From the Guidelines
Cefuroxime does cover soft tissue infections, but it is not the first choice. According to the Infectious Diseases Society of America guidelines 1, cefuroxime is a second-generation cephalosporin that has good activity against Pasteurella multocida, but it misses anaerobes.
- Key points to consider:
- The WHO's essential medicines list recommends amoxicillin-clavulanate, dicloxacillin, and cefalexin as first-choice antibiotics for mild skin and soft tissue infections 1.
- Cefuroxime is not listed as a first-choice antibiotic, but it can be used as an alternative in certain cases.
- Augmentin (amoxicillin-clavulanate) is a broad-spectrum antibiotic that covers a wide range of bacteria, including Streptococcus and Staphylococcus species, as well as anaerobes 1.
- The choice of antibiotic should be based on the severity of the infection, the suspected causative organisms, and the patient's medical history and allergies.
- Augmentin is a good option for soft tissue infections, especially when the causative organisms are unknown or when there is a high risk of anaerobic infection 1.
- However, it is essential to consider the potential for antibiotic resistance and to use antibiotics judiciously to minimize the risk of resistance development 1.
- The American College of Physicians recommends using short courses of antibiotics (5-6 days) for non-purulent cellulitis, which can help reduce the risk of resistance and minimize side effects 1.
From the Research
Cefuroxime Coverage for Soft Tissue Infections
- Cefuroxime is a second-generation cephalosporin with broad antimicrobial activity against both Gram-positive and Gram-negative organisms, including those that cause soft tissue infections 2.
- Clinical studies have shown cefuroxime to be effective therapy for infections of soft tissue, among other types of infections 2.
- Cefuroxime has been recommended by several international bodies and guidelines, including the US FDA and the World Society of Emergency Surgery (WSES), for the management of community-acquired pneumonia and skin and soft tissue infections 3.
- A study using clinical microdialysis in morbidly obese patients undergoing abdominal surgery found that cefuroxime distributes into the interstitial space fluid (ISF) of subcutaneous soft tissues, indicating its potential effectiveness in preventing surgical site infections 4.
Comparison with Augmentin
- A comparison study found that cefuroxime axetil (a prodrug of cefuroxime) was as safe and effective as Augmentin (amoxycillin/clavulanate) in the treatment of upper respiratory tract infections 5.
- Another study found that cefuroxime axetil was at least as effective as Augmentin in the treatment of patients with acute otitis media or acute bronchitis 6.
- Cefuroxime axetil has been shown to have a similar efficacy to established antibacterial agents, including Augmentin, in the treatment of various infections 6.
- The choice between cefuroxime and Augmentin may depend on specific patient factors and the type of infection being treated, as both antibiotics have their own strengths and weaknesses 5, 6.