Vetdrugs 2.0Cefuroxime is a second-generation cephalosporin available as parenteral cefuroxime sodium and the oral prodrug cefuroxime axetil. It offers activity against selected gram-positive and gram-negative bacteria. Veterinary use is extra-label and less extensively documented than that of several other cephalosporins, with applications determined by infection site and susceptibility.
Group
Second-generation cephalosporin antibacterial
Mechanism of Action
Active cefuroxime binds penicillin-binding proteins and inhibits formation of peptidoglycan cross-links in the bacterial cell wall. This weakens susceptible dividing bacteria and produces bactericidal activity. Cefuroxime axetil is hydrolyzed after absorption to release the active drug. Beta-lactamase production, altered target proteins and permeability changes can modify organism susceptibility.
Dose Rates
Dogs
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Susceptible bacterial infection | 20 mg/kg | IV, IM, SC | Every 12 h | PK-based proposal for organisms with MIC about 1 mcg/mL; adequacy depends on the pharmacodynamic target. |
| Higher-MIC susceptible infection | 20 mg/kg | IM, SC | Every 8 h | PK-based proposal for MIC about 4 mcg/mL; use susceptibility-directed interpretation. |
| Perioperative antibacterial prophylaxis | 20–50 mg/kg | IV | Give slowly IV as the selected perioperative prophylactic amount. Timing and intraoperative redosing require a separate surgical plan. | |
| Soft tissue infection | 10 mg/kg | PO | Every 12 h | Up to 10 days; Veterinary formulary regimen extrapolated from human dosing; use susceptibility and clinical response. |
| Systemic bacterial infection | 15 mg/kg | IV | Every 8 h | Veterinary formulary regimen extrapolated from human dosing; use susceptibility and clinical response. |
| Meningitis | 30 mg/kg | IV | Every 8 h | Veterinary formulary regimen extrapolated from human dosing; use susceptibility and clinical response. |
| Surgical antibacterial prophylaxis — Initial | 20 mg/kg | IV | Once | Administer 30 minutes before surgery; separate intraoperative redosing record applies only during surgery. |
| Surgical antibacterial prophylaxis — Maintenance | 20 mg/kg | IV | Every 2 h | Intraoperative redosing only; stop at completion of the indicated surgical prophylaxis course. |
Cats
| Use / stage | Dose | Route | Schedule | Instructions |
|---|---|---|---|---|
| Perioperative antibacterial prophylaxis | 20–50 mg/kg | IV | Give slowly IV as the selected perioperative prophylactic amount. Timing and intraoperative redosing require a separate surgical plan. |
Indications
- Treatment of selected cefuroxime-susceptible skin, soft-tissue, urinary or respiratory bacterial infections in dogs and cats.
- Selected perioperative antibacterial prophylaxis when cefuroxime provides appropriate coverage.
- Specialist treatment of selected susceptible central nervous system infections, with limited veterinary clinical evidence.
Contraindications
- Serious cephalosporin hypersensitivity
Interactions
- Probenecid can reduce renal tubular elimination.
- Aminoglycosides, furosemide or torsemide may increase nephrotoxicity risk.
Adverse effects
- Gastrointestinal disturbance
- Hypersensitivity
- Injection-site reaction
Toxicity
Excess beta-lactam exposure, especially with impaired elimination, may cause neurologic signs.
Preparations
| Preparation | Form | Strength | Route |
|---|---|---|---|
| Cefuroxime injection 750 mg vial Strength expressed as cefuroxime equivalent, supplied as sodium salt. | Injection | 750 mg / vial | IV, IM |
| Cefuroxime axetil tablets 125 mg cefuroxime equivalent Cefuroxime equivalent from axetil prodrug. Give with food. Crushing produces a strongly bitter taste. | Tablet | 125 mg / tablet | PO |
| Cefuroxime axetil tablets 250 mg cefuroxime equivalent Cefuroxime equivalent from axetil prodrug. Give with food. Crushing produces a strongly bitter taste. | Tablet | 250 mg / tablet | PO |
| Cefuroxime axetil tablets 500 mg cefuroxime equivalent Cefuroxime equivalent from axetil prodrug. Give with food. Crushing produces a strongly bitter taste. | Tablet | 500 mg / tablet | PO |
| Cefuroxime axetil oral suspension 125 mg/5 mL Cefuroxime base-equivalent strength after reconstitution. Refrigerate 2–8°C and discard after 10 days for the described product. | Oral Liquid | 125 mg / 5 mL | PO |
| Cefuroxime axetil oral suspension 250 mg/5 mL Cefuroxime base-equivalent strength after reconstitution. Refrigerate 2–8°C and discard after 10 days for the described product. | Oral Liquid | 250 mg / 5 mL | PO |
Monitoring and Administration
Use culture results to select dose interval. The dog schedules below are based on pharmacokinetic targets, not clinical efficacy trials.
Oral cefuroxime axetil requires its own absorption and dose evidence; do not substitute it into injectable schedules.
Give oral axetil with food; tablets and suspension are distinct dosage forms. Do not use chocolate-containing food to disguise bitter tablets.
Store tablets dry at 15–30°C. For described injectable sodium preparations reconstituted to 90 mg/mL, stability was 24 hours at room temperature or 48 hours refrigerated; further-diluted infusion stability was 24 hours or up to 7 days, respectively. Confirm the actual formulation and diluent.
Copper-reduction urine glucose tests can be falsely positive; glucose-oxidase testing is less affected. Coombs testing may also be affected. Do not admix with aminoglycosides, ciprofloxacin or ranitidine.