="ref-vol">62</span>(10):e51-77.</span> [<a href="/pmc/articles/PMC5006285/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC5006285</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/27080992" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 27080992</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>14.</dt><dd><div class="bk_ref" id="article-159953.r14">Bui T, Patel P, Preuss CV. <span class="ref-journal">StatPearls [Internet].</span> StatPearls Publishing; Treasure Island (FL): Feb 17, 2024. Cephalosporins. [<a href="https://pubmed.ncbi.nlm.nih.gov/31855361" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31855361</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>15.</dt><dd><div class="bk_ref" id="article-159953.r15">Marx MA, Fant WK. Cefuroxime axetil. <span><span class="ref-journal">Drug Intell Clin Pharm. </span>1988 Sep;<span class="ref-vol">22</span>(9):651-8.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/3063476" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3063476</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>16.</dt><dd><div class="bk_ref" id="article-159953.r16">Curtis NA, Orr D, Ross GW, Boulton MG. Competition of beta-lactam antibiotics for the penicillin-binding proteins of Pseudomonas aeruginosa, Enterobacter cloacae, Klebsiella aerogenes, Proteus rettgeri, and Escherichia coli: comparison with antibacterial activity and effects upon bacterial morphology. <span><span class="ref-journal">Antimicrob Agents Chemother. </span>1979 Sep;<span class="ref-vol">16</span>(3):325-8.</span> [<a href="/pmc/articles/PMC352854/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC352854</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/116592" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 116592</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>17.</dt><dd><div class="bk_ref" id="article-159953.r17">Dellamonica P. Cefuroxime axetil. <span><span class="ref-journal">Int J Antimicrob Agents. </span>1994 Mar;<span class="ref-vol">4</span>(1):23-36.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/18611587" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18611587</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>18.</dt><dd><div class="bk_ref" id="article-159953.r18">Sarkar P, Yarlagadda V, Ghosh C, Haldar J. A review on cell wall synthesis inhibitors with an emphasis on glycopeptide antibiotics. <span><span class="ref-journal">Medchemcomm. </span>2017 Mar 01;<span class="ref-vol">8</span>(3):516-533.</span> [<a href="/pmc/articles/PMC6072328/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6072328</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30108769" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30108769</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>19.</dt><dd><div class="bk_ref" id="article-159953.r19">Jones RN. Can antimicrobial activity be sustained? An appraisal of orally administered drugs used for respiratory tract infections. <span><span class="ref-journal">Diagn Microbiol Infect Dis. </span>1997 Jan-Feb;<span class="ref-vol">27</span>(1-2):21-8.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/9127102" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 9127102</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>20.</dt><dd><div class="bk_ref" id="article-159953.r20">Zhanel GG, Karlowsky JA, Low DE, Hoban DJ. Antibiotic resistance in respiratory tract isolates of Haemophilus influenzae and Moraxella catarrhalis collected from across Canada in 1997-1998. <span><span class="ref-journal">J Antimicrob Chemother. </span>2000 May;<span class="ref-vol">45</span>(5):655-62.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/10797089" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10797089</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>21.</dt><dd><div class="bk_ref" id="article-159953.r21">Richter SS, Brueggemann AB, Huynh HK, Rhomberg PR, Wingert EM, Flamm R, Doern GV. A 1997-1998 national surveillance study: Moraxella catarrhalis and Haemophilus influenzae antimicrobial resistance in 34 US institutions. <span><span class="ref-journal">Int J Antimicrob Agents. </span>1999 Oct;<span class="ref-vol">13</span>(2):99-107.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/10595568" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10595568</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>22.</dt><dd><div class="bk_ref" id="article-159953.r22">Perry CM, Brogden RN. Cefuroxime axetil. A review of its antibacterial activity, pharmacokinetic properties and therapeutic efficacy. <span><span class="ref-journal">Drugs. </span>1996 Jul;<span class="ref-vol">52</span>(1):125-58.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/8799689" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 8799689</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>23.