What is Ceferecin (Cephalosporin antibiotic) 250mg?

What is Cefuroxime 250 mg

Cefuroxime 250 mg is a second-generation cephalosporin antibiotic available in oral form (as cefuroxime axetil) that provides enhanced activity against β-lactamase-producing organisms including H. influenzae, M. catarrhalis, and S. aureus, making it particularly useful for respiratory tract infections, skin infections, and urinary tract infections. 1

Drug Classification and Mechanism

• Cefuroxime belongs to the second-generation cephalosporins, which have superior activity against β-lactamase-producing organisms compared to first-generation agents 1
• The oral formulation (cefuroxime axetil) is a prodrug that is converted to active cefuroxime after absorption 2
• It demonstrates broad-spectrum antibacterial activity against common gram-positive and gram-negative pathogens 2

Standard Dosing

• For outpatient infections: The standard adult dose is 250-500 mg orally twice daily 3
• For respiratory tract infections: 250-500 mg twice daily for 5-10 days is effective 2
• For urinary tract infections: 250 mg once daily at bedtime has shown 86% cure rates in acute uncomplicated cases 4
• For moderate-to-severe infections requiring hospitalization: 1.5 g IV every 8 hours is recommended 3

Clinical Applications

Respiratory Infections

• Cefuroxime is highly effective for community-acquired pneumonia, acute exacerbations of chronic bronchitis, sinusitis, and pharyngitis 2
• The 250 mg dose is appropriate for mild-to-moderate upper respiratory tract infections 2
• It provides excellent tissue penetration in respiratory tract fluids 2

Skin and Soft Tissue Infections

• For animal bites and uncomplicated skin infections, 500 mg orally twice daily is recommended 3
• The drug is effective for diabetic foot infections when combined with metronidazole for anaerobic coverage 3

Urinary Tract Infections

• Single daily dosing of 250 mg at bedtime with milk has demonstrated 95% clearance during treatment and 86% overall cure rates 4
• Particularly valuable for infections caused by β-lactamase-producing bacteria 4

Important Clinical Considerations

Advantages

• Convenient twice-daily dosing improves compliance compared to agents requiring more frequent administration 2
• Shorter 5-day courses are as effective as 10-day courses for many respiratory infections 2
• Well-tolerated with primarily mild-to-moderate gastrointestinal adverse effects 2
• Active absorption is not affected by acid suppression, so can be used with reflux medications 5

Limitations and Pitfalls

• No activity against MRSA or Pseudomonas - do not rely on cefuroxime for these pathogens 5
• First-generation cephalosporins have poor H. influenzae coverage and should not be substituted for respiratory infections 1
• For suspected bacterial meningitis, third-generation cephalosporins are required as second-generation agents have inadequate CNS penetration 1
• Consider local resistance patterns for S. pneumoniae and H. influenzae when selecting empiric therapy 3

Common Adverse Effects

• Gastrointestinal disturbances (diarrhea, nausea) are most common 2
• Candida vaginitis occurs in approximately 8% of patients 4
• Cefaclor (another second-generation agent) has higher risk of serum sickness-like reactions, making cefuroxime a safer choice 1
• Most adverse events are mild-to-moderate and reversible upon discontinuation 2

Sequential Therapy Option

• For hospitalized patients with community-acquired pneumonia, sequential therapy starting with IV cefuroxime 750 mg 2-3 times daily for 2-5 days followed by oral cefuroxime axetil 500 mg twice daily for 3-8 days is effective 2
• This approach provides similar efficacy to full parenteral courses while reducing hospital stay 2