Cefuroxime-induced fever

D Mevorach1, I S Lossos, R Oren

  • 1Department of Medicine, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel.

Abstract

Insights

Cefuroxime, an antibiotic, can cause fever in patients. This drug-induced fever resolved upon discontinuation and recurred upon re-administration in three cases, highlighting cefuroxime as a cause of fever.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Fever is a common symptom in patients with acute exacerbations of chronic obstructive pulmonary disease (COPD).
  • Antibiotic therapy, including cephalosporins, is standard for managing bacterial infections in COPD exacerbations.
  • Drug-induced fever is a recognized adverse effect of various medications.

Observation:

  • Three patients receiving cefuroxime sodium for COPD exacerbations developed unexplained fevers after 5-7 days of treatment.
  • No infectious source was identified in any of the patients.
  • Fever resolved within 30 hours of discontinuing cefuroxime and recurred in one rechallenged patient.

Findings:

  • Cefuroxime sodium administration was temporally associated with the onset of fever in these patients.
  • The pattern of fever resolution upon drug withdrawal and recurrence upon re-administration suggests a causal link.
  • Cefuroxime should be considered in the differential diagnosis of fever in patients undergoing treatment for COPD exacerbations.

Implications:

  • Clinicians should be aware of cefuroxime as a potential cause of drug-induced fever.
  • Consideration of cefuroxime-induced fever can prevent unnecessary investigations and treatments for infection.
  • This finding expands the list of cephalosporins known to induce fever, aiding in differential diagnosis.

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