Cefuroxime axetil, a
prodrug of the
cephalosporin cefuroxime, has proven in vitro antibacterial activity against several gram-positive and gram-negative organisms, including those most frequently associated with various common
community-acquired infections. In numerous randomised, controlled trials, 5 to 10 days' treatment with oral
cefuroxime axetil (250 or 500 mg twice daily) was an effective treatment in patients with upper (URTI) and lower
respiratory tract infections (LRTI) as assessed by clinical and bacteriological criteria. The
drug was as effective as several other
cephalosporins,
quinolones,
macrolides and
amoxicillin/clavulanic acid. Shorter courses (5 to 10 days') of
cefuroxime axetil were at least as effective as
a 10 day course. Furthermore, sequential
therapy with intravenous
cefuroxime (750 mg 2 or 3 times daily for 2 to 5 days) followed by oral
cefuroxime axetil (500 mg twice daily for 3 to 8 days) proved an effective treatment in adult patients with community-acquired
pneumonia (CAP). This approach provided similar efficacy to intravenous
ampicillin/sulbactam followed by oral
amoxicillin/clavulanic acid, a full parenteral course of
cefuroxime, or intravenous then oral
azithromycin or
clarithromycin. Additionally,
cefuroxime axetil was an effective treatment in patients with genitourinary, skin and
soft-tissue infections, and
erythema migrans associated with early stage
Lyme disease. The
drug is well tolerated by adult and paediatric patients, with adverse effects that are consistent with those of other
cephalosporins. The majority of adverse events (primarily gastrointestinal disturbances) were mild to moderate in intensity and reversible upon discontinuation of treatment, with very few serious adverse events reported.
CONCLUSIONS: