Cefuroxime Axetil & Clavulanic Acid combination is indicated in-
Pharyngitis and/or tonsillitis
Acute bacterial otitis media
Acute bacterial maxillary sinusitis
Lower respiratory tract infections including pneumonia
Acute bacterial exacerbations of chronic bronchitis and secondary bacterial infections of acute bronchitis
Skin and Skin-Structure Infections
Urinary tract infections
Bone and Joint infections
Gonorrhea: Uncomplicated and disseminated gonococcal infections
Early Lyme disease (erythema migrans)
Switch therapy (injectable to oral) after surgery when patient’s condition is improved.
Second generation Cephalosporins
Cefuroxime is one of the bactericidal second generation cephalosporin antibiotics, which is active against a wide range of Gram-positive and Gram-negative susceptible organisms including many beta-lactamase producing strains. It is indicated for the treatment of infections caused by sensitive bacteria.
Clavulanic acid has a similar structure to the beta-lactam antibiotics but binds irreversibly to the beta-lactamase enzymes.
Clavulanic acid protects Cefuroxime from degradation by beta-lactamase enzymes and effectively extends the antibacterial spectrum of Cefuroxime to include many bacteria normally resistant to Cefuroxime and other cephalosporins.
Pharyngitis or Tonsillitis: 250 mg twice daily for 5-10 days
Acute bacterial maxillary sinusitis: 250 mg twice daily for 10 days
Acute bacterial exacerbation of chronic bronchitis: 250-500 mg twice daily for 10 days
Secondary bacterial infections of acute bronchitis: 250-500 mg twice daily for 5-10 days
Community acquired pneumonia: 250-500 mg twice daily for 5-10 days
Uncomplicated skin & skin-structure infections: 250-500 mg twice daily for 10 days
Multidrug resistant typhoid fever: 500 mg twice daily for 10-14 days
Uncomplicated urinary tract infection: 250 mg twice daily for 7-10 days
Uncomplicated gonorrhea: 1000 mg once single dose
Lyme disease: 500 mg twice daily for 20 days
Cefuroxime & Clavulanic Acid may be administered without regard to meals.
Probenecid: Concomitant administration of probenecid with Cefuroxime increases the area under the serum concentration versus time curve by 50%. The peak serum Cefuroxime concentration after a 1.5 gm single dose is greater when taken with 1 gm of probenecid than without probenecid.
Antacids: Drugs that reduce gastric acidity may result in a lower bioavailability of Cefuroxime and Clavulanic acids compared with that of fasting state and tend to cancel the effect of postprandial absorption.
Oral contraceptives: In common with other antibiotics, Cefuroxime may affect the gut flora, leading to lower estrogen re absorption and reduced efficacy of combined oral estrogen/ progesterone.
It is contraindicated in patients with known allergy to Cefuroxime and Clavulanic acid or to the cephalosporin group of antibiotics.
Generally Cefuroxime and Clavulanic acid are well tolerated. However, a few side effects like nausea, vomiting, diarrhea, abdominal discomfort or pain may occur.
Pregnancy & Lactation
Both Cefuroxime and Clavulanic acid are pregnancy category B. Cefuroxime is excreted in human milk; consideration should be given to discontinuing nursing temporarily during treatment with Cefuroxime.
Cefuroxime should be given with caution to patients receiving concurrent treatment with potent diuretics because these diuretics are suspected of adversely affecting renal function. Cefuroxime, as with other broad-spectrum antibiotics, should be prescribed with caution in individuals with a history of colitis.
Symptoms: Overdosage of Cefaclav can cause cerebral irritation leading to convulsions.
Management: Serum levels of Cefaclav can be reduced by haemodialysis and peritoneal dialysis.
Should be kept in a cool (15–30°C) and dry place and protected from light.