CEFOVEX

Cefuroxime axetil
Diseases
Respiratory Tract Infection
(RTIs)
 Respiratory Tract Infection
(RTIs)
Main causative MO:
H.influenzae, M. catarrhalis, S. pneumoniae

Upper Respiratory Tract Infections

• Otitis media (infection & inflammation of middle ear)

• Sinusitis (infection & inflammation of sinuses)

• Pharyngitis (infection & inflammation of pharynx)

• Tonsillitis (infection & inflammation of tonsil)

 is inflammation of the middle ear, or middle ear
infection.
 Otitis media occurs in the area between the ear drum (the
end of the outer ear) and the inner ear, including a duct
known as the eustachian tube.
Causes
 Streptococcus pneumoniae and Haemophilus influenzae
are the most common bacterial causes of otitis media..
 is infection or inflammation of the sinuses,

Classification

By location
including the frontal, ethmoid, maxillary and sphenoid sinuses.
 Maxillary sinusitis - can cause pain or pressure in the maxillary (cheek) area (e.g.,
toothache, headache)

 Frontal sinusitis - can cause pain or pressure in the frontal sinus cavity (located
behind/above eyes), headache

 Ethmoid sinusitis - can cause pain or pressure pain between/behind eyes,

headache

 Sphenoid sinusitis - can cause pain or pressure behind the eyes, but often refers
to the vertex of the head
 Acute sinusitis

generally of viral origin. If the infection is of

bacterial
origin, the most common 3 causative
agents are Streptococcus pneumoniae, Haemophilus
influenzae, and Moraxella catarrhalis
 Chronic sinusitis
Chronic sinusitis is a complicated spectrum of diseases
.
 is an inflammation of the throat or pharynx.
 In most cases it is painful, and is often referred to as a sore throat.

 pharyngitis can be acute – characterized by a rapid onset and typically a relatively short
course – or chronic.

 Acute pharyngitis can result in very large tonsils which cause trouble swallowing and
breathing. Some cases are accompanied by a cough or fever.
 Most acute cases are caused by viral infections (40%–60%), with the remainder caused by
bacterial

 Bacterial pharyngitis
The most common bacterial agent is streptococcus. It causes about 15-30% of cases of
pharyngitis.

 symptoms
 red, inflamed, and swollen throat of sudden onset with severe pain
 the patient may have a high temperature, headache, and aching muscles (myalgia) and joints (
arthralgia).
 is an infection of the tonsils and will often, cause a sore throat and fever.

 Types
acute and chronic.
 Acute tonsillitis can either be bacterial or viral in origin.
 Chronic tonsillitis, which can last for long periods if not treated, is mostly caused by
bacterial infection.

Symptoms
 severe sore throat , painful/difficult swallowing, coughing, headache, myalgia (muscle
aches), fever and chills.

Causes
 Tonsillitis may be caused by Group A streptococcal bacteria,
 Lower Respiratory Tract Infections
• CAP
• Acute bronchitis-AECB
is infection & inflammation of bronchial mucosa.
• Main cuasative MO
H.influenzae 60%, M. catarrhalis 15%, S.pneumoniae 15%)
 is inflammation of the mucous membranes of the bronchi, the airways that carry airflow from the trachea
into the lungs.

Bronchitis can be classified into:

 Acute bronchitis
is characterized by the development of a cough,
Viruses cause about 90% of cases

 Chronic bronchitis,
is characterized by the presence of a productive cough that lasts for 3 months
or more per year for at least 2 years.

Develos due to recurrent injury to the airways caused by inhaled irritants. Cigarette
smoking is the most common cause, followed by air pollution and occupational
exposure to irritants, and cold air

 Symptoms

may include wheezing and shortness of breath

cough is often worst soon after awakening, and the sputum produced may have a yellow
or green color
 Urinary Tract Infection

•Is Inflammation and infection of urinary tract organs

•Escherichia coli the main cuasative MO plus
Klebsiella spp and Proteus spp.

Cystitis: is inflammation of the urinary bladder.

Pyelonephritis: is an ascending urinary tract infection that

has reached the pelvis of the kidney

Prostatitis:is an inflammation of the prostate gland, in men.

Urethritis:is inflammation of the urethra. The main

symptom is dysuria, which is painful or difficult urination
 Urinary Tract
Infections
UTI
UTI Symptoms :
- Dysuria – painful urination
- Burning sensation
- polyuria - Increased frequency
- Hematuria-blood in urine
- Fever
- Pyelonephritis - Nausea/Vomiting
- Pyelonephritis - Flank pain
- Cloudy urine
 is inflammation of the urinary bladder.

