CEFUROXIME

Drugs in Pregnancy and Lactation.

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Name: CEFUROXIME
Class: Antibiotic (Cephalosporin)
Risk Factor:    BM

Fetal Risk Summary

Cefuroxime is an oral and parenteral, semisynthetic cephalosporin antibiotic. Reproduction studies in rats have found no evidence of impaired fertility at doses up to 9 times the maximum recommended human dose on a mg/m2 basis (MRHD) or, mice and rats, of fetal harm at doses up to 23 times the MRHD (1).

Cefuroxime readily crosses the placenta in late pregnancy and labor, achieving therapeutic concentrations in fetal serum and amniotic fluid (2,3,4,5,6 and 7). Therapeutic antibiotic levels in infants can be demonstrated up to 6 hours after birth with measurable concentrations persisting for 26 hours. The pharmacokinetics of cefuroxime in pregnancy have been reported (8). The antibiotic has been used for the treatment of pyelonephritis in pregnancy (9). Adverse effects in the newborn after in utero exposure have not been observed. Cephalosporins are usually considered safe to use during pregnancy.

In women at 15–35 weeks' gestation, a single 750-mg IV dose produced mean serum concentrations in mothers, hydropic fetuses, and fetuses with oligohydramnios of 7.4, 6.2, and 4.9 µg/mL, respectively (10). The concentrations did not correlate with gestational age. Nine women with premature rupture of the membranes at 27–33 weeks' gestation received 1.5 g IV of cefuroxime three times daily (11). The mean concentrations of the antibiotic in the mothers (1 hour after a dose), umbilical cord plasma, placenta, and membranes were 35.0 µg/mL, 3.0 µg/mL, 11.2 µg/g, and 35.6 µg/g, respectively.

In a surveillance study of Michigan Medicaid recipients involving 229,101 completed pregnancies conducted between 1985 and 1992, 143 newborns had been exposed to cefuroxime during the 1st trimester (F. Rosa, personal communication, FDA, 1993). Three (2.1%) major birth defects were observed (six expected), but no anomalies were observed in six categories of defects for which specific data were available (cardiovascular defects, oral clefts, spina bifida, polydactyly, limb reduction defects, and hypospadias). These data do not support an association between the drug and congenital defects (see also Cefaclor, Cephalexin, and Cephradine for contrasting results).

The pregnancy outcomes of 106 women exposed in the 1st trimester to cefuroxime were described in a 2000 study (12). Compared to 106 matched controls, there was no difference in pregnancy outcomes in terms of live births, spontaneous abortions, gestational age at birth, prematurity, birth weight, fetal distress, method of delivery, and major or minor malformations. Induced abortions, however, occurred in significantly more cefuroxime-exposed women then controls, possibly due to misinformation and misperception of the risk the antibiotic posed to a pregnancy (12).

Breast Feeding Summary

Cefuroxime is excreted into breast milk in low concentrations (1), but published data have not been located. Even though the levels are low, three potential problems exist for the nursing infant exposed to cefuroxime in milk: modification of bowel flora, direct effects on the infant, and interference with the interpretation of culture results if a fever workup is required. Although not specifically listing cefuroxime, the American Academy of Pediatrics classifies other cephalosporin antibiotics as compatible with breast feeding (13).

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References

  1. Product information. Ceftin. Glaxo Wellcome, 1997.
  2. Craft I, Mullinger BM, Kennedy MRK. Placental transfer of cefuroxime. Br J Obstet Gynaecol 1981;88:141–5.
  3. Bousfield P, Browning AK, Mullinger BM, Elstein M. Cefuroxime: potential use in pregnant women at term. Br J Obstet Gynaecol 1981;88:146–9.
  4. Bergogne-Berezin E, Pierre J, Even P, Rouvillois JL, Dumez Y. Study of penetration of cefuroxime into bronchial secretions and of its placental transfer. Therapie 1980;35:677–84.
  5. Tzingounis V, Makris N, Zolotas J, Michalas S, Aravantinos D. Cefuroxime prophylaxis in caesarean section. Pharmatherapeutica 1982;3:140–2.
  6. Coppi G, Berti MA, Chehade A, Franchi I, Magro B. A study of the transplacental transfer of cefuroxime in humans. Curr Ther Res 1982;32:712–6.
  7. Bousefield PF. Use of cefuroxime in pregnant women at term. Res Clin Forums 1984;6:53–8.
  8. Philipson A, Stiernstedt G. Pharmacokinetics of cefuroxime in pregnancy. Am J Obstet Gynecol 1982;142:823–8.
  9. Faro S, Pastorek JG II, Plauche WC, Korndorffer FA, Aldridge KE. Short-course parenteral antibiotic therapy for pyelonephritis in pregnancy. S Med J 1984;77:455–7.
  10. Holt DE, Fisk NM, Spencer JAD, de Louvlis J, Hurley R, Harvey D. Transplacental transfer of cefuroxime in uncomplicated pregnancies and those complicated by hydrops or changes in amniotic fluid volume. Arch Dis Child 1993;68:54–7.
  11. De Leeuw JW, Roumen FJME, Bouckaert PXJM, Cremers HMHG, Vree TB. Achievement of therapeutic concentrations of cefuroxime in early preterm gestations with premature rupture of the membranes. Obstet Gynecol 1993;81:255–60.
  12. Berkovitch M, Segal-Socher I, Greenberg R, Bulkowshtein M, Arnon J, Perlob P, Or-Noy A. First trimester exposure to cefuroxime: a prospective chort study. Br J Clin Pharmacol 2000;50:161–5.
  13. Committee on Drugs, American Academy of Pediatrics. The transfer of drugs and other chemicals into human milk. Pediatrics 1994;93:137–50.

