VetSheet

セフロキシム

Cefuroxime

Cefuroxime axetil, Cefuroxime sodium

抗生物質 - 第2世代セファロスポリンPOIVIM犬猫

別名: Ceftin · Zinacef · Aprokam · Zinnat · CCI-15641 · cefuroxima · cefuroximum · cefuroksiimi · cefuroksimas · Cefuroxime axetil · Cefuroxime sodium

VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス

WHO高位重要抗菌薬 — 責任ある使用を推奨
10 mg/kg PO q12hPO· q12h· 10 days
— 🐕

用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。

動物種別用量

🌎 NA — North America🌍 EU — Europe

犬

適応用量経路頻度期間地域
Soft tissue infections10 mg/kg PO q12hPOq12h10 days🌎 NA
Systemic infections15 mg/kg IV q8hIVq8h—🌎 NA
Meningitis30 mg/kg IV q8hIVq8h—🌎 NA
Surgery prophylaxis20 mg/kg IV 30 minutes prior to surgery and every 2 hours during surgery.IV30 mins prior and q2h duringPerioperative🌎 NA
Surgical prophylaxis20 mg/kgIV30 min prior to surgery and then repeat q1.5-3h during surgeryPerioperative🌍 EU
Susceptible infections10-30 mg/kgIVq8-12hAs directed🌍 EU
  • Soft tissue infections: Extrapolated from human dosages.
  • Systemic infections: Extrapolated from human dosages.
  • Meningitis: Extrapolated from human dosages.
  • Surgical prophylaxis: Administer slowly over 5 min

猫

適応用量経路頻度期間地域
Surgical prophylaxis20 mg/kgIV30 min prior to surgery and then repeat q1.5-3h during surgeryPerioperative🌍 EU
Susceptible infections10-30 mg/kgIVq8-12hAs directed🌍 EU
  • Surgical prophylaxis: Administer slowly over 5 min

用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。

診察中ですか？VetSheet の AI が薬剤・用量・投与期間を構造化された診察記録に直接記入します。VetSheet の仕組みを見る

概要

セフロキシムは、経口（アキセチル）および注射（ナトリウム）の両方の製剤で利用可能な半合成の​第2世代セファロスポリン系​抗菌薬です。

  • ​抗菌スペクトル​: 第1世代セファロスポリン（セファレキシンなど）と比較して、特定の​グラム陰性菌​（大腸菌、肺炎桿菌、サルモネラ、エンテロバクターなど）に対して強化された活性を提供しつつ、多くのグラム陽性菌に対しても良好な有効性を維持します。
  • ​臨床的有用性​: 小動物医療において、第1世代セファロスポリンに耐性のある感染症の治療、​外科的予防​のためのより広範なグラム陰性菌のカバーが必要な場合、または​高い中枢神経系（CNS）濃度​が必要な場合（髄膜の炎症時に移行可能）に特に有用です。
  • ​制限事項​: メチシリン耐性ブドウ球菌（MRSA/MRSP）、緑膿菌、セラチア、または腸球菌には無効です。

作用機序

Cefuroxime is a bactericidal time-dependent antibiotic.

It binds to specific ​penicillin-binding proteins (PBPs)​ located inside the bacterial cell wall → inhibits the third and final stage of bacterial cell wall synthesis (peptidoglycan cross-linking) → weakens the cell wall → leads to cell lysis and death due to osmotic pressure.

Clinical Pearl: Like other beta-lactams, its efficacy depends on the amount of time the drug concentration remains above the Minimum Inhibitory Concentration (MIC) at the site of infection.

安全性・警告

禁忌

  • Known hypersensitivity to cefuroxime or other cephalosporins

有害事象

  • Inappetence
  • Vomiting
  • Diarrhea
  • Injection site inflammation (IV use)
  • Eosinophilia
  • Hypersensitivity reactions (including anaphylaxis)
  • Neurologic effects (hearing loss, seizures - rare)
  • Pseudomembranous colitis (rare)
  • Serious dermatologic reactions (TEN, Stevens-Johnson syndrome - rare)
  • Hematologic effects (pancytopenia, thrombocytopenia - rare)
  • Interstitial nephritis (rare)

注意事項

Renal Impairment: Dosage adjustment is recommended in patients with severe renal impairment, as the drug is primarily excreted unchanged in the urine.

  • Laboratory Interference: May cause false-positive urine glucose determinations when using the copper reduction method (Benedict's, Fehling's, Clinitest). Tests utilizing glucose oxidase are unaffected.
  • Coombs' Test: Cephalosporins have caused false-positive direct Coombs' tests in humans, particularly those with azotemia.
  • Nursing Mothers: Enters maternal milk in low concentrations; potential for altering gut flora of nursing offspring.

