Cefuroxime (Ceftin) versus Other Antibiotics

Cefuroxime vs Ceftriaxone (Rocepin)

Ceftriaxone is more potent against Streptococcus pneumoniae than cefuroxime17.

Meningitis

Ceftriaxone is superior to cefuroxime for bacterial meningitis in children. Ceftriaxone ensures milder hearing impairment and more rapid sterilization of the cerebrospinal fluid.

Results of comparison of ceftriaxone and cefuroxime for bacterial meningitis in children 12. Cefuroxime Ceftriaxone
Percentage of patients with positive cultures of cerebrospinal fluid after 18 to 36 hours of therapy
12 %
(6 of 52 percents)
2%
(1 of 52 patients)
Clinical response rate
similar, all children were cured
Number of patients in whom reversible biliary pseudolithiasis was detected
16 of 35 patients
0 of 35 patients
Moderate-to-profound hearing loss two months after treatment
17%
4%


Lower respiratory tract infections
Both ceftriaxone and cefuroxime are effective and safe. But ceftriaxone offers more convenient treatment regimen.

Results of randomized comparative study of ceftriaxone and cefuroxime in mild to moderate respiratory tract infections 16. Cefuroxime Ceftriaxone
Regimen 0.75 g 3 times a day
intavenously

1 g once a day
intravenously

Bacteriological eradication and clinical cure or clear improvement rate 79% 81%
Eradication rate 75% 80%

Cefuroxime vs Cefdinir (Omnicef)

Acute exacerbation of chronic bronchitis
Cefdinir and cefuroxime provide comparable efficacy and tolerability.

Results of study comparing cefdinir and cefuroxime axetil in the treatment of acute exacerbation of chronic bronchitis 15. Cefuroxime Cefdinir
Regimen 250 mg twice daily for 10 days 600 mg once per day for 10 days
Microbiologic eradication rates by pathogen
88%
90%
Clinical response rates by patient
80%
81%
Side effects diarrhea the most frequent complaint diarrhea the most frequent complaint

Cefuroxime vs Cephalexin

Skin or skin structure infections

Results of comparison of cefuroxime axetil and cephalexin in primary infections of the skin or skin structures 13. Cefuroxime Cephalexin
Regimen 250 mg twice daily for 10 days 500 mg twice daily for 10 days
Satisfactory clinical outcome (cure or improvement) rate
97%
(89 of 92 patients)
89%
(80 of 90 patients)
Eradication of the bacterial pathogens rate
96%
(69 of 72 patients)
85%
(60 of 71 patients)

Cefuroxime vs Cefaclor (Ceclor)

Acute Otitis Media
Cefaclor and cefuroxime axetil are equally effective in the treatment of acute otitis media with effusion.

Results of comparison of cefaclor and cefuroxime axetil in the treatment of acute otitis media with effusion in children 14. Cefuroxime Cefaclor
Clinical success rate
89.1%
(96 of 101 patients)
92.3%
(96 of 104 patients)
Favorable clinical outcomes at day 10-16 after completion of therapy
83.2%
(84 of 101 patients)
82.7%
(86 of 104 patients)
Percentage of parients, reported at least one adverse event 35.6%
(36 of 101 patients)

diarrhea in 11 (10.9%) patients
rhinitis in 10 (9.9%) patients
30.8%
(32 of 104 patients)

rhinitis in 9 (8.7%) patients
cough increased in 7 (6.7%) patients

Cefuroxime vs Cefixime (Suprax)

Bronchitis

Cefuroxime axetil is as effective as cefixime in the treatment of acute bronchitis. Cefuroxime produces fewer gastrointestinal side effects, particularly diarrhea.

Results of clinical comparison of cefuroxime axetil with cefixime for acute bronchitis 5. Cefuroxime Cefixime
Dosage
250 mg twice daily, 10 days
400 mg once daily, 10 days
Satisfactory clinical outcome (cure or improvement) rate
88%
91%
Gastrointestinal adverse effects
10%
18%


Acute exacerbations of chronic bronchitis
Cefuroxime eradicates S. pneumoniae significantly more rapidly than cefixime.

