Cefuroxime: mechanisms of action, antimicrobial activity, pharmacokinetics, clinical applications, adverse reactions and therapeutic indications

Abstract

Cefuroxime is a second generation cephalosporin with a broad antimicrobial activity against both Gram-positive and Gram-negative organisms. It has excellent in vitro activity against staphylococcal strains, streptococcal strains (other than enterococci), N. gonorrhoeae, H. influenzae and N. meningitidis. It also has excellent in vitro activity against members of the Enterobacteriaceae with the exception of Serratia and indole-positive Proteus. Ps. aeruginosa and B. fragilis are resistant. Cefuroxime is relatively free of serious side effects. It is metabolically stable, and most of it is excreted unchanged in the urine. Three fourths of it are distributed in the extravascular compartment. Blood levels exceed the in vitro minimum inhibitory concentrations for many important gram negative pathogens. Clinical studies have shown cefuroxime to be effective therapy for infections of soft tissue, respiratory tract, urinary tract, genital tract (caused by N. gonorrhoeae) and the central nervous system. Superinfections with Ps. aeruginosa and enterococcal strains may present a problem. In spite of excellent diffusion into bone and joint tissues, the available clinical data are too limited to make a recommendation for its use in bone and joint infections.