Cefuroxime (Ceftin) versus Other Antibiotics

• Cefuroxime vs Ceftriaxone
• Cefuroxime vs Cefdinir
• Cefuroxime vs Cephalexin
• Cefuroxime vs Cefaclor
• Cefuroxime vs Cefixime
• Cefuroxime vs Cefadroxil
• Cefuroxime vs Azithromycin
• Cefuroxime vs Clarithromycin
• Cefuroxime vs Levofloxacin
• Cefuroxime vs Ofloxacin

Based on "Antibiotic and Chemotherapy"
written by Roger G. Finch

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

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)

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 patients, 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

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%

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

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

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%

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%

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

• Cefuroxime (Ceftin) Facts

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• 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
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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
• 14. Turik MA, Johns D Jr. Comparison of cefaclor and cefuroxime axetil in the treatment of acute otitis media with effusion in children. J Chemother. 1998 Aug;10(4):306-12. PubMed
• 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
• 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 reviewed: February 17, 2017