Kefurox (cefuroxime)

Pronunciation: pronunciation varies by local usage.

Generic name: cefuroxime
Brand names: Kefurox
Drug class: Second-generation cephalosporin antibiotic
Form: Film-coated tablet (oral); injectable form unresolved
Route: Oral (cefuroxime axetil tablet) and injectable (cefuroxime)

Availability and supply rules vary by country

Trade names by country: United States · Canada

What cefuroxime is and how it works

Cefuroxime is a second-generation cephalosporin antibiotic that treats a range of bacterial infections. (1)

Approved indications, ages, and doses differ. A prescriber must confirm that the infection is susceptible, the formulation and dose are appropriate, and no contraindication applies. This information is based on the US oral tablet label; injectable use and non-US labels were not reviewed.

Mechanism of action: how cefuroxime works

Cefuroxime is classified as a second-generation cephalosporin antibiotic. (1)

What cefuroxime is used for

Pharyngitis / tonsillitis

Cefuroxime axetil may be used for eligible adults and adolescents aged 13 years and older, typically 250 mg every 12 hours for 10 days. (1)

Acute otitis media

May be used in paediatric patients (under 13 years) for acute otitis media, typically 250 mg every 12 hours for 10 days. (1)

Acute bacterial sinusitis

May be used in adults and adolescents (13 years and older) at 250 mg every 12 hours for 10 days, and in paediatric patients (under 13 years) at 250 mg every 12 hours for 10 days. (1)

Bronchitis

The US label includes bronchitis among the respiratory indications for cefuroxime axetil; specific bronchitis sub-type wording was not established in the sources reviewed for this page. (1)

Uncomplicated skin and skin-structure infections

Cefuroxime axetil may be used for eligible patients; exact dosing unresolved in the reviewed material. (1)

Uncomplicated urinary tract infections

The US label includes this indication; exact dosing unresolved in the reviewed material. (1)

Uncomplicated gonorrhoea

May be used as a single 1,000 mg dose for eligible patients. (1)

Early Lyme disease

May be used for eligible adults and adolescents (13 years and older), typically 500 mg every 12 hours for 20 days. (1)

Before taking cefuroxime

Do not take / not appropriate for

Tell the prescriber before treatment if you have a known hypersensitivity (including anaphylaxis) to cefuroxime or to other beta-lactam antibiotics (e.g., penicillins, cephalosporins). The prescriber will determine whether cefuroxime axetil is appropriate for you. (reviewed oral cefuroxime axetil tablet only; injectable cefuroxime not reviewed) (1)

Tell your clinician about

Any previous allergic reaction to an antibiotic, especially a penicillin or cephalosporin.
Current kidney problems or a history of kidney disease, because the dose may need adjustment.
A history of severe or persistent diarrhoea during or after antibiotic treatment.
Pregnancy, plans for pregnancy, or breastfeeding.
All other medicines you are taking, including over-the-counter antacids, heartburn treatments, or acid-reducing medicines.

(1)

How to take cefuroxime

Take cefuroxime axetil tablets exactly as prescribed. The dose, frequency, and duration depend on the infection, age, and kidney function.
Follow your prescriber's instructions and the product leaflet.
Any change to the dose or duration of treatment is a decision for your prescriber.

(1)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)

Missed dose

Contact the prescriber or pharmacist for instructions.

Overdose

If an overdose is suspected, contact a poison-information service, the prescribing clinician, or emergency services urgently.

Side effects

The most common adverse reactions reported in clinical trials of cefuroxime axetil are gastrointestinal. A Jarisch-Herxheimer reaction can occur when treating early Lyme disease.

Diarrhoea

What to notice: Loose or frequent bowel movements.

What to do: Report diarrhoea that is severe or persistent to the prescriber promptly. (1)

Nausea / vomiting

What to notice: Feeling sick or being sick.

What to do: Discuss persistent or troublesome symptoms with the prescriber; any change to treatment is their decision. (1)

Jarisch-Herxheimer reaction (early Lyme disease)

What to notice: Reported at 5.6% incidence during treatment for early Lyme disease.

