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AI-Generated response:

What are the potential adverse reactions to Cefuroxime?

Answer generated on June 4, 2024

The AI-generated responses are for illustration purposes only and should not be used for medical purposes.

Cefuroxime can cause gastrointestinal symptoms, hypersensitivity reactions, and hematologic abnormalities.

Serious reactions include anaphylaxis and Stevens-Johnson syndrome.

  • Common gastrointestinal side effects include diarrhea, nausea, and abdominal pain.[1-3]

  • Hypersensitivity reactions can range from rash and urticaria to severe conditions like anaphylaxis and Stevens-Johnson syndrome.[1-3]

  • Hematologic effects include eosinophilia, thrombocytopenia, and hemolytic anemia.[1-3]

  • Neurological side effects such as seizures and encephalopathy are rare but serious and are more likely in patients with renal impairment.[1]

  • Local reactions like thrombophlebitis can occur with IV administration.[1-3]

Additional info

Cefuroxime, a second-generation cephalosporin, is generally well-tolerated but can cause a range of adverse reactions. The gastrointestinal effects are among the most common and include symptoms like diarrhea and nausea, which were reported in clinical trials and post-marketing experiences. Hypersensitivity reactions are critical to monitor due to their potential severity, including life-threatening conditions like anaphylaxis and Stevens-Johnson syndrome. Hematologic abnormalities such as eosinophilia and thrombocytopenia, although less common, are significant due to their impact on patient safety. Neurological effects like seizures are particularly important in patients with renal impairment, highlighting the need for careful dosing and monitoring in this population. Local reactions such as thrombophlebitis are also notable, especially with IV administration, emphasizing the importance of proper administration techniques to minimize these reactions. These side effects are essential for clinicians to monitor and manage to ensure safe and effective use of cefuroxime in treating bacterial infections.

References

Reference 1

1.

Elsevier ClinicalKey Drug Monograph

Content last updated: April 1, 2024.

Adverse Reactions 1. anemia 2. diarrhea 3. diaper dermatitis 4. elevated hepatic enzymes 5. Jarisch-Herxheimer reaction 6. nausea 7. phlebitis 8. vaginitis 9. vomiting 10. abdominal pain 11. anaphylactoid reactions 12. anorexia 13. arthralgia 14. candidiasis 15. chest pain (unspecified) 16. chills 17. cough 18. dizziness 19. drowsiness 20. dyspepsia 21. dyspnea 22. dysuria 23. erythema multiforme 24. fever 25. flatulence 26. headache 27. hemolytic anemia 28. hyperactivity 29. hyperbilirubinemia 30. hypersalivation 31. hypoprothrombinemia 32. infection 33. interstitial nephritis 34. irritability 35. leukorrhea 36. muscle cramps 37. neutropenia 38. oral ulceration 39. pancytopenia 40. pruritus 41. rash 42. seizures 43. serum sickness 44. sinus tachycardia 45. sinusitis 46. Stevens-Johnson syndrome 47. thrombocytopenia 48. toxic epidermal necrolysis 49. urethral pain 50. urticaria 51. vaginal discharge 52. vaginal irritation 53. acute myocardial ischemia 54. agranulocytosis 55. angioedema 56. aplastic anemia 57. azotemia 58. bleeding 59. C. difficile-associated diarrhea 60. cholestasis 61. encephalopathy 62. eosinophilia 63. erythema 64. hepatitis 65. injection site reaction 66. jaundice 67. leukopenia 68. myocardial infarction 69. pseudomembranous colitis 70. superinfection 71. vasculitis

Adverse Reactions Diarrhea (4% to 10.6%) and nausea or vomiting (3% to 7%) were reported in patients receiving oral cefuroxime during clinical trials. Dislike of taste was reported in 5% of pediatric patients. Abdominal pain, flatulence, ptyalism (hypersalivation), dyspepsia, abdominal cramps, indigestion, oral ulceration, anorexia, and thirst were reported in less than 1% of patients receiving oral cefuroxime. Diarrhea (0.5%) and nausea (0.2%) have also been reported with parenteral use.

Adverse Reactions ADVERSE REACTIONS Cefuroxime is generally well-tolerated. The most common adverse effects have been local reactions following IV administration. Other adverse reactions have been encountered only rarely. Local Reactions: Thrombophlebitis has occurred with IV administration in 1 in 60 patients. Gastrointestinal: Gastrointestinal symptoms occurred in 1 in 150 patients and included diarrhea (1 in 220 patients) and nausea (1 in 440 patients). The onset of pseudomembranous colitis may occur during or after antibacterial treatment (see WARNINGS). Hypersensitivity Reactions: Hypersensitivity reactions have been reported in fewer than 1% of the patients treated with Cefuroxime for Injection and include rash (1 in 125). Pruritus, urticaria, and positive Coombs' test each occurred in fewer than 1 in 250 patients, and, as with other cephalosporins, rare cases of anaphylaxis, drug fever, erythema multiforme, interstitial nephritis, toxic epidermal necrolysis, and Stevens-Johnson syndrome have occurred. Blood: A decrease in hemoglobin and hematocrit has been observed in 1 in 10 patients and transient eosinophilia in 1 in 14 patients. Less common reactions seen were transient neutropenia (fewer than 1 in 100 patients) and leukopenia (1 in 750 patients). A similar pattern and incidence were seen with other cephalosporins used in controlled studies. As with other cephalosporins, there have been rare reports of thrombocytopenia. Hepatic: Transient rise in SGOT and SGPT (1 in 25 patients), alkaline phosphatase (1 in 50 patients), LDH (1 in 75 patients), and bilirubin (1 in 500 patients) levels has been noted. Kidney: Elevations in serum creatinine and/or blood urea nitrogen and a decreased creatinine clearance have been observed, but their relationship to cefuroxime is unknown.

Adverse Reactions Serious and sometimes fatal anaphylactoid reactions have been reported in patients receiving beta-lactam antibiotics, including cefuroxime. If an allergic reaction occurs, discontinue cefuroxime and institute appropriate therapy. Rash, hives, swollen tongue, erythema, pruritus, and urticaria have been reported in less than 1% of adult patients during clinical trials. Diaper dermatitis (3%) and rash (less than 1%) were reported in pediatric patients. Rarely, anaphylaxis, drug fever, erythema multiforme, toxic epidermal necrolysis, and Stevens-Johnson syndrome have occurred. Angioedema, cutaneous vasculitis, and serum sickness-like reaction have been reported with postmarketing use.

Adverse Reactions A decrease in hemoglobin and hematocrit (anemia) and eosinophilia have been reported in 10% and 1% to 7% of patients, respectively, after IV administration of cefuroxime. Transient neutropenia (less than 1%) and leukopenia (0.1%) were less common. A similar pattern and incidence has been seen with other cephalosporins used in controlled studies. As with other cephalosporins, there have been rare reports of thrombocytopenia. A positive Coombs' test has been reported in less than 1% of pediatric patients receiving oral cefuroxime. Hemolytic anemia, pancytopenia, and increased prothrombin time (hypoprothrombinemia) have been reported with postmarketing use. Aplastic anemia, hemorrhage (bleeding), and agranulocytosis have been reported with the cephalosporin class.

Adverse Reactions Headache, dizziness, drowsiness, and somnolence were reported in less than 1% of adults treated with cefuroxime during clinical trials, while hyperactivity and irritability have been reported in less than 1% of pediatric patients. Seizures and encephalopathy are a rare but a serious complication of cephalosporin therapy, and have been reported in postmarketing experience with cefuroxime. If seizures occur, discontinue treatment and administer appropriate anticonvulsant therapy as indicated. More commonly associated with penicillins, the epileptogenic properties of both penicillins and cephalosporins are thought to be related to their beta-lactam ring. Renal impairment and lack of needed dosage adjustment are associated with an increased risk of seizures.

