Cefutil 500
(CEFUROXIME 500MG)

Drug Effects

Synonyms(It is also Known As)


Cefuroxim

Chemical Formula


C16H16N4O8S

Iupac Name


(6R,7R)-3-{[(aminocarbonyl)oxy]methyl}-7-{[(2Z)-2-(2-furyl)-2-(methoxyimino) acetyl]amino}-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylic acid

Usage


Cefuroxime is a parenteral second generation cephalosporin antibiotic. Cefuroxime axetil is an acetoxyetyl ester prodrug of cefuroxime which is effective orally. Used for the treatment of many different types of bacterial infections such as bronchitis, sinusitis, tonsillitis, ear infections, skin infections, gonorrhea, and urinary tract infections.

Adverse Effect


Large doses can cause cerebral irritation and convulsions; nausea, vomiting, diarrhoea, GI disturbances; erythema multiforme, Stevens-Johnson syndrome, epidermal necrolysis.

Potentially Fatal: Anaphylaxis, nephrotoxicity, pseudomembranous colitis.

Mechanism Action


Cefuroxime binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.

Precaution


Caution should be exercised in patients with history of kidney or liver disease, colitis, or stomach problems, any allergy, who are taking other medications, elderly, children, during pregnancy and breast-feeding. 

Patient may experience with diarrhea, blood in stool or stomach pain; if it so consult with your doctor. 

Avoid long-term use of this medication; otherwise it may cause secondary infection. 

Monitor kidney function, sugar level regularly while taking this medication.

Drug Interaction


Probenecid decreases renal clearance of cefuroxime.

Potentially Fatal: Nephrotoxicity with aminoglycosides and furosemide.

Pregnancy Category


Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1sttrimester (and there is no evidence of a risk in later trimesters).

Absorption


Absorbed from the GI tract with peak plasma concentrations after 2-3 hr (oral); may be enhanced by the presence of food.

Distribution


Pleural and synovial fluid, sputum, bone and aqueous fluids; CSF (therapeutic concentrations). Crosses the placenta and enters breast milk. Protein-binding: Up to 50%.

Metabolism


The axetil moiety is metabolized to acetaldehyde and acetic acid.

Elemination


Via the urine by glomerular filtration and renal tubular secretion (as unchanged); via bile (small amounts)

References


  1. Perry CM, Brogden RN: Cefuroxime axetil. A review of its antibacterial activity, pharmacokinetic properties and therapeutic efficacy. Drugs. 1996 Jul;52(1):125-58.