What to do: Tell the prescriber if you have concerning symptoms; any change to treatment is their decision. (1)

Vaginitis

What to notice: Vaginitis is a reported common adverse reaction.

What to do: Discuss with the prescriber if troublesome or persistent. (1)

Clostridioides difficile-associated diarrhoea

What to notice: The label describes a spectrum from mild diarrhoea to fatal colitis.

What to do: Contact the prescriber promptly for assessment. (1)

Serious hypersensitivity reaction

What to notice: The label recognizes serious hypersensitivity reactions including anaphylaxis.

What to do: Seek emergency medical attention immediately. (1)

Microbial overgrowth

What to notice: The label notes potential overgrowth of non-susceptible organisms with prolonged use.

What to do: Contact the prescriber for assessment if you notice a new or unexplained infection during or after treatment. (1)

Serious warnings

Anaphylaxis / severe hypersensitivity — emergency

Symptoms: The label recognizes serious hypersensitivity reactions including anaphylaxis.

Action: Seek emergency medical attention immediately. The clinician treating the reaction will decide about any further doses. (1)

Clostridioides difficile-associated diarrhoea — potentially serious

Symptoms: The label describes a spectrum from mild diarrhoea to fatal colitis.

Action: Contact the prescriber urgently for assessment. (1)

Interactions

Medicine or test	Effect	Action
Gastric acid-reducing agents (antacids, H2 blockers, proton pump inhibitors)	These medicines decrease the absorption of cefuroxime axetil, potentially reducing its effectiveness.	Tell the prescriber about all medicines you take for heartburn, indigestion, or acid reflux. (1)
Probenecid	Coadministration increases systemic cefuroxime exposure.	Coadministration is not recommended. Give the prescriber a complete medicine list. (1)
Urine glucose tests	Cefuroxime may cause false results with some urine glucose tests.	If you monitor urine glucose, ask the prescriber or pharmacist which test method is suitable during treatment. (1)

Pregnancy, breastfeeding, kidney/liver function, age

Renal impairment

Dosage adjustment is required when creatinine clearance is less than 30 mL/min. The prescriber must determine the exact dose. (1)

Pregnancy

Available animal reproduction and epidemiologic data have not established a fetal risk. Discuss benefits and risks with the prescriber. (1)

Breastfeeding

Cefuroxime is present in breast milk at levels less than 1% of the maternal dose. Discuss with the prescriber. (1)

Hepatic impairment

No hepatic-impairment-specific dosing guidance was reviewed in this pass. The prescriber must assess individually.

Paediatric use

The US label covers paediatric patients for certain indications (e.g., acute otitis media, sinusitis). Doses and age cut-offs are indication-specific and must be determined by the prescriber using the exact product label. (1)

Monitoring

Before starting

Ask about previous hypersensitivity to beta-lactam antibiotics.
Evaluate renal function because dose adjustment is required when creatinine clearance is below 30 mL/min.
Review all concurrent medicines, including over-the-counter acid-reducing products, since they decrease cefuroxime axetil absorption.

During treatment

Be alert for signs of hypersensitivity, including anaphylaxis.
Be alert for severe or persistent diarrhoea, which may indicate C. difficile-associated disease.
Watch for signs of a new secondary infection, particularly with prolonged use.
In early Lyme disease treatment, be aware of the possibility of Jarisch-Herxheimer reaction.

(1)

Storage

Specific storage instructions for cefuroxime axetil tablets were not reviewed in this pass. Follow the instructions on the dispensing label and packaging. Unresolved.

Professional information

Clinician-facing context based on the US cefuroxime axetil tablet label only. Injectable cefuroxime and non-US labels were not reviewed.

United States (oral tablet)

Indication: Pharyngitis/tonsillitis (adults and adolescents ≥13 years)

Dose summary: 250 mg every 12 hours for 10 days.

Renal context: Adjust dose when creatinine clearance <30 mL/min; prescriber must use full label guidance. (1)