Cefuroxime is a reliable beta-lactamase–stable option when first-line amoxicillin regimens fail. These pearls help clinicians use it effectively.
Cefuroxime axetil absorption improves by ~50% with food—advise families to give doses immediately after meals to maximize efficacy and reduce GI upset.
Many 'penicillin allergies' are non-IgE rashes; document reaction type and timing. Cefuroxime is safe for most delayed rashes but avoid in true anaphylaxis without allergy workup.
Once culture data are available, de-escalate to narrower therapy (e.g., amoxicillin) to preserve cefuroxime for future beta-lactamase–driven infections.
Educate families about persistent watery diarrhea during or after therapy; counsel on hydration and prompt evaluation.