Cefuroxime, sold under the brand name Zinacef among others, is an antibiotic used to treat and prevent a number of bacterial infections.[1] These include pneumonia, meningitis, otitis media, sepsis, urinary tract infections, and Lyme disease.[2] It is used by mouth or by injection into a vein or muscle.[2] Common side effects include nausea, diarrhea, allergic reactions, and pain at the site of injection.[2] Serious side effects may include Clostridium difficile infection, anaphylaxis, and Stevens-Johnson syndrome.[2] Use in pregnancy and breastfeeding is believed to be safe.[3] It is a second-generation cephalosporin and works by interfering with a bacteria's ability to make a cell wall resulting in its death.[2] Cefuroxime was patented in 1971 and approved for medical use in 1977.[4] It is available as a generic medication.[1] A week of treatment when taken by mouth in the United Kingdom costs the NHS about £18 as of 2019.[1] In the United States, the wholesale cost of this amount is about US$8.50.[5] In 2016, it was the 291st most prescribed medication in the United States, with more than a million prescriptions.[6] As with the other cephalosporins, it is susceptible to beta-lactamase, although as a second-generation variety, it is less so. Hence, it may have greater activity against Haemophilus influenzae, Neisseria gonorrhoeae, and Lyme disease. Unlike most other second-generation cephalosporins, cefuroxime can cross the blood-brain barrier. A systematic review found high quality evidence that injecting the eye with cefuroxime after cataract surgery will lower the chance of developing endophthalmitis after surgery.[7] Cefuroxime is generally well-tolerated and its side effects are usually transient. If ingested after food, this antibiotic is both better absorbed and less likely to cause its most common side effects of diarrhea, nausea, vomiting, headaches/migraines, dizziness, and abdominal pain compared to most antibiotics in its class.[citation needed] Although a widely stated cross-allergic risk of about 10% exists between cephalosporins and penicillin, recent assessments have shown no increased risk for a cross-allergic reaction for cefuroxime and several other second-generation or later cephalosporins.[8] Cefuroxime axetil is an acetoxyethyl ester prodrug of cefuroxime which is effective when taken by mouth.[9] It is a second-generation cephalosporin. In US it is available as Zinacef by Covis Pharmaceuticals as the company acquired the US rights of the product from GSK.[10] GSK had continued marketing a pediatric oral suspension as Ceftin; however, this presentation was discontinued as of June 24, 2017.[11] In Bangladesh it is available as Kilbac by Incepta and Xorimax by Sandoz. In India it is available as Ceftum in tablet form and Supacef in injection form by GSK.[12] In Poland it is available as Zamur by Mepha, subsidiary of Teva Pharmaceutical Industries.[13] In Australia, the "first generic" form of Cefuroxime axetil, Pharmacor Cefuroxime (tablets) from Pharmacor Pty Ltd, was registered on 27 March 2017 by the Therapeutic Goods Administration.[14] Cefuroxime axetil is also available (in two strengths) as granules for oral suspension from Aspen Pharmacare Australia Pty Ltd under the brand name Zinnat cefuroxime.[15]