Cefuroxime

Prescription ·Exploratory record · not publication-reviewed ·Updated July 13, 2026

Cefuroxime is a second-generation cephalosporin beta-lactam antibiotic used to treat a range of bacterial infections, including respiratory tract infections, urinary tract infections, skin and soft tissue infections, and early Lyme disease. It is available as an oral prodrug (cefuroxime axetil) and as an intravenous or intramuscular salt (cefuroxime sodium). Compared with first-generation agents, it offers improved activity against many gram-negative organisms while retaining useful gram-positive coverage and greater stability against many beta-lactamases.

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Publication status

Exploratory record, not a reviewed medical publication.

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This generated database record has not completed a claim-level review by a qualified human medical reviewer. Bibliography links and evidence labels are not approval. The page remains available for reference and is excluded from search indexing.

In short

What the research says.

A quick, data-only summary. The full evidence, dosing, and sources are below.

Cefuroxime is a second-generation cephalosporin beta-lactam antibiotic used to treat a range of bacterial infections, including respiratory tract infections, urinary tract infections, skin and soft tissue infections, and early Lyme disease. NutriStack rates the supporting evidence as strong. Common adult dosing is Oral (cefuroxime axetil): typically 250-500 mg twice daily for 5-10 days depending on indication. Intravenous/intramuscular (cefuroxime sodium): typically 750 mg to 1.5 g every 8 hours. Dosing is reduced in significant renal impairment., though a prescriber sets the actual dose. With long-term use it can deplete vitamin k. This profile indexes 3 sources.

What it's good for

Community-acquired respiratory infections (acute bacterial sinusitis, acute bronchitis exacerbations, pharyngitis/tonsillitis)^3,2
Uncomplicated urinary tract infections^2,3
Skin and soft tissue infections^2,3
Early Lyme disease (erythema migrans)^1,2
Surgical prophylaxis and certain pneumonia/gonococcal infections (parenteral form)³

What to watch for

Diarrhea
Nausea and vomiting
Abdominal pain or dyspepsia
Known hypersensitivity to cefuroxime or other cephalosporins^3,1
History of severe (e.g., anaphylactic) reaction to penicillins or other beta-lactams; use caution given possible cross-reactivity

The bottom line

Evidence rating strong. Most-documented uses: community-acquired respiratory infections (acute bacterial sinusitis, acute bronchitis exacerbations, pharyngitis/tonsillitis), uncomplicated urinary tract infections, skin and soft tissue infections. 3 sources indexed (1992–2019), with 0 interaction records on file.

The science

How it works, mechanistically.

Core mechanism

Cefuroxime is a bactericidal beta-lactam that binds to and inhibits penicillin-binding proteins (PBPs) in the bacterial cell wall. By acetylating the active site of these transpeptidase enzymes, it blocks the cross-linking of peptidoglycan strands required for cell wall synthesis and integrity. This leads to weakened cell walls, activation of autolytic enzymes, and ultimately osmotic lysis and death of dividing bacteria. Its second-generation structure confers relative resistance to hydrolysis by many bacterial beta-lactamases, broadening its activity against gram-negative species such as Haemophilus influenzae and Moraxella catarrhalis.^2,1

Class

Second-generation cephalosporin antibiotic

Absorption

Water-soluble; take with food

Dosing

Dosing & protocol.

Common range

Oral (cefuroxime axetil): typically 250-500 mg twice daily for 5-10 days depending on indication. Intravenous/intramuscular (cefuroxime sodium): typically 750 mg to 1.5 g every 8 hours. Dosing is reduced in significant renal impairment.

Recommended form

Oral cefuroxime axetil tablets (taken with food) for outpatient infections; intravenous or intramuscular cefuroxime sodium for more serious or hospital-treated infections.

Oral cefuroxime axetil absorption is enhanced when taken with food, which increases bioavailability; the tablet should be taken after a meal. The intravenous and intramuscular forms bypass gastrointestinal absorption entirely. Tablets should not be crushed because of a persistent bitter taste; the oral suspension must be taken with food.³

Depletions

What it depletes.

Nutrients this medication can lower over time, and what to replace.

