A fixed-dose combination of a second-generation cephalosporin antibiotic (Cefuroxime) and a beta-lactamase inhibitor (Clavulanic Acid). Cefuroxime acts by inhibiting bacterial cell wall synthesis, while clavulanic acid protects it from degradation by beta-lactamase enzymes produced by resistant bacteria. This combination extends the antibacterial spectrum to include beta-lactamase-producing strains of Staphylococcus aureus, Haemophilus influenzae, Klebsiella spp., and Moraxella catarrhalis, making it highly effective for respiratory, skin, and urinary tract infections in the Indian context where resistance is prevalent.
Adult: One tablet (Cefuroxime 500mg + Clavulanic Acid 125mg) orally twice daily. For severe infections, the dose can be increased to one tablet thrice daily.
Note: Administer with food to enhance absorption of cefuroxime axetil and minimize gastrointestinal upset. Tablets should be swallowed whole, not crushed or chewed. Complete the full prescribed course even if symptoms improve.
Cefuroxime binds to specific penicillin-binding proteins (PBPs) located inside the bacterial cell wall, inhibiting the final transpeptidation step of peptidoglycan synthesis. This leads to the formation of a defective cell wall and osmotic lysis of the bacterium. Clavulanic acid is a 'suicide' inhibitor that irreversibly binds to and inactivates a wide variety of beta-lactamase enzymes (particularly those encoded by TEM-1, SHV-1, and plasmid-mediated enzymes), thereby protecting cefuroxime from hydrolysis and extending its spectrum.
Pregnancy: Pregnancy Category B. Cefuroxime crosses the placenta. Studies in animals have not shown teratogenic effects. Use during pregnancy only if clearly needed, after consulting a physician. Generally considered safe when indicated.
Driving: May cause dizziness. Patients should not drive or operate machinery if they experience dizziness.
| Probenecid | Inhibits renal tubular secretion of cefuroxime, increasing and prolonging its serum levels. Risk of toxicity. | Moderate |
| Anticoagulants (Warfarin, Acenocoumarol) | Cefuroxime may potentiate anticoagulant effect by altering gut flora and reducing vitamin K synthesis. Monitor INR closely. | Major |
| Oral Contraceptives | Potential reduction in efficacy due to altered gut flora. Advise use of non-hormonal backup contraception. | Moderate |
| Aminoglycosides (e.g., Gentamicin) | Additive nephrotoxicity. Monitor renal function. | Moderate |
| Loop Diuretics (e.g., Furosemide) | Potential increase in nephrotoxicity. | Moderate |
| Methotrexate | Cefuroxime may decrease renal clearance of methotrexate, increasing risk of methotrexate toxicity. | Major |
Same composition (Cefuroxime (500mg) + Clavulanic Acid (125mg)), different brands: