Cefuroxime
A second-generation cephalosporin, taken by mouth as cefuroxime axetil or injected, for throat, sinus, ear and urinary infections and Lyme disease.
Drug card
- Class
- Cephalosporin
- How it works
- Binding penicillin-binding proteins so the bacterial wall is never cross-linked
- Used for
- Throat and tonsil infections
- Sinusitis
- Middle ear infections (otitis media)
- Uncomplicated urinary tract infections
- Known for
- Allergic reactions, including anaphylaxis
- Its name
- cef- means a cephalosporin
Study it as a flashcard, and it comes back before you forget it.
Mechanism of action
How does cefuroxime work?
Cefuroxime is a second-generation cephalosporin that stays active against many beta-lactamase producers, including H. influenzae and Moraxella catarrhalis, as well as streptococci and staphylococci. The oral form, cefuroxime axetil, is an ester: esterases in the gut wall and blood split it to release active cefuroxime.
Like other cephalosporins: Cephalosporins are beta-lactams first derived from Acremonium (Cephalosporium) fungi. Like penicillins, they bind and inactivate penicillin-binding proteins, so peptidoglycan is not cross-linked and the bacterial cell wall weakens and lyses. They withstand many beta-lactamases; from first to third generation, Gram-negative activity rises and Gram-positive activity falls.
Uses
What is cefuroxime used for?
- Throat and tonsil infections
- Sinusitis
- Middle ear infections (otitis media)
- Uncomplicated urinary tract infections
- Early Lyme disease
- Preventing infection in surgery
Side effects
Side effects of cefuroxime
- Allergic reactions, including anaphylaxisKnown forSerious
- Diarrhea
- Nausea and vomiting
- Headache
- Vaginitis and vaginal thrush
- Jarisch-Herxheimer reaction when treating Lyme disease
- C. difficile colitisSerious
- Hepatitis and cholestasisSerious
- Hemolytic anemiaSerious
- Seizures and encephalopathySerious
- Severe skin reactions (SJS, TEN)Serious
- Prolonged prothrombin time
Known for marks what an exam expects you to know it for.
Watch for
Cautions and what sets it apart
- Contraindicated after anaphylaxis or another serious reaction to any beta-lactam, including penicillins.
- Antacids, H2 blockers and PPIs reduce absorption of oral cefuroxime axetil, which is better absorbed with food.
- Probenecid raises cefuroxime levels, so the two are not given together.
Good to know: WHO's essential medicines list places it in the Watch group, as a second choice for surgical prophylaxis.
Remember it
A way to remember it
Climb the generations, gain the Gram-negatives: from first to third generation, Gram-negative reach grows while Gram-positive reach shrinks.
First-generation cefalexin suits streptococcal and staphylococcal skin infections. Second-generation cefuroxime adds beta-lactamase-producing H. influenzae. Third-generation ceftriaxone and cefixime reach gonococci, E. coli and Klebsiella, and cefixime misses most staphylococci.
Written for biofideX
Its name
cef- means cephalosporin
Cefalexin, cefuroxime, ceftriaxone and cefixime share it. Older US names keep the spelling ceph- (cephalexin).
- Every drug name stem
Its class
Cephalosporins
Other cephalosporins with a card:
Easily mixed up with penicillins and carbapenems.
Sources
Checked against
Written for biofideX in plain words, after checking these references:
- Cefuroxime axetil tablets: label (DailyMed)
- Cefuroxime (NCI Thesaurus)
- WHO Model List of Essential Medicines, 24th list (2025) (WHO)
For learning pharmacology, not for treatment decisions: no doses are given, and a prescriber, pharmacist or the product's own label is the word on any one patient. Spotted a mistake? Tell us and we'll correct it.
Antibiotics: the cell wall
Cefuroxime is one of 12 drugs practiced together here: their classes, how they work, what they treat and what they're known for.
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