 The condition more often affects women -because of their relatively shorter urethra
—bacteria do not have to travel as far to enter the bladder
 More than 85% of cases of cystitis are caused by Escherichia coli ("E. coli"),

Symptoms

 Pressure in the lower pelvis

 Painful urination (dysuria)
 Frequent urination (polyuria)
 Need to urinate at night (nocturia)
 Abnormal urine color (cloudy)
 Blood in the urine (hematuria)
 Foul or strong urine odor
 is an ascending urinary tract infection that has reached the
pyelum (pelvis) of the kidney

Signs and symptoms

 It presents with dysuria,abdominal pain

 systemic symptoms in the form of fever, rigors (violent shivering

while the temperature rises), headache, and vomiting.

Causes
 Common organisms are E. coli (70-80%)
 Most cases of pyelonephritis start off as lower urinary tract infections, mainly cystitis
and prostatitis.
 is an inflammation of the prostate gland, in men. A
prostatitis diagnosis is assigned at 8% of all urologist
Causes
 E-coli,Enterobacter,Pseudomonas and staph

Symptoms:
 Painful urination (dysuria)

 Enlarged prostate with pressure induced pain

 is inflammation of the urethra.
 The main symptom is dysuria, which is painful or difficult urination.

Causes

 Sexual intercourse (Gonorrhea)

 Mechnical casueses (Catheters)

Causatvie MO:

 Escherichia coli
 Mycoplasma genitalium
 Trichomonas

Symptoms

 Discharge (milky or pus-like) from the penis, burning during urination, itching, burning or
irritation inside the penis.
 Sexual Transmitted disease:

Gonorrhea ( Uncomplicated)
is a common sexually transmitted infection caused by the bacterium
Neisseria gonorrhoeae

Symptoms
in males include a yellowish discharge from the penis, which causes
painful, frequent urination.

Complications
In men, (prostatitis) and (urethritis) can result from untreated
gonorrhea[6].

In women, the most common result of untreated gonorrhea is pelvic

inflammatory disease, a serious infection of the uterus that can lead
to infertility.
► Cefazolin (Ancef; IV), Cephalexin (Keflex)
► Spectrum: Most gram positive cocci (Strep, S. aureus),
E. coli, Proteus, Klebsiella.
► Use: S. aureus infection, surgical prophylaxis.
► Cefuroxime (Ceftin; IV ; Oral)
► Increased activity against H. flu, enterobacter, Neisseria,
proteus, E. coli, klebsiella, M. catarrhalis, anaerobes
and B. fragilis.
► Not as effective against S. aureus as the 1st generation.

► Cefpodoxime and Cefuroxime active against

intermediate level resistant strep pneumo.
► Spectrum: gram negative > gram positive.
► Ceftriaxone (Rocephin; IM/IV), Cefotaxime.
 Useful for meningitis.
 Ceftriaxone used for highly resistant and multi drug resistant
strep pneumo along with vancomycin.
► Ceftazidime active against pseudomonas.
► Cefepime (IV)
► Active against Strep, Staph (mssa), aerobic gram
negatives (enterobacter, e. coli, klebsiella, proteus and
pseudomonas).
CEFOVEX
Cefuroxime axetil

Take the challenge…

 CEFOVEX
Indications

As for the other cephalosporins, although as a second-

generation it is less susceptible to beta-lactamase and so may
have greater activity against Haemophilus influenzae,
Neisseria gonorrhoeae and Lyme disease. Unlike other second
generation cephalosporins, cefuroxime can cross the blood-
brain-barrier.
 CEFOVEX
•Most infections:
500 mg twice a day.

• Mild to moderate bronchitis or chest infections:

250 mg twice a day.

• Chronic bronchitis:
Treatment will start with injections twice a day for 48 to 72 hours
After this the dose of Cefovex Tablets will be500 mg twice a day for 5 to 7 days.

• Severe chest infections or pneumonia:

Treatment for pneumonia will start with injections twice a day for 48 to 72 hours
After this the dose of Cefovex Tablets will be 500 mg twice a day for 7 days.

• Urinary tract (water) infections: 125 mg twice aday.