</dt><dd><div class="bk_ref" id="article-159953.r23">Jones RN, Jenkins SG, Hoban DJ, Pfaller MA, Ramphal R. In vitro efficacy of six cephalosporins tested against Enterobacteriaceae isolated at 38 North American medical centres participating in the SENTRY Antimicrobial Surveillance Program, 1997-1998. <span><span class="ref-journal">Int J Antimicrob Agents. </span>2000 Jul;<span class="ref-vol">15</span>(2):111-8.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/10854806" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10854806</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>24.</dt><dd><div class="bk_ref" id="article-159953.r24">Fluit AC, Jones ME, Schmitz FJ, Acar J, Gupta R, Verhoef J. Antimicrobial susceptibility and frequency of occurrence of clinical blood isolates in Europe from the SENTRY antimicrobial surveillance program, 1997 and 1998. <span><span class="ref-journal">Clin Infect Dis. </span>2000 Mar;<span class="ref-vol">30</span>(3):454-60.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/10722427" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10722427</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>25.</dt><dd><div class="bk_ref" id="article-159953.r25">Jones RN, Croco MA, Kugler KC, Pfaller MA, Beach ML. Respiratory tract pathogens isolated from patients hospitalized with suspected pneumonia: frequency of occurrence and antimicrobial susceptibility patterns from the SENTRY Antimicrobial Surveillance Program (United States and Canada, 1997). <span><span class="ref-journal">Diagn Microbiol Infect Dis. </span>2000 Jun;<span class="ref-vol">37</span>(2):115-25.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/10863106" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10863106</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>26.</dt><dd><div class="bk_ref" id="article-159953.r26">Lowy FD. Antimicrobial resistance: the example of Staphylococcus aureus. <span><span class="ref-journal">J Clin Invest. </span>2003 May;<span class="ref-vol">111</span>(9):1265-73.</span> [<a href="/pmc/articles/PMC154455/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC154455</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/12727914" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 12727914</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>27.</dt><dd><div class="bk_ref" id="article-159953.r27">Pang Z, Raudonis R, Glick BR, Lin TJ, Cheng Z. Antibiotic resistance in Pseudomonas aeruginosa: mechanisms and alternative therapeutic strategies. <span><span class="ref-journal">Biotechnol Adv. </span>2019 Jan-Feb;<span class="ref-vol">37</span>(1):177-192.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/30500353" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30500353</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>28.</dt><dd><div class="bk_ref" id="article-159953.r28">Laborda P, Hernando-Amado S, Martínez JL, Sanz-García F. Antibiotic Resistance in Pseudomonas. <span><span class="ref-journal">Adv Exp Med Biol. </span>2022;<span class="ref-vol">1386</span>:117-143.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/36258071" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 36258071</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>29.</dt><dd><div class="bk_ref" id="article-159953.r29">Mendes GD, Borges A, de Cássia Val L, Patni AK, Reyar S, Monif T, Sereno D, Orellana AM, De Nucci G. Comparative bioavailability of cefuroxime axetil suspension formulations administered with food in healthy subjects. <span><span class="ref-journal">Arzneimittelforschung. </span>2010;<span class="ref-vol">60</span>(2):101-5.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/20329659" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20329659</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>30.</dt><dd><div class="bk_ref" id="article-159953.r30">DeAngelis AF, Barrowman RA, Harrod R, Nastri AL. Review article: Maxillofacial emergencies: oral pain and odontogenic infections. <span><span class="ref-journal">Emerg Med Australas. </span>2014 Aug;<span class="ref-vol">26</span>(4):336-42.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/25065769" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25065769</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>31.</dt><dd><div class="bk_ref" id="article-159953.r31">Khan AA, Atiya A, Akhtar S, Yadav Y, Qureshi KA, Jaremko M, Mahmood S. Optimization of a Cefuroxime Axetil-Loaded Liquid Self-Nanoemulsifying Drug Delivery System: Enhanced Solubility, Dissolution and Caco-2 Cell Uptake. <span><span class="ref-journal">Pharmaceutics. </span>2022 Apr 01;<span class="ref-vol">14</span>(4)</span> [<a href="/pmc/articles/PMC9028143/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC9028143</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/35456606" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 35456606</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>32.