When using cefuroxime axetil in pediatrics, rule out true beta-lactam allergy, review renal function, and counsel on GI warning signs.
Cefuroxime is contraindicated in children with previous anaphylaxis or SCAR to cephalosporins. Relative contraindications include severe penicillin allergy, renal impairment, and prior C. difficile colitis. The suspension contains sucrose—plan dental hygiene for long courses.
Documented severe hypersensitivity (anaphylaxis, angioedema, SJS/TEN) to cefuroxime or any cephalosporin
Known hypersensitivity to suspension excipients
History of IgE-mediated penicillin allergy—evaluate cross-reactivity risk before prescribing
Creatinine clearance <30 mL/min—adjust dosing and monitor renal function
Previous Clostridioides difficile-associated diarrhea—counsel on recurrence and monitor stools
Phenylketonuria—oral suspension contains phenylalanine
Extended therapy in renal or hepatic impairment—monitor CBC, liver enzymes, and renal function