• Kidney infections: 250 mg twice a day.
• Gonorrhea (a sexually transmitted disease): a single 1 g dose.
• Lyme disease (an infection spread by infected ticks): 500 mg twice a day for 20
days.
 CEFOVEX
Side effects
Cefovex is generally well tolerated and side effects are usually
transient.
most common side effects of diarrhea, nausea, vomiting,
headaches/migraines, dizziness and abdominal pain.

Kidney problems
In case of kidney problems the dose will be the same as for adults,
elderly patients and children over 12 years above to the normal
maximum of 1 g per day.

Children under 12 years Suspension is a more suitable choice

 CEFOVEX
► Strength
SWOT
 Established market
► Weakness
 Late entry
 Availability of only one strength till date
 Non-availability of 250mg at this stage. It will come after few months.
► Opportunities
 Amoxi-clav market
 Amoxicillin market
 Zinnat Market share
► Threat
 No threat
 Positioning
► Target market: Against Amoxi- Clav & plain amoxicillin market and when

Cefuroxime Axetil is favored by a Doctor

► Pay off Line:

► Mnemonic: Victory Sign

► Tgt. Customers:

 All General Physicians

 All Physicians/ Surgeons

 All Gynecologists

 All Dentists
Reference support targetting Amoxycillin
Clavulanic acid
Comparison of cefuroxime axetil and amoxicillin/clavulanate in the
treatment of acute bacterial sinusitis.

Author(s): Henry DC, Sydnor A Jr, Settipane GA, Allen J, Burroughs S, Cobb MM, Holley HP Jr

Affiliation(s): Foothill Family Clinic, Salt Lake City, Utah, USA.

LB
Publication date & source: 1999-07, Clin Ther., 21(7):1158-70. LC
LIN
Publication type: Clinical Trial; Randomized Controlled Trial
IC
AL
This double-masked, multicenter, randomized clinical trial compared the efficacy and tolerability S
of cefuroxime axetil and amoxicillin/clavulanate in the treatment of acute bacterial maxillary
sinusitis. A total of 263 patients with acute bacterial maxillary sinusitis were randomly assigned to
receive 10 days of treatment with either cefuroxime axetil 250 mg twice daily (n = 132) or
amoxicillin/clavulanate 500/125 mg 3 times daily (n = 131). Patients' responses to treatment were
assessed once during treatment (6 to 8 days after the start of treatment), at the end of treatment
(1 to 3 days posttreatment), and at follow-up (26 to 30 days after cessation of treatment). Clinical
success, defined as cure or improvement, was equivalent in the cefuroxime axetil and amoxicillin/
clavulanate groups at the end-of-treatment and follow-up assessments. Patients in both groups
showed improvements in symptoms of acute sinusitis at the during-treatment visit. Treatment with
amoxicillin/clavulanate was associated with a significantly higher incidence of drug-related
adverse events than treatment with cefuroxime axetil (29% vs 17%), primarily reflecting a higher
incidence of gastrointestinal adverse events (23% vs 11%), particularly diarrhea. Two patients in
the cefuroxime axetil group and 8 patients in the amoxicillin/clavulanate group withdrew from the
study due to adverse events (P = 0.06). These results indicate that cefuroxime axetil 250 mg
twice daily is as effective as amoxicillin/clavulanate 500 mg 3 times daily in the treatment of acute
sinusitis and produces fewer gastrointestinal adverse events. cefuroxime axetil,
amoxicillin/clavulanate, acute sinusitis.
Prospective and comparative study between cefuroxime, ceftriaxone
and amoxicillin-clavulanic acid in the treatment of community-
acquired pneumonia]

Author(s): Sanchez ME, Gomez J, Gomez Vargas J, Banos V, Ruiz Gomez J, Munoz L, Simarro
E, Soto MC, Canteras M, Valdes M
LB
L
Affiliation(s): Servicio de Medicina Interna, Unidad de Infecciosas, Servicio deCL
Urgencias y
IN Murcia.
Secciones de Neumologia y Microbiologia, Hospital Universitario Virgen de la Arrixaca,
IC
AL
Publication date & source: 1998-06, Rev Esp Quimioter., 11(2):132-8. S
Publication type: Clinical Trial; Randomized Controlled Trial

