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Ceftum 500: Uses, Dosage, Side Effects, and Precautions
Discover everything about Ceftum 500 its uses for bacterial infections, recommended dosage, common side effects, and essential precautions. Stay informed for safe and effective treatment
MEDICINES
1/23/202513 min read
Ceftum 500, powered by Cefuroxime Axetil, is a widely prescribed second-generation cephalosporin antibiotic that delivers reliable results against a broad spectrum of bacterial infections.
Known for its efficacy, safety, and resistance to beta-lactamase enzymes, Ceftum 500 is a trusted choice for treating respiratory tract infections, skin infections, urinary tract infections, and more.
Its twice-daily dosing regimen and well-tolerated profile make it a preferred option for doctors and patients alike.
Whether you're looking for a solution to combat sinusitis, bronchitis, or even gonorrhea, Ceftum 500 offers a clinically proven approach to tackling bacterial pathogens.
Explore the unique features, dosage, and FAQs about Ceftum 500 to understand why it’s a go-to antibiotic for healthcare professionals worldwide.
Stay ahead in managing infections with the right information about Ceftum 500.
What is Ceftum500
Ceftum 500 is a broad-spectrum antibiotic medication that belongs to the class of cephalosporin antibiotics.
It contains Cefuroxime Axetil as its active ingredient, which is a second-generation cephalosporin antibiotic.
Ceftum 500 is prescribed by doctors to treat a wide range of bacterial infections, including respiratory tract infections such as bronchitis and pneumonia, skin infections like acne and cellulitis, and urinary tract infections like cystitis and pyelonephritis.
What is the composition of Ceftum 500?
Ceftum 500 contains the active ingredient Cefuroxime Axetil, which is a second-generation cephalosporin antibiotic.
Composition Details:
Active Ingredient: Cefuroxime Axetil (equivalent to 500 mg of Cefuroxime)
Excipients (inactive ingredients):
Microcrystalline cellulose (binder)
Sodium lauryl sulfate (surfactant)
Croscarmellose sodium (disintegrant)
Colloidal silicon dioxide (anti-caking agent)
Magnesium stearate (lubricant)
Hypromellose (coating agent)
Titanium dioxide (coloring agent)
Propylene glycol (plasticizer)
Cefuroxime Axetil is the prodrug form of cefuroxime, which becomes active after absorption in the gastrointestinal tract. This formulation ensures effective treatment of various bacterial infections. Always check the leaflet or consult a healthcare provider for more details about the formulation.
How Ceftum 500 Works | Mode of Action of Ceftum 500
Ceftum 500, containing Cefuroxime Axetil as its active ingredient, is a second-generation cephalosporin antibiotic that exerts its bactericidal effect by inhibiting the synthesis of the bacterial cell wall. Here's a detailed explanation of its mode of action:
Inhibition of Cell Wall Synthesis
Bacteria have a rigid cell wall that provides structural support and maintains the osmotic balance. The bacterial cell wall is composed of a layer of peptidoglycan (also known as murein), which is a polymer of sugars and amino acids.
Interference with Transpeptidation
Cefuroxime Axetil, the active ingredient in Ceftum 500, binds to and inhibits the action of penicillin-binding proteins (PBPs) located inside the bacterial cell wall. PBPs are enzymes responsible for the final step of peptidoglycan synthesis, known as transpeptidation.
Inhibition of Cross-Linking
During transpeptidation, PBPs catalyze the formation of cross-links between adjacent peptidoglycan chains, which provides strength and rigidity to the bacterial cell wall. By inhibiting PBPs, Cefuroxime Axetil prevents the formation of these cross-links, thereby weakening the bacterial cell wall.
Lysis and Death of Bacterial Cells
As the bacterial cell wall weakens, the cell becomes osmotically fragile and prone to lysis (rupture). The inability of the bacterial cell to maintain its structural integrity ultimately leads to its death.
Spectrum of Activity
Cefuroxime Axetil has a broad spectrum of activity against Gram-positive and Gram-negative bacteria, including:
Streptococcus pneumoniae
Haemophilus influenzae
Escherichia coli
Klebsiella pneumoniae
Staphylococcus aureus
Resistance
Resistance to Cefuroxime Axetil can occur through various mechanisms, including:
Beta-lactamase production: Some bacteria produce enzymes that break down the beta-lactam ring of Cefuroxime Axetil, rendering it ineffective.