Reference 2

2.

Food and Drug Administration (DailyMed).

Publish date: December 6, 2020.

Adverse Reactions ADVERSE REACTIONS Cefuroxime is generally well tolerated. The most common adverse effects have been local reactions following IV administration. Other adverse reactions have been encountered only rarely. Local Reactions: Thrombophlebitis has occurred with IV administration in 1 in 60 patients. Gastrointestinal: Gastrointestinal symptoms occurred in 1 in 150 patients and included diarrhea (1 in 220 patients) and nausea (1 in 440 patients). The onset of pseudomembranous colitis may occur during or after antibacterial treatment (see WARNINGS ). Hypersensitivity Reactions: Hypersensitivity reactions have been reported in fewer than 1% of the patients treated with cefuroxime and include rash (1 in 125). Pruritus, urticaria, and positive Coombs' test each occurred in fewer than 1 in 250 patients, and, as with other cephalosporins, rare cases of anaphylaxis, drug fever, erythema multiforme, interstitial nephritis, toxic epidermal necrolysis, and Stevens-Johnson syndrome have occurred. Blood: A decrease in hemoglobin and hematocrit has been observed in 1 in 10 patients and transient eosinophilia in 1 in 14 patients. Less common reactions seen were transient neutropenia (fewer than 1 in 100 patients) and leukopenia (1 in 750 patients). A similar pattern and incidence were seen with other cephalosporins used in controlled studies. As with other cephalosporins, there have been rare reports of thrombocytopenia. Hepatic: Transient rise in SGOT and SGPT (1 in 25 patients), alkaline phosphatase (1 in 50 patients), LDH (1 in 75 patients), and bilirubin (1 in 500 patients) levels has been noted. Kidney: Elevations in serum creatinine and/or blood urea nitrogen and a decreased creatinine clearance have been observed, but their relationship to cefuroxime is unknown.

Reference 3

3.

Food and Drug Administration (DailyMed).

Publish date: April 1, 2019.

Adverse Reactions ADVERSE REACTIONS Cefuroxime for Injection is generally well tolerated. The most common adverse effects have been local reactions following IV administration. Other adverse reactions have been encountered only rarely. Local Reactions Thrombophlebitis has occurred with IV administration in 1 in 60 patients. Gastrointestinal Gastrointestinal symptoms occurred in 1 in 150 patients and included diarrhea (1 in 220 patients) and nausea (1 in 440 patients). The onset of pseudomembranous colitis may occur during or after antibacterial treatment (see WARNINGS ). Hypersensitivity Reactions Hypersensitivity reactions have been reported in fewer than 1% of the patients treated with Cefuroxime for Injection and include rash (1 in 125). Pruritus, urticaria, and positive Coombs' test each occurred in fewer than 1 in 250 patients, and, as with other cephalosporins, rare cases of anaphylaxis, drug fever, erythema multiforme, interstitial nephritis, toxic epidermal necrolysis, and Stevens-Johnson syndrome have occurred. Blood A decrease in hemoglobin and hematocrit has been observed in 1 in 10 patients and transient eosinophilia in 1 in 14 patients. Less common reactions seen were transient neutropenia (fewer than 1 in 100 patients) and leukopenia (1 in 750 patients). A similar pattern and incidence were seen with other cephalosporins used in controlled studies. As with other cephalosporins, there have been rare reports of thrombocytopenia. Hepatic Transient rise in SGOT and SGPT (1 in 25 patients), alkaline phosphatase (1 in 50 patients), LDH (1 in 75 patients), and bilirubin (1 in 500 patients) levels has been noted. Kidney Elevations in serum creatinine and/or blood urea nitrogen and a decreased creatinine clearance have been observed, but their relationship to cefuroxime is unknown. Postmarketing Experience with Cefuroxime for Injection In addition to the adverse events reported during clinical trials, the following events have been observed during clinical practice in patients treated with Cefuroxime for Injection and were reported spontaneously.

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