Results of double-blind, randomised study comparing cefuroxime axetil versus cefixime for bacteriological eradication of Streptococcus pneumoniae from patients with acute exacerbations of chronic bronchitis 18. Cefuroxime Cefixime
S. pneumoniae eradication
significantly more rapidly
Response rates
94%
71%

Cefuroxime vs Cefadroxil (Duricef)

Skin infections

Cefuroxime axetil may be more effective than cafadroxil for the treatment of skin or skin structure infections in children.

Results of randomized, single-blind, multicenter study evaluating cefuroxime axetil and cefadroxil for skin or skin structure infections in children 8. Cefuroxime Cefadroxil
Regimen 30 mg/kg per day in 2 divided doses 30 mg/kg per day in 2 divided doses
Satisfactory bacteriological response (cure or presumed cure) rate
97.1%
94.3%
Satisfactory clinical responses (cure or improvement) rate
97.8%
90.3%
Edverse effects rate
7.9%
6.1%
Number of patients who refused to take medication
7 of 189 children
0 of 98 children

Cefuroxime vs Azithromycin (Zithromax)

Community-acquired pneumonia

Results of international, randomized, open-label study of azithromycin sequential therapy vs standard cefuroxime sequential therapy in the treatment of community-acquired pneumonia 19. Cefuroxime Azithromycin
Regimen 1.5 g intravenously 3 times daily for 1-4 days followed by 500 mg orally twice daily for 7 days 500 mg intravenously once daily for 1-4 days followed by 500 mg orally once daily for 3 days
Clinical efficacy rate
82%
(73 of 89 patients)
81.7%
(67 of 82 patients)
Duration of total therapy
10.1 days
6.2 days
Adverse events rate
29.7%
38.2%


Exacerbations of chronic obstructive pulmonary disease

Both azithromycin and cefuroxime are effective for exacerbations of chronic obstructive pulmonary disease. Azithromycin has a lower rate of side effects.

Results of randomized comparative study of azithromycin and cefuroxime in exacerbations of chronic obstructive pulmonary disease 11. Acetyl Cefuroxime Azithromycin
Regimen 500 mg twice daily for 10 days 500 mg per day for 3 days
Evolution of the symptoms
similar, although with a trend to greater improvement in azithromycin grope
Functional and gasometric evolution
similar
Number of patients required hospital admission
5 of 51 patients
3 of 50 patients

Cefuroxime vs Clarithromycin (Biaxin)

Sinusitis

Cefuroxime and clarithromycin are equally effective in the treatment of acute maxillary sinusitis.

Results of randomised, double-blind, multicentre study comparing cefuroxime axetil and clarithromycin 2. Cefuroxime Clarithromycin
Regimen
250 mg twice daily for 10 days
250 mg twice daily for 10 days
Number of patients cured/improved at post-treatment
169 of 185 patients
(91%)
172 of 185 patients
(93%)
Reduction in incidence of air fluid level and/or opacification
from 96% to 15%
from 96% to 11%
Decrease in frequency of mucosal thickening
from 58% to 28%
from 56% to 29%

Cefuroxime vs Levofloxacin (Levaquin)

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD)

Results of randomized, controlled trial was comparing levofloxacin with cefuroxime axetil in patients with AECOPD 6 Cefuroxime Levofloxacin
Regimen
250-500 mg twice daily for 7 days
500 mg daily for 7 days
Clinical efficacy rate
90.6%
90.4%
Microbiologic response rate   higher in the levofloxacin group


Acute exacerbations of chronic obstructive bronchitis (AECOB)

Cefuroxime and levofloxacin have similar efficacy in the treatment of acute exacerbations of chronic obstructive bronchitis.

