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頭孢呋辛

Cefuroxime

Cefuroxime axetil, Cefuroxime sodium

抗生素 - 第二代頭孢菌素POIVIM狗貓

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

由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本

WHO 高度重要抗生素 — 建議負責任地使用
10 mg/kg PO q12hPO· q12h· 10 days
— 🐕

劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

各物種劑量

🌎 NA — North America🌍 EU — Europe

狗

適應症劑量途徑頻次療程地區
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

貓

適應症劑量途徑頻次療程地區
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

劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。

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概覽

頭孢呋辛是一種半合成的​第二代頭孢菌素類​抗生素，具有口服（酯化物）和注射（鈉鹽）兩種劑型。

  • ​抗菌譜​：與第一代頭孢菌素（如頭孢氨苄）相比，它對某些​革蘭氏陰性病原體​（如大腸桿菌、克雷伯氏肺炎桿菌、沙門氏菌、腸桿菌）具有更強的抗菌活性，同時保留了對許多革蘭氏陽性菌的良好療效。
  • ​臨床應用​：在小動物醫學中，當感染對第一代頭孢菌素產生抗藥性、需要更廣泛的革蘭氏陰性菌覆蓋以進行​外科預防​，或需要​高血腦屏障穿透率​（腦膜發炎時可進入中樞神經系統）時，本藥特別有用。
  • ​限制​：對抗甲氧西林金黃色葡萄球菌 (MRSA/MRSP)、綠膿桿菌、沙雷氏菌或腸球菌無效。

作用機制

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.

安全性與警告

禁忌症

  • Known hypersensitivity to cefuroxime or other cephalosporins

不良反應

  • 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.

藥物相互作用

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.

監測

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

藥物動力學

吸收

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).

分佈

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).

排除

Primarily excreted unchanged in the urine.

過量

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.

可用產品

劑型

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

人用標示

  • 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)

各地核准狀態

European Union✓ 已核准處方藥EMA

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

United Kingdom✓ 已核准處方藥VMD

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

暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

儲存與穩定性

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.

飼主須知

  • ​隨餐服用​：請將口服錠劑與食物一起餵食，以促進藥物吸收並減少腸胃不適的機會。
  • ​請勿壓碎​：避免壓碎錠劑。它們具有非常強烈的苦味，寵物會排斥。如果絕對必須壓碎，請將粉末與味道濃郁的乳製品（如牛奶或寵物安全的起司）混合，以掩蓋味道並改善吸收。
  • ​完成療程​：請完全按照獸醫師的指示給藥。即使您的寵物看起來已經完全康復，也請繼續治療直到處方療程結束，以防止感染復發或產生抗藥性。
  • ​注意副作用​：如果您的寵物出現嚴重嘔吐、持續腹瀉、皮疹、發癢或面部腫脹，請聯繫您的獸醫師。

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