What bacteria is cefuroxime (Cefuroxime) effective against?

Cefuroxime Antimicrobial Coverage

Cefuroxime is active against a broad spectrum of bacteria including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, methicillin-sensitive Staphylococcus aureus, and many Enterobacteriaceae. 1

Gram-Positive Coverage

• Streptococcus pneumoniae: Cefuroxime is active against 75-85% of S. pneumoniae strains 2, including penicillin-susceptible and penicillin-intermediate strains 3
• Streptococcus pyogenes (Group A streptococci): Highly effective 1, 4
• Staphylococcus aureus: Active against methicillin-sensitive strains only 1, 4
• Staphylococcus epidermidis: Shows in vitro activity 1

Gram-Negative Coverage

• Haemophilus influenzae: Effective against virtually all strains, including β-lactamase producing strains 2
• Moraxella catarrhalis: Effective against approximately 50% of strains 2
• Neisseria meningitidis: Good activity 1
• Neisseria gonorrhoeae: Effective 1
• Enterobacteriaceae:
  • Escherichia coli 1
  • Klebsiella species 1
  • Enterobacter species 1
  • Proteus mirabilis 1
  • Salmonella species 1
  • Shigella species 1

Organisms with Limited or No Susceptibility

• Atypical pathogens: All cephalosporins (including cefuroxime) are inactive against atypical agents such as Mycoplasma, Chlamydia, and Legionella 2
• Pseudomonas aeruginosa: Resistant 5
• Bacteroides fragilis: Resistant 5
• Enterococci (Group D streptococci): Resistant 4
• Drug-resistant Streptococcus pneumoniae (DRSP): Limited activity against highly penicillin-resistant strains 3

Clinical Considerations

• Cefuroxime is a second-generation cephalosporin with better gram-negative coverage than first-generation agents 2
• When treating respiratory infections, it's important to note that cefuroxime is less active against S. pneumoniae than amoxicillin 2
• For sinusitis treatment, cefuroxime axetil is considered a suitable agent, unlike cefixime and ceftibuten which have poor activity against S. pneumoniae 2
• Cefuroxime has broad spectrum activity against β-lactamase positive respiratory pathogens H. influenzae and M. catarrhalis 3

Potential Pitfalls

• Cefuroxime is less predictably active against S. pneumoniae compared to amoxicillin 2
• The suspension formulation of cefuroxime axetil is unpalatable, which may limit its use in children 2
• For severe infections with suspected penicillin-resistant S. pneumoniae, higher doses or alternative agents may be needed 2
• Always consider local resistance patterns when selecting antimicrobial therapy, as regional variations in susceptibility can occur

Cefuroxime's broad spectrum of activity against common respiratory and other community-acquired pathogens makes it a useful option for empiric treatment of various infections, particularly when β-lactamase producing organisms are suspected.