Cefuroxime is an antibiotic used to treat a wide range of bacterial infections, from ear infections and strep throat to urinary tract infections and early Lyme disease. It belongs to a class of antibiotics called cephalosporins, which are chemically related to penicillin. It’s available as an oral tablet, a liquid suspension, and an injectable form.
Infections Cefuroxime Treats
Cefuroxime is approved to treat infections in several parts of the body. For upper respiratory infections, it covers strep throat, tonsillitis, sinus infections, and ear infections. For the lower respiratory tract, it treats flare-ups of chronic bronchitis and secondary bacterial infections that develop after a bout of acute bronchitis.
Beyond the respiratory tract, cefuroxime is used for uncomplicated urinary tract infections, uncomplicated skin infections, impetigo in children, and uncomplicated gonorrhea. It’s also one of the standard oral antibiotics for early Lyme disease, the stage where you typically see a bull’s-eye rash and flu-like symptoms before the infection spreads to joints or the nervous system.
For community-acquired pneumonia in adults who have other health conditions like diabetes, chronic lung disease, or liver disease, clinical guidelines list cefuroxime as an alternative to other antibiotics, typically paired with a second antibiotic from a different class. It’s not the first-line choice for pneumonia, but it’s a recognized option when preferred drugs aren’t suitable.
How Cefuroxime Works
Bacteria build and maintain rigid cell walls to survive. Cefuroxime kills bacteria by binding to specific proteins on the bacterial cell surface that are essential for assembling this wall. Once those proteins are blocked, the cell wall weakens, the bacterium swells, and it ruptures. This is the same basic mechanism penicillin uses, which is why cephalosporins and penicillins are considered relatives. The key difference is that cefuroxime resists breakdown by certain enzymes that some bacteria produce to destroy penicillin, giving it a broader reach against resistant strains.
Common Side Effects
The most frequent side effects are digestive: nausea, vomiting, and diarrhea. These are generally mild and resolve once you finish the course of treatment.
Less common but more serious reactions include skin rash, hives, itching, difficulty breathing or swallowing, and swelling of the face, throat, or tongue. These can signal an allergic reaction and need immediate medical attention. Watery or bloody stools with stomach cramps or fever, whether during treatment or up to two months afterward, can indicate a serious intestinal infection caused by disruption of normal gut bacteria.
Taking It With Food Matters
Cefuroxime tablets absorb significantly better when taken with food. If you take them on an empty stomach, your body may not absorb enough of the drug for it to work effectively. The liquid suspension, often used for children, can be taken with or without food, but food still helps. Treatment courses typically run 5 to 14 days depending on the infection, though some conditions like gonorrhea require only a single dose.
Allergies and Precautions
If you’ve had a severe allergic reaction to any cephalosporin antibiotic, you should not take cefuroxime. The bigger question most people have is whether it’s safe if they’re allergic to penicillin. The cross-reactivity rate between penicillins and cephalosporins like cefuroxime is less than 1%, far lower than the 5% figure that was cited for decades. For many people with a penicillin allergy, cefuroxime is a safe alternative, though the specific nature of your allergy matters.
People with kidney or liver disease may need adjusted treatment since the drug is cleared through the kidneys. If you have a history of gastrointestinal disease, particularly colitis, your doctor will want to know before prescribing cefuroxime because antibiotics can worsen these conditions. The liquid suspension contains aspartame, which is relevant for anyone with phenylketonuria (PKU).
Use in Children
Cefuroxime is widely used in pediatric medicine. Ear infections are one of the most common reasons it’s prescribed for young children. For kids, dosing is based on body weight, and the liquid suspension makes it easier for small children to take. Children 13 and older are generally dosed the same as adults for most infections. For younger children and infants, the injectable form is dosed at roughly 30 to 100 milligrams per kilogram of body weight per day, split into several doses throughout the day. A dose of 60 milligrams per kilogram per day is appropriate for most routine infections in this age group.
What Cefuroxime Does Not Treat
Like all antibiotics, cefuroxime works only against bacteria. It has no effect on viral infections such as the common cold, flu, or COVID-19. Taking antibiotics for viral infections won’t speed recovery and contributes to antibiotic resistance, making these drugs less effective for everyone over time. Cefuroxime also does not cover every type of bacteria. Your doctor chooses it when the likely cause of your infection falls within its known range of activity.