Click here for a poem on cefuroxime.

 Yay! Back to antibiotics! Life is busy but good, but not too busy for the occasionally preposterous blog reader. Yes you. You’re the only one so hello. I hope you’re happy, this one’s for you buddy. 

Working our way through as many antibiotics that I can write about, we are moving from the ever lovable cephalexin to the younger siblings: second generation cephalosporins. Specifically cefuroxime, another beta-lactam antibiotic. Right now you may be thinking why the hell do we need another one? Because people are not smart when using antibiotics willy-nilly and causing resistance, so it is kinda important to keep finding new ones as we just to get smart about what we do have. 

Anyways, cefuroxime (and most second gens) have longer half-lives than their first gen counterparts which allows for less frequent dosing. This is, as mentioned previously, helpful for patients who may have a lot of different medications they take daily. This dosing is PO or IV by the way. Secondly, if administered in the hospital, maybe the patient can rest more. I would love to have me around but I am sure the patients think otherwise. 

Cefuroxime is used for most of the bugs that a first gen would cover along with H. influenzae, Lyme disease in pediatrics and pregnant women, Enterobacter aerogenes, Neisseria, and others expanding the gram negative coverage. It has better resistance to beta-lactamases as well and can cross the blood-brain-barrier. Can you say meningitis? I also found a neat study of cefuroxime, levofloxacin, a PPI, and bismuth for the treatment of H. pylori in those with penicillin allergies. The results were >85% eradication in penicillin allergic patients in a single hospital in China. 

Fun story H. pylori is the first bacteria I learned about and actually remembered. I had just started my foray into healthcare when I heard about it and saw how painful it can be. It really did spark my interest as I had no idea what the hell was going on or what my friend was telling me at the time. Might have pushed me down this road of infectious fascination. 

Something I don't thin I mentioned in other posts, cephalosporins are time-dependent killers. That is, they work based on time above the MIC of the offending buggys. Regardless, you know now. I hope I can remember. Studying for my nursing boards has my brain filled up at the moment. That is what I wanted to learn so that is what I posted. 

Last but not least, a poem about ceufroxime by ChatGPT: 

Cefuroxime, Cefuroxime, 

A medicine that's quite divine, 

Fights off germ with all its might, 

Making sure you'll be alright. 

References 

Cefuroxime from Antimicrobe.org

Cefuroxime, levofloxacin, esomeprazole, and bismuth as first-line therapy for eradicating Helicobacter pylori in patients allergic to penicillin by Song, Fu, & Zhou from BMC Gastroenterology 2019.

Cephalosporins from StatPearls at the NIH: National Library of Medicine. 

Concentrations of Cefuroxime in Brain Tissue of Neurointensive Care Patients by Hosmann et al., in Antimicrobial Agents and Chemotherapy February 2018.

Image of Enterobacter aerogenes from Quip Laboratories.


Comments

Post a Comment

Popular posts from this blog

What the H?

Image
As far as I can remember, I was never a medically minded person up until Christmas 2019. I knew what food poisoning was, blastomycosis, blood clots,  and cracked ribs were, but that was it. I'm sure I knew of others, but I never gave them a second thought as I was spared much in the way of illness. It's funny how such things shaped my life, and I never gave them any hold in my mind until much later. Not that these diagnoses were as profound as say, a cancer diagnosis, but they impacted me in many ways. All this to say, that was my breadth of awareness of the medical field, the corpsmen (God love them, seriously) were no help to teach me. I do remember vividly for some reason I can't explain, the time I found out about H. pylori, the "H" in the title. I had a buddy at the time with some gnarly, debilitating stomach pain. Boy did I not known what the hell to do about that. Ibuprofen? Acetaminophen? Nah, I know better now. And that. bug, and subsequent complications,...
Read more

Well S*#t

Image
We are just going to keep talking about GI subjects until I get tired of them. Probably after this but who knows? I get to take care of a lot of GI/GU patients at work with some of the "Greatest Hits" of the gut. Diverticulitis, intestinal perforations, colorectal cancer, pancreatitis, bowel obstructions, abscesses, bleeds, and the like. I won't ever be a GI specialist but I do love infections and the big dog at the moment is everyone's favorite, Clostridioides difficile  AKA Clostridium difficile maybe C. diff  or in this mess of words, CD.  CD is a Gram -positive, spore forming, obligate anaerobic, motile, "drumstick-shaped" bacillus. To expand on that, they need low-no oxygen environments (like the gut), create spores that are hardy and able to survive conditions that would kill the live bacteria, and CD creates toxins that cause many of the effects of a CD infection. Though we generally associate CD with the diseases it causes, sometimes called CDAD or C...
Read more

Bacitracin: Bacteria from Tracey

Image
Not even joking. No cap. The solemn truth. On the record. The truth, the whole truth, and nothing but da truth. Bacitracin was named after bacteria from a lady named Margaret Tracey. How is that for useless knowledge taking up space in your brain? Before we get into that story, me thinks the three of you reading this have probably used, or had been the target of use for, bacitracin as a kid. The little packets are ubiquitous in first aid kits across the world. Got a cut? Bacitracin. Burn or scrape? Bacitracin. Ran out of toothpaste? Bacitracin. I really hope that sarcasm was evident, the lack of humor nowadays is stunning. Please don't eat bacitracin.  In 1943, a young girl named Margaret Tracy was seen at a hospital in New York, the precursor to Columbia-Presbyterian Medical Center. She had been hit by a car earlier that day and suffered a compound fracture of her tibia, which collected dirt from the road. The doctors cultures the wound which grew Bacillus subtilis and Staph aureu...
Read more