Abstract

CLINICAL PHARMACOLOGY OF CEFUROXIME

Prof. Gian Maria Pacifici*

ABSTRACT

Cefuroxime is a second-generation cephalosporin and is active against Haemophilus influenzae (including strains resistant to ampicillin), Neisseria meningitidis, and Streptococcus pneumoniae and the activity against Escherichia coli and Klebsiella is modest. Cefuroxime axetil is 1-acetyloxyethyl ester of cefuroxime and is hydrolysed into cefuroxime. The efficacy and safety of cefuroxime axetil and cefuroxime and the diffusion of cefuroxime into human body-tissues have been reviewed. The peak concentration of cefuroxime in muscle and in subcutaneous tissue is about one third of that in plasma and the peak concentration of cefuroxime in brain is about 10% of that in serum. The pharmacokinetics of cefuroxime have been studied in healthy subjects and the elimination half-life of cefuroxime is about 1 hour. The prophylaxis with cefuroxime axetil and with cefuroxime, and the treatment, and trials with cefuroxime axetil have been reviewed. Cefuroxime penetrates into the cerebrospinal fluid is significant amounts, sterilizes the cerebrospinal fluid, and treats the meningitis caused by different bacteria. Some bacteria may become resistant to cefuroxime. Cefuroxime is transferred across the human placenta in significant amounts and poorly migrates into the breast-milk. The aim of this study is to review the efficacy and safety of cefuroxime axetil and cefuroxime, the diffusion of cefuroxime into body-tissues, the pharmacokinetics of cefuroxime, the prophylaxis with cefuroxime, and the treatment and trials with cefuroxime axetil, the penetration of cefuroxime into the cerebrospinal fluid, the treatment of bacterial meningitis with cefuroxime, the resistance of bacteria to cefuroxime, the transfer of cefuroxime across the human placenta, and the migration of cefuroxime into the breast-milk.

Keywords: breast-milk, cefuroxime, cefuroxime axetil, cerebrospinal-fluid, efficacy-safety, meningitis, pharmacokinetics, placental transfer, prophylaxis, resistance, tissue-concentration, treatment, and trials.