Index

Q&A about Cefuroxime

Chixxy
I'm pregnant and I have UTI, my doctor says to take anti biotic cefuroxime axetil? im not sure if this is safe
I'm pregnant, am being asked to take anti biotic which is cefuroxime axetil. Im scared it could led to affect my baby. Please advise
Ruth
UTI's are quite common during pregnancy. Did your OB Doc ordered this antibiotic or your Primary Doc? either way, this particular antibiotic is in the "Pregnancy B" Category. There is no revealed evidence of impaired fertility or harm to the fetus. If your Doc prescribed it ( OB or Primary) , then it is ok to take it. Be sure to complete the full course of the antibiotic, even if your symptoms go away. If your symptoms persist ( after 3-4 full days of antibiotic) or worsen, please contact your Doc.

I hope that this is helpful. Congrats !! ( on your pregnancy)
Kentucky Fried Chicken
what should i do if i accidently take Cefuroxime of ceftin?
im 15 year old boy its my sister (17) year old medicine and i thought it was my pimple medicine and i took it by accident what should i do? please help
Cassandr...
It's just an antibiotic. You should be fine (just make sure your not allergic), but let your parents know in case your sister needs the dose you took.

Good Luck!!!
Michelle
What will happen if you drink alcohol while on Apo-Cefuroxime (antibiotics) ??
I've just been put on this medication for Strep throat and a water infection, and i want to go out this weekend with my friends. What would happen if i drank? anything or maybe something serious?
gigglebo...
everything i've ever read says NOT to drink while on antibiotics and for a week to ten days after you've taken the last one.

here's why: alcohol lowers the effectiveness of the antibiotic. in short it keeps it from working, depending on how much you drink it's like not taking it for a day or more; or even worse like throwing it in the trash.

it doesn't matter if you're taking a thirty day antibiotic or a 5 day, you shouldn't drink for forty days (30 day at the very least) because you mess with the healing the antibiotic is doing and the protection it's giving you.
tejas_ry...
Cefuroxime Axetil 500 mg tablets during 3 to 4 weeks of pregnancy? Is it safe for the baby?
My wife is having Urinary tract infection for last 2 weeks, she is 4 weeks pregnant. She has been taking Cefuroxime Axetil 500 mg tablets for almost 10 days, doctor says urine reports shows its getting better. Is it safe for the mother & baby? Please comment, we are worried. Doctor says its no harm for the baby!
Ladyoasi...
Cefuroxime is an antibiotic from the cephalosporin group, which has not demonstrated harm to pregnant women or the children. It is pregnancy category B, which means there are no studies that proves any harm to the baby. If you have any questions about any meds for your wife, you can call any pharmacy and they can tell you the same info I wrote. Every med has a US pregnancy category. Best wishes.
diane35
effectivity of diane 35 as birth contro when taking cefuroxime (antibiotic) as treatment for tonsillitis?
does cefuroxime (antibiotic/antibacterial) affects the effectiveness of diane 35 as birth control pill? is the chance of pregnancy high or low? or not at all. i'm safe?
mmlvly
No your not safe! Any time you take an antibiotic with a contraceptive pill you should take extra precautions. Some other substances and conditions also affect how the pill works. Ie: Herbal remedies, gastric upsets etc...

Follow the link below for further information.
Tonya C
Has anyone used cefuroxime axetil for strep throat?
rak
Usually something in the penicillin family is prescribed, but cefuroxime is a good choice as well to treat strep throat. It might be given in the case that a patient has a penicillin allergy.

Cefuroxime is a second generation cephalosporin. Cephalosporins will always kill Group A strep (the organism that causes "strep throat").
Aileen M
does Cefuroxime effect the Aviane birth control pill?
Seraphim
Almost all antibiotics will interfere with the metabolistation of birthc control pills, so it is safest to presume that this one will too.

You need to use back up protection (condoms etc) each day that you take the antibiotics and continue using condoms until you have taken an active BC pill each day for at least seven days in a row after the last of the antibiotics. If those seven days would take you into the hormone-free sugar pills then you need to start a new pack of active pills instead of taking the sugar pills, and you'll skip your period this month.
Monet
Hi there.Is it safe to get pregnant if you are taking Cefuroxime(Zinacef 250mg,2x a day for 7 days) for UTI?Ty
I've been taking Cefuroxime for about 2 days for UTI when my husband & I had sexual contact (once only). And it's my fertile week. I'm just a little bit worried that if ever I get pregnant, there will be an effect on my baby. Will i still continue taking it for my UTI or should i change it to Cefalexin 500 mg, 3x a day for another 7 days? Thanks so much
tripleha...
I would change .....just to be on the safe side. Cefalexin is a antibiotic that is also prescribed while you are pregnant and is totally safe for you and possible fetus. For more information, you can serch the web for the medicine you are taking, and at Webmd, you find accurate information. Best of luck to you.
aks
which antidot is used for cefuroxime toxicity?
Dr. Maddog
no specific antidote is known, general supportive treatment, or dialysis to reduce serum levels...interesting question.