</dt><dd><div class="bk_ref" id="article-159953.r32">Shi AX, Qu Q, Zhuang HH, Teng XQ, Xu WX, Liu YP, Xiao YW, Qu J. Individualized antibiotic dosage regimens for patients with augmented renal clearance. <span><span class="ref-journal">Front Pharmacol. </span>2023;<span class="ref-vol">14</span>:1137975.</span> [<a href="/pmc/articles/PMC10410082/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC10410082</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/37564179" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 37564179</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>33.</dt><dd><div class="bk_ref" id="article-159953.r33">Viberg A, Lannergård A, Larsson A, Cars O, Karlsson MO, Sandström M. A population pharmacokinetic model for cefuroxime using cystatin C as a marker of renal function. <span><span class="ref-journal">Br J Clin Pharmacol. </span>2006 Sep;<span class="ref-vol">62</span>(3):297-303.</span> [<a href="/pmc/articles/PMC1885139/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1885139</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/16934045" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16934045</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>34.</dt><dd><div class="bk_ref" id="article-159953.r34">Arulappen AL, Danial M, Haron N, Hau LC, Khan AH. The Impact of Antimicrobial Stewardship Program on Injudicious Use of Cefuroxime. <span><span class="ref-journal">Front Pharmacol. </span>2020;<span class="ref-vol">11</span>:565818.</span> [<a href="/pmc/articles/PMC7921835/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7921835</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33664664" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33664664</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>35.</dt><dd><div class="bk_ref" id="article-159953.r35">Okolicsanyi L, Venuti M, Orlando R, Xerri L, Pugina M. Pharmacokinetic studies of cefuroxime in patients with liver cirrhosis. <span><span class="ref-journal">Arzneimittelforschung. </span>1982;<span class="ref-vol">32</span>(7):777-82.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/6889880" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6889880</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>36.</dt><dd><div class="bk_ref" id="article-159953.r36">Bathini L, Jandoc R, Kuwornu P, McArthur E, Weir MA, Sood MM, Battistella M, Muanda FT, Liu A, Jain AK, Garg AX. Clinical Outcomes of Failing to Dose-Reduce Cephalosporin Antibiotics in Older Adults with CKD. <span><span class="ref-journal">Clin J Am Soc Nephrol. </span>2019 Feb 07;<span class="ref-vol">14</span>(2):197-205.</span> [<a href="/pmc/articles/PMC6390923/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6390923</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30630861" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30630861</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>37.</dt><dd><div class="bk_ref" id="article-159953.r37">Dallmann A, Ince I, Solodenko J, Meyer M, Willmann S, Eissing T, Hempel G. Physiologically Based Pharmacokinetic Modeling of Renally Cleared Drugs in Pregnant Women. <span><span class="ref-journal">Clin Pharmacokinet. </span>2017 Dec;<span class="ref-vol">56</span>(12):1525-1541.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/28391404" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 28391404</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>38.</dt><dd><div class="bk_ref" id="article-159953.r38">Committee on Practice Bulletins-Obstetrics. ACOG Practice Bulletin No. 199: Use of Prophylactic Antibiotics in Labor and Delivery. <span><span class="ref-journal">Obstet Gynecol. </span>2018 Sep;<span class="ref-vol">132</span>(3):e103-e119.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/30134425" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30134425</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>39.</dt><dd><div class="bk_ref" id="article-159953.r39">Thønnings S, Jensen KS, Nielsen NB, Skjønnemand M, Hansen DS, Lange KHW, Frimodt-Møller N. Cefuroxime pharmacokinetics and pharmacodynamics for intravenous dosage regimens with 750 mg or 1500 mg doses in healthy young volunteers. <span><span class="ref-journal">J Med Microbiol. </span>2020 Mar;<span class="ref-vol">69</span>(3):387-395.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/31958049" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31958049</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>40.</dt><dd><div class="bk_ref" id="article-159953.r40"><span class="ref-journal">LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet].</span> National Institute of Diabetes and Digestive and Kidney Diseases; Bethesda (MD): Dec 20, 2021. Cephalosporins. [<a href="/pmc/articles/PMC547852/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC547852</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/31643977" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 31643977</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>41.</dt><dd><div class="bk_ref" id="article-159953.r41">Baillargeon J, Holmes HM, Lin YL, Raji MA, Sharma G, Kuo YF. Concurrent use of warfarin and antibiotics and the risk of bleeding in older adults. <span><span class="ref-journal">Am J Med. </span>2012 Feb;<span class="ref-vol">125</span>(2):183-9.</span> [<a href="/pmc/articles/PMC3712345/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3712345</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/22269622" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 22269622</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>42.</dt><dd><div class="bk_ref" id="article-159953.r42">Sharifzadeh S, Mohammadpour AH, Tavanaee A, Elyasi S. Antibacterial antibiotic-induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome: a literature review. <span><span class="ref-journal">Eur J Clin Pharmacol. </span>2021 Mar;<span class="ref-vol">77</span>(3):275-289.</span> [<a href="/pmc/articles/PMC7537982/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7537982</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/33025080" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 33025080</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>43.</dt><dd><div class="bk_ref" id="article-159953.r43">Bailey O, Torkington MS, Anthony I, Wells J, Blyth M, Jones B. Antibiotic-related acute kidney injury in patients undergoing elective joint replacement. <span><span class="ref-journal">Bone Joint J. </span>2014 Mar;<span class="ref-vol">96-B</span>(3):395-8.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/24589798" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24589798</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>44.</dt><dd><div class="bk_ref" id="article-159953.r44">Teng C, Frei CR. Delirium Associations with Antibiotics: A Pharmacovigilance Study of the FDA Adverse Event Reporting System (FAERS). <span><span class="ref-journal">Drugs Real World Outcomes. </span>2022 Mar;<span class="ref-vol">9</span>(1):23-29.</span> [<a href="/pmc/articles/PMC8844315/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC8844315</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/34275113" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 34275113</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>45.</dt><dd><div class="bk_ref" id="article-159953.r45">Sultana N, Mubeen T, Arayne MS, Ifzal R. Cefuroxime antacid interactions. <span><span class="ref-journal">Pak J Pharm Sci. </span>2001 Jan;<span class="ref-vol">14</span>(1):1-8.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/16414845" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 16414845</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>46.</dt><dd><div class="bk_ref" id="article-159953.r46">Tucker A, Hegarty P, Magill PJ, Blaney J, Armstrong LV, McCaffrey JE, Beverland DE. Acute Kidney Injury After Prophylactic Cefuroxime and Gentamicin in Patients Undergoing Primary Hip and Knee Arthroplasty-A Propensity Score-Matched Study. <span><span class="ref-journal">J Arthroplasty. </span>2018 Sep;<span class="ref-vol">33</span>(9):3009-3015.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/29807788" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29807788</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>47.</dt><dd><div class="bk_ref" id="article-159953.r47">Gu J, Liu S, Zhi Y. Cefuroxime-induced anaphylaxis with prominent central nervous system manifestations: A case report. <span><span class="ref-journal">J Int Med Res. </span>2019 Feb;<span class="ref-vol">47</span>(2):1010-1014.</span> [<a href="/pmc/articles/PMC6381482/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6381482</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/30522387" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 30522387</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>48.</dt><dd><div class="bk_ref" id="article-159953.r48">Al-Obaydi W, Smith CD, Foguet P. Changing prophylactic antibiotic protocol for reducing Clostridium difficile-associated diarrhoeal infections. <span><span class="ref-journal">J Orthop Surg (Hong Kong). </span>2010 Dec;<span class="ref-vol">18</span>(3):320-3.</span> [<a href="https://pubmed.ncbi.nlm.nih.gov/21187543" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21187543</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>49.