Cefuroxime axetil is an oral
cephalosporin which is rapidly hydrolysed to the active parent compound,
cefuroxime.
Cefuroxime has a broad spectrum of in vitro antibacterial activity which encompasses
methicillin-sensitive staphylococci and the common respiratory pathogens Streptococcus pneumoniae, Haemophilus influenzae, Moraxella (Branhamella) catarrhalis and group A beta-haemolytic streptococci.
Cefuroxime has broad spectrum activity against the
beta-lactamase positive respiratory pathogens H. influenzae and M. catarrhalis; it is also active against
penicillin-susceptible and -intermediate strains of S. pneumoniae. In clinical trials,
cefuroxime axetil (administered twice daily) has been evaluated in the treatment of upper and lower
respiratory tract infections and has demonstrated similar efficacy to established
antibacterial agents, including
amoxicillin/clavulanic acid and
cefaclor. Five days' treatment with
cefuroxime axetil was recently shown to be as effective as 10 days' treatment with either
cefuroxime axetil or
amoxicillin/clavulanic acid in patients with acute
otitis media or acute
bronchitis.
Cefuroxime axetil was at least as effective as
phenoxymethylpenicillin (
penicillin V) in the treatment of patients with group A beta-haemolytic streptococcal tonsillopharyngitis. A number of studies have evaluated the efficacy of
cefuroxime axetil as the oral component of intravenous to oral sequential
therapy in hospitalised patients with lower
respiratory tract infection. In each study patients received parenteral
cefuroxime for approximately 2 days followed by
cefuroxime axetil for 5 to 10 days. In comparative studies,
cefuroxime sequential
therapy was as effective as
amoxicillin/ clavulanic acid sequential
therapy and full courses of parenteral
cefuroxime,
cefotiam or
cefoperazone. Adults with
urinary tract infections and skin
infections were also effectively treated with
cefuroxime axetil, as were adults and adolescents with early stage
lyme disease.
Cefuroxime axetil is associated with a low incidence of adverse events, with gastrointestinal disturbances being the most frequently observed. Thus,
cefuroxime axetil is an effective and convenient treatment for a wide range of
infections and may be considered a therapeutic option when empirical treatment of
community-acquired infections is required. Moreover, given the promising results of several intravenous/oral sequential treatment studies,
cefuroxime axetil may also become established as an oral component of sequential treatment regimens.