医薬品相互作用

AminoglycosidesMinor

Potential for increased risk of nephrotoxicity; monitor renal function. However, may have synergistic or additive actions against some gram-negative bacteria (Enterobacteriaceae).

FurosemideModerate

Possible increased risk of nephrotoxicity.

Torsemide

Possible increased risk of nephrotoxicity.

Probenecid

Reduced renal excretion of cephalosporins, potentially increasing serum levels.

OxytetracyclineModerate

Bacteriostatic agents may antagonize the bactericidal activity of cefuroxime.

ErythromycinModerate

Bacteriostatic agents may antagonize the bactericidal activity of cefuroxime.

Amphotericin BMajor

Increased risk of nephrotoxicity; monitor renal function.

監視

  • Clinical efficacy (resolution of infection signs)
  • Renal function in patients with pre-existing renal insufficiency
  • Gastrointestinal tolerance

薬物動態

吸収

In humans, cefuroxime axetil is well absorbed orally and rapidly hydrolyzed in the intestinal mucosa and circulation to the parent compound. Bioavailability is 37% (fasted) to 52% (with food). Peak serum levels occur in 2-3 hours (PO) or 15 min-1 hour (IM).

分布

Widely distributed to tissues including bone, aqueous humor, and joint fluid. Therapeutic levels can be attained in the CSF if meninges are inflamed. Human plasma protein binding is 35-50%.

代謝

Cefuroxime axetil is rapidly hydrolyzed in the intestinal mucosa and systemic circulation to the active parent compound (cefuroxime).

消失

Primarily excreted unchanged in the urine.

過剰投与

Cefuroxime has a wide margin of safety. Beagles receiving daily dosages up to 1600 mg/kg/day orally tolerated the drug well, with only minor vomiting, slight weight gain suppression, and minor hematologic changes at the highest doses.

In humans, massive overdoses have caused cerebral irritation and seizures. If severe toxicity occurs, plasma levels can be reduced via hemodialysis or peritoneal dialysis. Treatment is largely supportive.

製品

製剤

  • Oral tablets (film coated)
  • Oral suspension
  • Powder for injection
  • Premixed frozen injection

ヒト用医薬品

  • Cefuroxime Axetil Oral Tablets (film coated): 125 mg, 250 mg, & 500 mg (Ceftin, generic)
  • Cefuroxime Axetil Oral Suspension: 125 mg/5 mL & 250 mg/5 mL (generic)
  • Cefuroxime Sodium Powder for Injection: 750 mg, 1.5 g & 7.5 g (Zinacef, generic)
  • Cefuroxime Sodium Injection: 750 mg & 1.5 g premixed frozen (Zinacef)

規制ステータス

European Union✓ 承認済み処方箋医薬品EMA

Human authorized products (POM) used off-label in veterinary medicine under the cascade.

United Kingdom✓ 承認済み処方箋医薬品VMD

Human authorized products (POM) used off-label in veterinary medicine under the cascade.

規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

保管・安定性

Tablets: Store in tight containers at room temperature (15-30°C); protect from excessive moisture. Suspension: Unreconstituted powder store at 2-30°C. Once reconstituted, refrigerate (2-8°C) and discard any unused portion after 10 days. Injection: Powder store at room temperature (15-30°C). Reconstituted solution (90 mg/mL) is stable for 24 hours at room temperature or 48 hours refrigerated. Diluted in compatible IV solutions (D5W, normal saline, Ringer's), it is stable for 24 hours at room temperature or up to 7 days refrigerated.

飼主向け情報

  • ​食事と一緒に与える​: 薬の吸収を高め、胃の不調を防ぐために、経口錠剤は食事と一緒に与えてください。
  • ​砕かないでください​: 錠剤を砕くのは避けてください。非常に強い苦味があり、ペットが嫌がります。どうしても砕く必要がある場合は、味をごまかして吸収を良くするために、味の濃い乳製品（牛乳やペット用のチーズなど）と混ぜてください。
  • ​処方分を飲み切る​: 獣医師の指示通りに正確に投薬してください。ペットが完全に良くなったように見えても、感染症の再発や耐性菌の発生を防ぐため、処方された期間は治療を続けてください。
  • ​副作用に注意​: ペットに激しい嘔吐、持続的な下痢、発疹、かゆみ、または顔の腫れが見られた場合は、獣医師に連絡してください。

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