</dt><dd><div class="bk_ref" id="article-159953.r49">McDonald LC, Gerding DN, Johnson S, Bakken JS, Carroll KC, Coffin SE, Dubberke ER, Garey KW, Gould CV, Kelly C, Loo V, Shaklee Sammons J, Sandora TJ, Wilcox MH. Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). <span><span class="ref-journal">Clin Infect Dis. </span>2018 Mar 19;<span class="ref-vol">66</span>(7):e1-e48.</span> [<a href="/pmc/articles/PMC6018983/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC6018983</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/29462280" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 29462280</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>50.</dt><dd><div class="bk_ref" id="article-159953.r50">Al-Tawfiq JA. The pattern and impact of infectious diseases consultation on antimicrobial prescription. <span><span class="ref-journal">J Glob Infect Dis. </span>2013 Apr;<span class="ref-vol">5</span>(2):45-8.</span> [<a href="/pmc/articles/PMC3703209/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3703209</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/23853430" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 23853430</span></a>]</div></dd></dl><dl class="bkr_refwrap"><dt>51.</dt><dd><div class="bk_ref" id="article-159953.r51">Deshpande A, Richter SS, Haessler S, Lindenauer PK, Yu PC, Zilberberg MD, Imrey PB, Higgins T, Rothberg MB. De-escalation of Empiric Antibiotics Following Negative Cultures in Hospitalized Patients With Pneumonia: Rates and Outcomes. <span><span class="ref-journal">Clin Infect Dis. </span>2021 Apr 26;<span class="ref-vol">72</span>(8):1314-1322.</span> [<a href="/pmc/articles/PMC7901260/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC7901260</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/32129438" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 32129438</span></a>]</div></dd></dl></dl></div><div><dl class="temp-labeled-list small"><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_top_margin">
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<b>Disclosure: </b>Adekunle Omole declares no relevant financial relationships with ineligible companies.</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_top_margin">
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<b>Disclosure: </b>Ayoola Awosika declares no relevant financial relationships with ineligible companies.</p></div></dd></dl><dl class="bkr_refwrap"><dt></dt><dd><div><p class="no_top_margin">
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<b>Disclosure: </b>Preeti Patel declares no relevant financial relationships with ineligible companies.</p></div></dd></dl></dl></div></div></div><div class="fm-sec"><h2 id="_NBK599503_pubdet_">Publication Details</h2><h3>Author Information and Affiliations</h3><p class="contrib-group"><h4>Authors</h4><span itemprop="author">Adekunle E. Omole</span><sup>1</sup>; <span itemprop="author">Ayoola O. Awosika</span><sup>2</sup>; <span itemprop="author">Preeti Patel</span>.</p><h4>Affiliations</h4><div class="affiliation"><sup>1</sup> Louisiana State University Health Sciences Center</div><div class="affiliation"><sup>2</sup> University of Illinois College of Medicine</div><h3>Publication History</h3><p class="small">Last Update: <span itemprop="dateModified">January 11, 2024</span>.</p><h3>Copyright</h3><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright</a> © 2025, StatPearls Publishing LLC.<p class="small">
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This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
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(<a href="https://creativecommons.org/licenses/by-nc-nd/4.0/" ref="pagearea=meta&targetsite=external&targetcat=link&targettype=uri">
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http://creativecommons.org/licenses/by-nc-nd/4.0/
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</a>), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.
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</p></div></div><h3>Publisher</h3><p><a href="https://www.statpearls.com/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">StatPearls Publishing</a>, Treasure Island (FL)</p><h3>NLM Citation</h3><p>Omole AE, Awosika AO, Patel P. Cefuroxime. [Updated 2024 Jan 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. <span class="bk_cite_avail"></span></p></div><div class="small-screen-prev"></div><div class="small-screen-next"></div></article></div><div id="jr-scripts"><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/libs.min.js"> </script><script src="/corehtml/pmc/jatsreader/ptpmc_3.22/js/jr.min.js"> </script></div></div>
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