Results of randomised, open-label study of levofloxacin and cefuroxime in patients experiencing AECOB episodes 10 Cefuroxime Levofloxacin
Regimen 250 mg twice daily for 10 days 500 mg once daily for 10 days
Clinical cure rates at test of cure
93.8%
94.6%
The probability that 25% of patients would relapse during follow-up was reached
within 81 days
within 93 days
Possibly related treatment-emergent adverse events
2.9%
5.0%


Acute exacerbations of chronic bronchitis

Levofloxacin is at least as effective as cefuroxime axetil in the treatment of acute exacerbation of chronic bronchitis.

Results randomized, double-blind study of levofloxacin versus cefuroxime in the treatment of acute exacerbation of chronic bronchitis 7 Cefuroxime Levofloxacin
Regimen 250 mg twice daily for 7-10 days 250 mg or
500 mg daily for 7-10 days
Cure rates in the intention-to-treat population 61% (166 of 271 patients) 70% (196 of 281 patients)
70% (195 of 280 patients)
Cure rates in the per-protocol population 66% (88 of 134 patients) 78% (121 of 156 patients)
79% (108 of 137 patients)

Community-acquired pneumonia

Oral levofloxacin is less expensive than oral cefuroxime axetil for treatment of adults with community-acquired pneumonia 4.

Results of randomised, open-label study of levofloxacin and cefuroxime in patients experiencing AECOB episodes 4 Cefuroxime Levofloxacin
Regimen 250 mg twice daily for 10 days 500 mg once daily for 10 days
Clinical cure rates at test of cure
93.8%
94.6%
The probability that 25% of patients would relapse during follow-up was reached
within 81 days
within 93 days
Possibly related treatment-emergent adverse events
2.9%
5.0%


Sinusitis

Levofloxacin may be more effective than cefuroxime for the treatment of sinusitis.

Results of comparison of levofloxacin and cefuroxime for the treatment of sinusitis 3 Cefuroxime Levofloxacin
Regimen 250 mg twice daily for 10 to 14 days 200 mg once daily, 200/100 mg twice daily for 10 to 14 days
Success rates after the end of treatment
92.8%
97.4%
Resolution rates of bacteria
80.0%
91.6%

Cefuroxime vs Ofloxacin (Floxin)

Urinary Tract Infections (UTI)

Ofloxacin may be somewhat more effective than cefuroxime axetil in the treatment of urinary tract infections in women.

Results of multicentre study of cefuroxime axetil versus ofloxacin for acute uncomplicated lower urinary tract infections in women 9 Cefuroxime Ofloxacin
Regimen 125 mg twice daily for 3 days 100 mg twice daily for 3 days
Clinical cure and improvement 84.8%
(56 of 66 patients)
95.2%
(59 of 62 patients)
Eliminated bacteriuria 7-9 days after therapy 80.3%
(53 of 66 patients)
89.1%
(57 of 64 patients)


Acute Exacerbations of Chronic Bronchitis

Cefuroxime axetil has better efficacy and lower risk of side effects than ofloxacin.

Results of randomized comparative study of cefuroxime axetil versus ofloxacin for acute exacerbations of chronic bronchitis 1 Cefuroxime Ofloxacin
Regimen 500 mg twice daily for 7-8 days 200 mg twice daily for 7-8 days
Cure rate
75%
50%
Tolerability   treatment was terminated in 2 cases due to side effects
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Further reading

References
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  • 2. Stefansson P, Jacovides A, Jablonicky P, Sedani S, Staley H. Cefuroxime axetil versus clarithromycin in the treatment of acute maxillary sinusitis. Rhinology. 1998 Dec;36(4):173-8. PubMed
  • 3. Li XP, Qin ZM, Zheng RH, Tan QL, Zhou YY, Zhu L, Yin AF. Comparison of the effectiveness of levofloxacin and cefuroxime for the treatment of sinusitis. PubMed
  • 4. Rittenhouse BE, Stinnett AA, Dulisse B, Henke CJ, Potter L, Parasuraman B, Martens LL, Williams RR, Kojak C. An economic evaluation of levofloxacin versus cefuroxime axetil in the outpatient treatment of adults with community-acquired pneumonia. Am J Manag Care. 2000 Mar;6(3):381-9. PubMed
  • 5. Arthur M, McAdoo M, Guerra J, Maloney R, McCluskey D, Giguere G, Gomez G, Collins JJ. Clinical Comparison of Cefuroxime Axetil with Cefixime in the Treatment of Acute Bronchitis. Am J Ther. 1996 Sep;3(9):622-629. PubMed
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  • 7. Shah PM1, Maesen FP, Dolmann A, Vetter N, Fiss E, Wesch R. Levofloxacin versus cefuroxime axetil in the treatment of acute exacerbation of chronic bronchitis: results of a randomized, double-blind study. J Antimicrob Chemother. 1999 Apr;43(4):529-39. PubMed
  • 8. Jacobs RF, Brown WD, Chartrand S, Darden P, Drehobl MA, Yetman R, Ossi MJ. Evaluation of cefuroxime axetil and cefadroxil suspensions for treatment of pediatric skin infections. Antimicrob Agents Chemother. 1992 Aug;36(8):1614-8. PubMed
  • 9. Naber KG, Koch EM. Cefuroxime axetil versus ofloxacin for short-term therapy of acute uncomplicated lower urinary tract infections in women. Infection. 1993 Jan-Feb;21(1):34-9. PubMed
  • 10. Petitpretz P, Chone C, Tremolieres F; Investigator Study Group. Levofloxacin versus cefuroxime in patients with acute exacerbations of chronic obstructive bronchitis: clinical efficacy and exacerbation-free interval. Int J Antimicrob Agents. 2007 Jul;30(1):52-9. PubMed
  • 11. Alvarez Gutie'rrez FJ, Soto Campos G, del Castillo Otero D, Sa'nchez Go'mez J, Caldero'n Osuna E, Rodri'guez Becerra E, Castillo Go'mez J. A randomized comparative study of 3 days of azithromycin and 10 days of cefuroxime in exacerbations in patients with chronic obstructive pulmonary disease Med Clin (Barc). 1999 Jul 3;113(4):124-8. PubMed
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  • 13. Gooch WM 3rd, Kaminester L, Cole GW, et al. Clinical comparison of cefuroxime axetil, cephalexin and cefadroxil in patients with primary infections of the skin or skin structures. Dermatologica. 1991;183(1):36-43. PubMed
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  • 15. Van Herwaarden CL, Langan CE, Siemon G, Rudolph C, Keyserling CH, Nemeth MA, Tack KJ. International study comparing cefdinir and cefuroxime axetil in the treatment of patients with acute exacerbation of chronic bronchitis. Int J Infect Dis. 2000;4(1):26-33. PubMed
  • 16. Gao B, Hu J, Deng W. Multicentre, randomized, prospective and comparative study of ceftriaxone, cefotaxime and cefuroxime in treating mild to moderate respiratory tract infection. Zhonghua Jie He He Hu Xi Za Zhi. 1998 Sep;21(9):528-31. PubMed
  • 17. Barry AL1, Brown SD, Fuchs PC. Eur J Clin Microbiol Infect Dis. 1996 Apr;15(4):344-6.
  • 18. Zuck P, Petitpretz P, Geslin P, Rio Y, Leblanc F. Bacteriological eradication of Streptococcus pneumoniae from patients with acute exacerbations of chronic bronchitis: cefuroxime axetil versus cefixime. Int J Clin Pract. 1999 Sep;53(6):437-43. PubMed
  • 19. Kuzman I1, Daković-Rode O, Oremus M, Banaszak AM. Clinical efficacy and safety of a short regimen of azithromycin sequential therapy vs standard cefuroxime sequential therapy in the treatment of community-acquired pneumonia: an international, randomized, open-label study. J Chemother. 2005 Dec;17(6):636-42. PubMed

Published: March 31, 2008
Last updated: March 27, 2014

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