CEFUROXIME AXETIL - A REVIEW OF ITS ANTIBACTERIAL ACTIVITY, PHARMACOKINETIC PROPERTIES AND THERAPEUTIC EFFICACY

Cefuroxime axetil is an oral cephalosporin which is rapidly hydrolysed to the active parent compound, cefuroxime. Cefuroxime has a broad spe ctrum of in vitro antibacterial activity which encompasses methicillin -sensitive staphylococci and the common respiratory pathogens Streptoc occus pneumoniae, Haemophilus influenzae, Moraxella (Branhamella) cata rrhalis and group A beta-haemolytic streptococci. Cefuroxime has broad spectrum activity against the beta-lactamase positive respiratory pat hogens H. influenzae and M. catarrhalis; it is also active against pen icillin-susceptible and -intermediate strains of S. pneumoniae. In cli nical trials, cefuroxime axetil (administered twice daily) has been ev aluated in the treatment of upper and lower respiratory tract infectio ns and has demonstrated similar efficacy to established antibacterial agents, including amoxicillin/clavulanic acid and cefaclor. Five days' treatment with either cefuroxime axetil or amoxicillin/clavulanic aci d in patients with acute otitis media or acute bronchitis. Cefuroxime axetil was at least as effective as phenoxymethylpenicillin )penicilli n V) in the treatment of patients with group A beta-haemolytic strepto coccal tonsillopharyngitis. A number of studies have evaluated the eff icacy of cefuroxime axetil as the oral component of intravenous to ora l sequential therapy in hospitalised patients with lower respiratory t ract infection. In each study patients received parenteral cefuroxime for approximate to 2 days followed by cefuroxime axetil for 5 to 10 da ys. In comparative studies, cefuroxime sequential therapy was as effec tive as amoxicillin/clavulanic acid sequential therapy and full course s of parenteral cefuroxime, cefotiam or cefoperazone. Adults with urin ary tract infections and skin infections were also effectively treated with cefuroxime axetil, as were adults and adolescents with early sta ge Lyme disease. Cefuroxime axetil is associated with a low incidence of adverse events, with gastrointestinal disturbances being the most f requently observed. Thus, cefuroxime axetil is an effective and conven ient treatment for a wide range of infections and may be considered a therapeutic option when empirical treatment of community-acquired infe ctions is required. Moreover, given the promising results of several i ntravenous/oral sequential treatment studies, cefuroxime axetil may al so become established as an oral component of sequential treatment reg imes.