Aquacef: Uses, Dosage, Side Effects and Composition

Description and Composition of Aquacef

Aquacef is a second generation cephalosporin antibiotic used in the treatment and prevention (prophylaxis) of bacterial infections. It contains Cefuroxime Axetil as its active pharmaceutical ingredient. It has broad spectrum of activity against both gram positive and negative bacteria. It is a prodrug that is converted to Cefuroxime, its active moiety, within 3 minutes after absorption.


Uses and Indications of Aquacef

Cefuroxime axetil being an antibiotic is used in the treatment of infection of bacterial origin which are susceptible to the drug. Generally, Cefuroxime axetil When determined to be effective through MCS test, can be used in the treatment of:

  • Sore throat (pharyngitis/tonsillitis) of bacterial origin
  • Infection of the middle ear (Acute bacterial otitis media)
  • Uncomplicated skin and skin structure infection
  • Uncomplicated urinary tract infection
  • Uncomplicated gonorrhea.
  • Early Lyme disease
  • Pneumonia and other lower respiratory tract infection.

Dosage of Aquacef

1. Pharyngitis/Tonsillitis

Adult: 250 mg PO q12hr for 10 days

Children: 3 months-12 years: 20 mg/kg/day PO divided q12hr for 10 days; not to exceed 500 mg/day or 75-150 mg/kg/day IV/IM divided q8hr; not to exceed 6 g/day

2. Acute Bacterial Otitis Media and maxillary sinusitis

Adult: 250 mg PO q12hr for 10 days

Children: months-12 years: 30 mg/kg/day suspension PO divided q12hr for 10 days; not to exceed 1000 mg/day; alternatively, 75-150 mg/kg/day IV/IM divided q8hr; not to exceed 6 g/day.

3. Uncomplicated Skin and Skin Structure infections

Oral: 250-500 mg PO q12hr for 10 days

IV/IM: 750 mg IV/IM q8hr; switch to oral therapy as soon as clinically possible

4. Uncomplicated Urinary Tract Infection

Oral: 125-250 mg PO q12hr for 7-10 days

IV/IM: 750 mg IV/IM q8hr

5. Gonorrhoea

Cefuroxime is not recommended for the treatment of gonorrhoea because of resistance.

Uncomplicated: 1 g PO once or 1.5 g IM once at 2 different sites with 1 g probenecid PO.

Complicated: 750 mg IV/IM q8hr

6. Early Lyme Disease

500 mg PO q12hr for 20 days

7. Pneumonia and Other Respiratory Tract Infections

Uncomplicated Pneumonia: 750 mg IV/IM q8hr

Acute Bacterial Exacerbation of Chronic Bronchitis: 250-500 mg PO q12hr for 10 days or 500-750 mg IV q8hr then switch to oral after improvement.

Secondary Bacterial Infections of Acute Bronchitis: 250-500 mg PO q12hr for 5-10 days

8. Impetigo

Adult: 250-500 mg tablet PO q12hr for 10 days

Children: 3 months-12 years: 30 mg/kg/day suspension PO divided q12hr for 10 days; not to exceed 1000 mg/day or 75-100mg/kg/day IV/IM divided q8hr; not to exceed 6 g/day.

Dosage of drugs usually depends on body weight, age, disease severity and or response. This means that there is no fixed drug dosage, hence you are to adhere to your physician’s prescription as the dose might differ depending on your condition, or what he wants to achieve.

Side Effects of Aquacef

Some side effects associated with Cefuroxime include:

  • Diarrhea
  • Nausea and Vomiting
  • Abdominal pain and cramps
  • Rash
  • Headache

You may experience other side effects other than those listed above. Some people however can experience allergic reactions and it could be life threatening. If it occurs, stop your medication immediately and seek emergency medical help.

Mechanism of Action of Aquacef

How does Cefuroxime work to cure or prevent bacteria infections?

Cefuroxime axetil undergoes hydrolysis by esterase enzymes to the active antibiotic, cefuroxime. Remember that Cefuroxime axetil is a prodrug.

Cefuroxime inhibits bacterial cell wall synthesis following attachment to penicillin binding proteins (PBPs). This results in the interruption of cell wall (peptidoglycan) biosynthesis, which leads to bacterial cell lysis and death.

When not to use Aquacef

Do not use Cefuroxime if you are allergic to it or to any of cephalosporins and penicillin antibiotics.

Can Aquacef be used in pregnancy?

Cefuroxime is considered safe in pregnancy.

Pregnancy category B.

Can Aquacef be used while breastfeeding

It enters breast milk, use not advised.

Aquacef Interactions

  • Food increases Cefuroxime absorption, so take it with food.
  • Cefuroxime may affect the gut flora, leading to lower oestrogen reabsorption and reduced efficacy of combined oral contraceptives.
  • Concomitant use of probenicid is not recommended. This is because administration of probenecid with Cefuroxime prolongs the excretion of cefuroxime and produces an elevated peak serum level.
  • Ttreatments with cephalosporins should be carried out with caution on patients who are taking strong-acting diuretics (such as furosemide) or potential nephrotoxic preparations (such as aminoglycoside antibiotics), since impairment of renal function through such combinations cannot be ruled out.
  • Determination of blood/plasma glucose levels: A false-positive reaction for glucose in the urine may occur with copper reduction tests (e.g., Benedict’s or Fehling’s solution). As a false-negative result may occur in the ferricyanide test, it is recommended that either the glucose oxidase or hexokinase method be used to determine blood/plasma glucose levels in patients receiving cefuroxime axetil.
  • Concomitant use with oral anticoagulants may give rise to increased international normalised ratio (INR).
  • Drugs that reduce gastric acidity may result in a lower bioavailability of Cefuroxime compared with administration in the fasting state.

Aquacef Chemical Structure



This write up is neither a prescription nor medical advice and should not substitute them. You are therefore advised to strictly rely and  adhere to your doctor’s prescription. Remember not to take any drug without consulting your healthcare provider first. Self medication can be very deadly.


  1. National Center for Biotechnology Information. PubChem Compound Summary for CID 5479529, Cefuroxime. Accessed Dec. 22, 2020.

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