Vitamin K

Mild

Broad-spectrum antibiotic suppression of vitamin K-producing colonic bacteria reduces the supply of menaquinones (vitamin K2). Unlike cephalosporins bearing an N-methylthiotetrazole (NMTT) side chain (e.g., cefamandole, cefoperazone), cefuroxime lacks this group and does not directly inhibit the vitamin K epoxide reductase / hepatic gamma-carboxylation pathway, so any hypoprothrombinemia is generally mild and largely confined to patients with poor dietary vitamin K intake, malnutrition, prolonged therapy, or concurrent anticoagulant use.

Replace Vitamin K1 (phylloquinone)Monitor Prothrombin time / INR (consider in malnourished or anticoagulated patients on prolonged therapy)Onset Typically only with prolonged courses (more than 1 to 2 weeks) and predominantly in nutritionally compromised patients

Full Cefuroxime depletion and interaction guide →

Safety

Full safety detail.

Side effects

Diarrhea
Nausea and vomiting
Abdominal pain or dyspepsia
Headache
Rash or hypersensitivity reactions
Vaginal candidiasis (overgrowth)
Transient elevations in liver enzymes
Eosinophilia
Clostridioides difficile-associated diarrhea/colitis (can be severe)
Rare anaphylaxis

Contraindications

Known hypersensitivity to cefuroxime or other cephalosporins^3,1
History of severe (e.g., anaphylactic) reaction to penicillins or other beta-lactams; use caution given possible cross-reactivity
Use with caution in patients with significant renal impairment (dose adjustment required)³
Caution in patients with a history of gastrointestinal disease, particularly colitis^1,2

Sources

Sources, by evidence tier.

Numbered references. Citations throughout the page link here.

Randomized controlled trials

1Cefuroxime axetil compared with doxycycline for the treatment of acute disseminated and early localized Lyme borreliosisNadelman RB, Luger SW, Frank E, et al. · Annals of Internal Medicine · 1992
Cefuroxime axetil produced clinical outcomes comparable to doxycycline in patients with early Lyme disease.

Reference material

2Ceftin (cefuroxime axetil) US Prescribing InformationGlaxoSmithKline · FDA Prescribing Information · 2019
Approved labeling describes mechanism, indications (including acute bacterial maxillary sinusitis, pharyngitis/tonsillitis, uncomplicated UTI, early Lyme disease), dosing, and adverse effects for oral cefuroxime axetil.
3Zinacef (cefuroxime for injection) US Prescribing InformationGlaxoSmithKline · FDA Prescribing Information · 2019
Parenteral cefuroxime is indicated for lower respiratory, urinary, skin, bone/joint, gonococcal, and septicemic infections and for perioperative prophylaxis, with renal dose adjustment.

FAQ

Common questions.

Quick answers about Cefuroxime, drawn from the data on this page.

What is Cefuroxime?

What is Cefuroxime used for?

Commonly cited benefits of Cefuroxime include: Community-acquired respiratory infections (acute bacterial sinusitis, acute bronchitis exacerbations, pharyngitis/tonsillitis); Uncomplicated urinary tract infections; Skin and soft tissue infections; Early Lyme disease (erythema migrans); Surgical prophylaxis and certain pneumonia/gonococcal infections (parenteral form). NutriStack rates the overall evidence as strong.

What is a typical dose of Cefuroxime?

A typical adult dose of Cefuroxime is Oral (cefuroxime axetil): typically 250-500 mg twice daily for 5-10 days depending on indication. Intravenous/intramuscular (cefuroxime sodium): typically 750 mg to 1.5 g every 8 hours. Dosing is reduced in significant renal impairment.. The commonly recommended form is Oral cefuroxime axetil tablets (taken with food) for outpatient infections; intravenous or intramuscular cefuroxime sodium for more serious or hospital-treated infections.. These are general ranges, not personalized advice; confirm the right dose with a clinician.

What are the side effects of Cefuroxime?

Reported side effects include diarrhea, nausea and vomiting, abdominal pain or dyspepsia, headache, rash or hypersensitivity reactions, vaginal candidiasis (overgrowth). This is educational information; check with a healthcare professional before use.

How strong is the evidence for Cefuroxime?

NutriStack rates this as Strong, meaning multiple high-quality meta-analyses or systematic reviews converge on the same finding. Full tier criteria are at https://nutristackapp.com/methodology/evidence-tiers.

Use this with your stack

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