Among community-acquired infections, pneumonia is still a large health problem which is of great
interest mainly due its high mortality and morbidity. From 1991 to 1997, 409 patients who had
been diagnosed with community-acquired pneumonia and had been admitted to the internal
medicine service of a university hospital were prospectively studied. The patients were classified
into three groups according to the random antibiotic treatment they had received (ceftriaxone,
cefuroxime or amoxicillin-clavulanic acid). The initial characteristics of the patients with regard to
epidemiology, clinical description and critical situation were similar in all the groups studied. A
total of 36.9% of the cases were documented microbiologically, with the most frequently isolated
pathogens being Streptococcus pneumoniae and Haemophilus influenzae. The recovery rate was
92.2% and three patients had a recurrence of pneumonia. Global mortality was 5.8%. No
statistically significant differences were found in the evolution of patients treated with cefuroxime,
ceftriaxone or amoxicillin-clavulanic acid, with the latter representing an empirical treatment of
choice for community-acquired pneumonia.
Short course therapy with cefuroxime axetil for acute otitis media:
results of a randomized multicenter comparison with
amoxicillin/clavulanate.

Author(s): Pessey JJ, Gehanno P, Thoroddsen E, Dagan R, Leibovitz E, Machac J, Pimentel

JM, Marr C, Leblanc F

Affiliation(s): CHU Rangueil, Toulouse, France.

LB
Publication date & source: 1999-10, Pediatr Infect Dis J., 18(10):854-9. LC
LIN
Publication type: Clinical Trial; Multicenter Study; Randomized Controlled Trial
IC
AL
BACKGROUND: Otitis media is a common infection of childhood. Increasing antibiotic resistance
rates among the principal causative pathogens, Streptococcus pneumoniae and Haemophilus
S
influenzae, are associated with failure of first line agents. OBJECTIVE: This open, randomized,
multicenter study compared the clinical efficacy of a short 5-day course of cefuroxime axetil
(CAE) suspension with that of amoxicillin/clavulanate (A/CA) suspension for 8 or 10 days.
METHODS: Children age 6 to 36 months with acute otitis media with effusion, diagnosed by
tympanocentesis and microbiologic culture, were randomized to receive CAE (30 mg/kg/day in
two divided doses for 5 days) or A/CA 40 mg/kg/day in three divided doses for 10 days (A/CA-
10). In French centers A/CA was given at 80 mg/kg/day in three divided doses for 8 days (A/CA-
8). Patients were assessed 1 to 4 days after completing the course (posttreatment) and followed
up at 21 to 28 days after completing the course. RESULTS: Of the 716 patients randomized, 252
were treated with CAE, 255 with A/CA-10 and 209 with A/CA-8. In the clinically evaluable
population, the proportions of patients with clinical cure at posttreatment were 175 of 203 (86%),
181 of 205 (88%) and 145 of 164 (88%) in the CAE, A/CA-10 and A/CA-8 groups, respectively,
demonstrating equivalence among the three treatments. For patients <18 months old, clinical
cures were 111 of 134 (83%), 116 of 131 (89%) and 83 of 99 (84%) in the CAE, A/CA-10 and
A/CA-8 groups, respectively; equivalence was also demonstrated. At follow-up, 130 of 175 (74%)
CAE, 121 of 172 (70%) A/CA-10, and 112 of 142 (79%) A/CA-8 had maintained cure. A total of
837 pretreatment pathogens were isolated from middle ear fluid in 73% (522 of 716) patients, the
majority of isolates were S. pneumoniae (30%) and H. influenzae (27%). The most common
adverse events were gastrointestinal, the incidence of drug-related diarrhea being higher in the
A/CA-10 group (18%) than in either the CAE or A/CA-8 groups (10%). CONCLUSIONS: A 5-day
course of CAE, given twice daily, was shown to be equivalent to the two regimens of A/CA for
treatment of acute otitis media with effusion in children.
Comparative study of cefuroxime axetil versus amoxicillin in children
with early Lyme disease.

