Description

Cefuroxime axetil is a second-generation cephalosporin antibiotic. It is a prodrug, which means it is an inactive compound that is converted into an active drug within the body. When taken orally, it is absorbed from the gastrointestinal tract and rapidly hydrolyzed by esterase enzymes in the intestinal mucosa and blood into its active form, cefuroxime. Cefuroxime is a bactericidal agent, effective against a broad spectrum of bacteria, including many Gram-positive and Gram-negative organisms. It is available in various oral forms, such as tablets and suspension, making it a convenient option for outpatient treatment.

Indications

Cefuroxime axetil is used to treat a wide range of bacterial infections, particularly those affecting the respiratory, urinary, and skin systems. Its ability to combat bacteria that have developed resistance to some older antibiotics makes it a valuable therapeutic option. Key indications include:

• Respiratory Tract Infections: Such as acute bacterial sinusitis, acute exacerbations of chronic bronchitis, and pneumonia.

• Ear, Nose, and Throat (ENT) Infections: Including otitis media (middle ear infections), pharyngitis, and tonsillitis.

• Urinary Tract Infections (UTIs): For complicated and uncomplicated UTIs.
• Skin and Soft Tissue Infections: Such as impetigo and other uncomplicated skin infections.

• Lyme Disease: It is a common treatment for early Lyme disease (erythema migrans).

• Gonorrhea: It can be used to treat uncomplicated gonorrhea.

Mechanism of Action

Cefuroxime axetil’s mechanism of action is based on the activity of its active metabolite, cefuroxime, which, like other beta-lactam antibiotics, targets the bacterial cell wall. The process involves:

1. Conversion to Active Form: After oral administration, cefuroxime axetil is converted into the active drug, cefuroxime.

2. Binding to Penicillin-Binding Proteins (PBPs): Cefuroxime binds to and inactivates specific enzymes located in the bacterial cell wall known as penicillin-binding proteins (PBPs). These PBPs are crucial for the synthesis of the peptidoglycan layer, which provides the cell wall with its structural integrity.

3. Inhibition of Cross-linking: The binding of cefuroxime to PBPs inhibits the transpeptidation reaction, a critical step where the peptidoglycan chains are cross-linked.

4. Cell Lysis and Death: By preventing the proper formation of the cell wall, the antibiotic causes the cell to become structurally unstable and unable to withstand the internal osmotic pressure. This leads to the activation of autolytic enzymes, which cause the cell to swell and burst (lyse), resulting in the death of the bacterium.

A key advantage of cefuroxime, as a second-generation cephalosporin, is its enhanced stability against many beta-lactamase enzymes produced by bacteria. This allows it to be effective against some strains of bacteria that have become resistant to first-generation cephalosporins and penicillins.