Cefuroxime for Corynebacterium Infections
Cefuroxime is NOT effective against Corynebacterium species and should not be used to treat these infections.
Antimicrobial Spectrum Limitations
Cefuroxime has well-documented activity against common respiratory pathogens including Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and certain Enterobacteriaceae, but Corynebacterium species are not within its spectrum of activity 1, 2, 3.
- The published in vitro activity profiles of cefuroxime consistently demonstrate coverage against gram-positive cocci (staphylococci and streptococci) and select gram-negative organisms, but do not include Corynebacterium 3, 4.
- Clinical indications for cefuroxime include respiratory tract infections, urinary tract infections, skin and soft tissue infections, and gonorrhea—all caused by susceptible organisms that do not include Corynebacterium 1, 5.
Appropriate Treatment Alternatives
For Corynebacterium infections (including C. diphtheriae and other pathogenic species):
- Penicillin or ampicillin are the first-line agents for most Corynebacterium species 6.
- Macrolides (erythromycin, azithromycin, clarithromycin) serve as alternatives for penicillin-allergic patients 6.
- Vancomycin may be required for resistant strains or in specific clinical contexts 6.
Clinical Pitfall to Avoid
The major risk is assuming that because cefuroxime has broad-spectrum activity against many gram-positive organisms, it will cover all gram-positive bacteria 3, 4. Corynebacterium species require specific antimicrobial selection based on susceptibility patterns, and empiric use of cefuroxime for suspected or confirmed Corynebacterium infections will result in treatment failure 1, 5.