Author(s): Eppes SC, Childs JA

Affiliation(s): Alfred I. DuPont Hospital for Children, Division of Infectious Diseases, Wilmington,
DE 19899, USA. seppes@nemours.org
LB
Publication date & source: 2002-06, Pediatrics., 109(6):1173-7.
LC
LIN
Publication type: Clinical Trial; Randomized Controlled Trial IC
AL
Cefuroxime axetil has been shown to have efficacy comparable to doxycycline in adults with early
S
Lyme disease (LD). Because of toxicity, doxycycline is usually avoided in children. For children
who are unable to tolerate amoxicillin, there is currently no proven alternative oral therapy for LD.
This randomized, unblinded study compared 2 dosage regimens of cefuroxime axetil (20 mg/kg/d
and 30 mg/kg/d) with amoxicillin (50 mg/kg/d), each given for 20 days. Children were enrolled if
they were 6 months to 12 years of age, had erythema migrans, and met other eligibility
requirements. Serologic testing occurred at entry and after 6 months. Follow-up evaluations for
safety, tolerability, and efficacy occurred at 10 and 20 days, 6 months, and 1 year. Forty-three
children were randomized (13 in the amoxicillin group, 15 in each cefuroxime axetil group); 39
completed 12 months of follow-up. At the completion of treatment, there was total resolution of
erythema migrans in 67% of the amoxicillin group, 92% of the low-dose cefuroxime group, and
87% of the high-dose cefuroxime group, and resolution of constitutional symptoms occurred in
100%, 69%, and 87%, respectively. All patients had a good outcome, with no long-term problems
associated with LD. One patient, who was well at the first 2 follow-up visits, was treated with
doxycycline because of new constitutional symptoms. Mild diarrhea occurred in a small number of
participants in each group (1 patient was diagnosed and treated for Clostridium difficile-
associated diarrhea, which occurred after completing the full course of study medication). No
hypersensitivity reactions occurred. The number of patients in this trial was not sufficient to
demonstrate a statistically significant difference between the 3 groups; however, both amoxicillin
and cefuroxime axetil seem to be safe, efficacious treatments for children with early LD.
[Prospective, randomized, comparative study of the efficacy, safety
and cost of cefuroxime versus cephradine in acute pyelonephritis
during pregnancy]

Author(s): Ovalle A, Martinez MA, Wolff M, Cona E, Valderrama O, Villablanca E, Lobos L

Affiliation(s): Servicio de Obstetricia, Ginecologia y Neonatologia, Hospital Clinico San Borja

Arriaran, Santiago, Chile. aovalle@hotmail.com LB
LC
Publication date & source: 2000-07, Rev Med Chil., 128(7):749-57.
LIN
IC
Publication type: Clinical Trial; Randomized Controlled Trial
AL
BACKGROUND: Second generation cephalosporins (CFPs) are more active in the treatment of
S
acute pyelonephritis during pregnancy but their cost is considerably higher than their
predecessors. Cefuroxime, a second generation CFP with oral and parenteral presentations,
might offer significant advantages and become a first choice antimicrobial in this setting. AIM: To
compare the efficacy, safety and cost of cefuroxime and cephradine in the treatment of acute
pyelonephritis in pregnancy. PATIENTS AND METHODS: Hospitalized women with 12 to 34
weeks of pregnancy, with clinical and bacteriological diagnosis of acute pyelonephritis, were
randomly assigned to receive cefuroxime (Curocef(r), Glaxo Wellcome) 750 mg t.i.d, i.v. or
cephradine 1 g q.i.d., i.v. If the isolated organism was resistant to the assigned drug the patient
was excluded. Once patients were afebrile, they were switched to an oral form of the same
antimicrobial. They were discharged according to the clinical status and treated for a total of 14
days. laboratory tests, including urine culture were requested during controls and at the end of
follow-up at 28 days. RESULTS: One hundred and one patients were randomized: 49 to receive
cephradine and 52 to receive cefuroxime. Patients in the cefuroxime group hed fewer febrile days
(mean 1.7 vs 2.2, p < 0.05), faster clinical recovery (mean 2.7 vs 3.1 days, p < 0.05), a higher
rate of bacteriological cure at 28 days (78.8% and 59.2%, p < 0.05) and lower rate of failure
(21.2% vs 40.8% p < 0.05). The rate of resistance of isolated uropathogens was 14% to
cephradine and 1% to cefuroxime. CONCLUSIONS: Cefuroxime can be considered as a first
choice option in the treatment of acute pyelonephritis during pregnancy due to its tolerance,
microbiological activity and efficacy.
Comparison of cefuroxime axetil and amoxicillin/clavulanate in the
treatment of acute bacterial sinusitis.

Author(s): Henry DC, Sydnor A Jr, Settipane GA, Allen J, Burroughs S, Cobb MM, Holley HP Jr

Affiliation(s): Foothill Family Clinic, Salt Lake City, Utah, USA.

