Cefuroxime
CEFTIN
What it isPBP-inhibiting second-generation cephalosporin; respiratory, urinary, skin, and Lyme infections.
Why this oneBetter Haemophilus and Moraxella cover than first-generation agents, with oral and IV forms.
What limits itTake the oral form with food for absorption. No pseudomonal or MRSA cover; renally adjusted.
FDA-approved for
- respiratory infections (1983)
- otitis media (1983)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Pharyngitis/tonsillitis (mild–moderate) | Adults/adolescents ≥13 y | 250 mg q12h ×10 days | 250 mg q12h | |
| Acute bacterial maxillary sinusitis (mild–moderate) | Adults/adolescents ≥13 y | 250 mg q12h ×10 days | 250 mg q12h | |
| Acute exacerbation of chronic bronchitis (mild–moderate) | Adults/adolescents ≥13 y | 250–500 mg q12h ×10 days | 250–500 mg q12h | |
| Uncomplicated skin/skin-structure infection | Adults/adolescents ≥13 y | 250–500 mg q12h ×10 days | 250–500 mg q12h | |
| Uncomplicated UTI | Adults/adolescents ≥13 y | 250 mg q12h ×7–10 days | 250 mg q12h | |
| Uncomplicated gonorrhea | Adults/adolescents ≥13 y | 1,000 mg single dose | 1,000 mg single dose | |
| Early Lyme disease | Adults/adolescents ≥13 y | 500 mg q12h ×20 days | 500 mg q12h | |
| Acute otitis media | Children <13 y (able to swallow tablets) | 250 mg q12h ×10 days | 250 mg q12h | |
| Acute bacterial maxillary sinusitis | Children <13 y (able to swallow tablets) | 250 mg q12h ×10 days | 250 mg q12h |
Renal CrCl ≥30: no adjustment. CrCl 10–<30: standard dose q24h. CrCl <10 (no dialysis): standard dose q48h. Hemodialysis: additional standard dose after each session
Hepatic Undefined
Instructions
- Take tablets with or without food
- Swallow tablets whole (strong bitter taste if crushed); use oral suspension if unable to swallow
Cautions
- Serious/fatal anaphylactic reactions; cross-reactivity in beta-lactam/penicillin-allergic patients
- CDAD
- Potential microbial/fungal overgrowth (superinfection)
- False-positive urine glucose (copper reduction) and false-negative blood glucose (ferricyanide)
Adverse reactions
- Diarrhea, nausea/vomiting; transient AST/ALT/LDH elevations; eosinophilia
- Early Lyme: Jarisch-Herxheimer reaction, vaginitis
- Rare: hemolytic anemia, pancytopenia, Stevens-Johnson syndrome, toxic epidermal necrolysis, seizures, hepatitis/cholestasis
Pregnancy No established drug-associated risks of birth defects or miscarriage; no adverse developmental outcomes in animals
Lactation Present in human milk; estimated breastfed-infant dose <1% of the adult dose
NO BOXED WARNINGS
Principal riskHypersensitivity
Cost, est. cash$20–$1,500/dose or month
Generic entry1986
Classes and tags
Clinical profile
Legacy pregnancy categoryB
Defining liabilityAllergy, gastrointestinal effects and agent-specific renal, hepatic, hematologic or interaction risks.
Mechanism of action: Cefuroxime ballicule
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