Cefuroxime and Abdominal Pain
Yes, cefuroxime can cause abdominal pain as part of its gastrointestinal adverse effect profile, though diarrhea is the most commonly reported gastrointestinal symptom rather than abdominal pain specifically. 1
Gastrointestinal Adverse Events with Cefuroxime
The FDA drug label for cefuroxime documents that gastrointestinal symptoms occurred in approximately 1 in 150 patients, with specific mention of diarrhea (1 in 220 patients) and nausea (1 in 440 patients) as the predominant manifestations. 1 Notably, the label also lists abdominal pain as part of the cephalosporin-class adverse reactions, confirming it can occur with cefuroxime treatment. 1
Incidence and Clinical Context
- In comparative trials, adverse events were observed in approximately 9.5% of cefuroxime-treated patients, with diarrhea being the most common gastrointestinal complaint. 2
- Gastrointestinal disturbances with cefuroxime have generally been characterized as mild and transient in nature, including diarrhea, nausea, and vomiting. 3, 4
- In a study comparing cefuroxime to cefoxitin, diarrhea occurred in 5 of 31 patients (16%) receiving intravenous cefuroxime, particularly in those with decreased renal function or higher dosages. 5
Important Clinical Considerations
Patients with pre-existing gastrointestinal disorders may be at higher risk for developing abdominal pain while taking cefuroxime. 6 This is an important consideration when prescribing, as baseline GI sensitivity may predispose to symptomatic adverse effects.
Serious Gastrointestinal Complications
- Pseudomembranous colitis can occur during or after cefuroxime treatment, which would present with more severe abdominal pain and diarrhea. 1 This represents a potentially serious complication requiring immediate evaluation and discontinuation of the antibiotic.
- The FDA label specifically warns that colitis has been reported as a cephalosporin-class adverse reaction. 1
Management Approach
For mild abdominal pain associated with cefuroxime, supportive measures including hydration and dietary modifications are recommended. 6 However, if abdominal pain is severe, persistent, or accompanied by bloody diarrhea or fever, immediate evaluation for pseudomembranous colitis is warranted, as this requires discontinuation of cefuroxime and specific treatment. 1
When to Discontinue
- Severe or worsening abdominal pain
- Development of bloody diarrhea
- Signs suggesting pseudomembranous colitis (fever, leukocytosis, severe cramping)
- Intolerable symptoms despite supportive measures