LB
Publication date & source: 1999-07, Clin Ther., 21(7):1158-70. LC
LIN
Publication type: Clinical Trial; Randomized Controlled Trial IC
AL
This double-masked, multicenter, randomized clinical trial compared the efficacy and tolerability S
of cefuroxime axetil and amoxicillin/clavulanate in the treatment of acute bacterial maxillary
sinusitis. A total of 263 patients with acute bacterial maxillary sinusitis were randomly assigned to
receive 10 days of treatment with either cefuroxime axetil 250 mg twice daily (n = 132) or
amoxicillin/clavulanate 500/125 mg 3 times daily (n = 131). Patients' responses to treatment were
assessed once during treatment (6 to 8 days after the start of treatment), at the end of treatment
(1 to 3 days posttreatment), and at follow-up (26 to 30 days after cessation of treatment). Clinical
success, defined as cure or improvement, was equivalent in the cefuroxime axetil and amoxicillin/
clavulanate groups at the end-of-treatment and follow-up assessments. Patients in both groups
showed improvements in symptoms of acute sinusitis at the during-treatment visit. Treatment with
amoxicillin/clavulanate was associated with a significantly higher incidence of drug-related
adverse events than treatment with cefuroxime axetil (29% vs 17%), primarily reflecting a higher
incidence of gastrointestinal adverse events (23% vs 11%), particularly diarrhea. Two patients in
the cefuroxime axetil group and 8 patients in the amoxicillin/clavulanate group withdrew from the
study due to adverse events (P = 0.06). These results indicate that cefuroxime axetil 250 mg
twice daily is as effective as amoxicillin/clavulanate 500 mg 3 times daily in the treatment of acute
sinusitis and produces fewer gastrointestinal adverse events. cefuroxime axetil,
amoxicillin/clavulanate, acute sinusitis.
Short-course cefuroxime axetil therapy in the treatment of acute
exacerbations of chronic bronchitis.

Author(s): Langan C, Clecner B, Cazzola CM, Brambilla C, Holmes CY, Staley H

L
Affiliation(s): Department of Postgraduate Medical Education, University ofBGlasgow,
L CL
UK.
IN
Publication date & source: 1998-07, Int J Clin Pract., 52(5):289-97. IC
AL
S
Publication type: Clinical Trial; Multicenter Study; Randomized Controlled Trial

The efficacy and safety of a five-day course of cefuroxime axetil (250 mg b.d.) and a seven-day
course of clarithromycin (250 mg b.d.) were compared in a large double-blind, randomised,
multinational study involving 684 patients with acute exacerbations of chronic bronchitis. In an
intent-to-treat analysis, the post-treatment clinical responses to each treatment were comparable
(82%) and rates at follow-up were similar: 64% on cefuroxime axetil and 61% on clarithromycin.
Pre-treatment pathogens were isolated from a total of 192 patients, Haemophilus influenzae
being the most common. Overall pathogen eradication rates were similar for both treatments.
Both treatments were well tolerated. In conclusion, a five-day course of cefuroxime axetil is
clinically equivalent to a seven-day course of clarithromycin in the treatment of acute
exacerbations of chronic bronchitis, and may have potential socioeconomic benefits.
Cefuroxime compared to amoxicillin-clavulanic acid in the treatment
of community-acquired pneumonia.

Author(s): Oh HM, Ng AW, Lee SK

LBSingapore.
Affiliation(s): Department of Infectious Diseases, Tan Tock Seng Hospital,
LC
Publication date & source: 1996-06, Singapore Med J., 37(3):255-7.
LIN
IC
AL
Publication type: Clinical Trial; Randomized Controlled Trial S
The study compared the efficacy and safety of cefuroxime (CFX) versus amoxicillin-clavulanic
acid (AC) in the treatment of community-acquired pneumonia. A total of 48 patients (mean age 44
years; 32 males and 16 females) were randomised to receive sequential intravenous/oral CFX
(750 mg i.v. 8H for 48 H/500 mg p.o bid) and sequential intravenous/oral AC (1.2 g i.v. 8 H for 48
H/ 750 mg p.o. tid) for 7-14 days. The two groups were well matched for age, sex and treatment
duration (median 7 days). The most frequent causative organisms were Mycoplasma (3),
Klebsiella species (2), Pseudomonas aeruginosa (2) and hemolytic streptococcus (2). clinical
cure was obtained in 20 patients (83.3%) and 18 patients (75%) of CFX and AC group
respectively. Clinical improvement was observed in one patient of the CFX group. There were 3
failures in the CFX group and 4 failures in the AC group. Two patients in the AC group developed
adverse drug reactions (namely vomiting and rash) and were withdrawn from the study. In
conclusion, cefuroxime and amoxicillin-clavulanic acid have comparable efficacy and safety in the
treatment of community-acquired pneumonia.
 Take the
challenge…to win