Altered PBPs: Some bacteria have altered PBPs that have a reduced affinity for Cefuroxime Axetil.
Efflux pumps: Some bacteria have efflux pumps that actively remove Cefuroxime Axetil from the bacterial cell.
In summary, Ceftum 500 exerts its bactericidal effect by inhibiting the synthesis of the bacterial cell wall, ultimately leading to the lysis and death of bacterial cells.
What are the Indications of Ceftum 500
Ceftum 500, containing Cefuroxime Axetil, is a broad-spectrum antibiotic indicated for the treatment of various bacterial infections. Here are the indications of Ceftum 500 in detail:
Respiratory Tract Infections
Acute Bacterial Bronchitis: Ceftum 500 is effective against Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis, which are common causes of acute bacterial bronchitis.
Community-Acquired Pneumonia (CAP): Ceftum 500 is indicated for the treatment of CAP caused by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
Acute Exacerbations of Chronic Bronchitis (AECB): Ceftum 500 is effective against bacteria that cause AECB, including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
Skin and Soft Tissue Infections
Uncomplicated Skin and Soft Tissue Infections: Ceftum 500 is indicated for the treatment of uncomplicated skin and soft tissue infections caused by Staphylococcus aureus, Streptococcus pyogenes, and Escherichia coli.
Cellulitis: Ceftum 500 is effective against bacteria that cause cellulitis, including Streptococcus pyogenes and Staphylococcus aureus.
Urinary Tract Infections
Uncomplicated Urinary Tract Infections: Ceftum 500 is indicated for the treatment of uncomplicated urinary tract infections caused by Escherichia coli, Klebsiella pneumoniae, and Staphylococcus saprophyticus.
Pyelonephritis: Ceftum 500 is effective against bacteria that cause pyelonephritis, including Escherichia coli and Klebsiella pneumoniae.
Other Infections
Otitis Media: Ceftum 500 is indicated for the treatment of otitis media caused by Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
Tonsillitis: Ceftum 500 is effective against bacteria that cause tonsillitis, including Streptococcus pyogenes.
Important Note:
Ceftum 500 is not indicated for the treatment of viral infections, such as the common cold or flu.
It is essential to use Ceftum 500 only under the guidance of a healthcare professional and to complete the full course of treatment to ensure effective treatment and prevent antibiotic resistance.
What is the Dosage of Ceftum 500 in adults and Children
The dosage of Ceftum 500, containing Cefuroxime Axetil, varies depending on the type and severity of the infection, as well as the age and weight of the patient. Here are the recommended dosages:
Adult Dosage
Respiratory Tract Infections: 250-500 mg twice daily for 7-10 days
Skin and Soft Tissue Infections: 250-500 mg twice daily for 7-10 days
Urinary Tract Infections: 250 mg twice daily for 7-10 days
Otitis Media: 250-500 mg twice daily for 7-10 days
Pediatric Dosage
Children 3 months to 12 years: 15-30 mg/kg/day divided into two doses for 7-10 days
Children over 12 years: 250-500 mg twice daily for 7-10 days
Dosage Adjustments
Renal Impairment: Reduce the dosage by 50% in patients with severe renal impairment (creatinine clearance < 30 mL/min)
Hepatic Impairment: No dosage adjustment is necessary in patients with hepatic impairment
Administration of Ceftum 500
Tablets: Swallow the tablets whole with food to enhance absorption
Suspension: Shake the suspension well before each use and administer with food
Important Note
Complete the full course of treatment: It is essential to complete the full course of treatment, even if symptoms improve before finishing the medication, to ensure effective treatment and prevent antibiotic resistance.
Consult a healthcare professional: Consult a healthcare professional before taking Ceftum 500, especially if you have a history of allergies, kidney or liver disease, or are pregnant or breastfeeding.
What are the Side effects of Ceftum 500 ?
Ceftum 500, containing Cefuroxime Axetil, is generally well-tolerated, but like all medications, it can cause side effects. Here are some of the possible side effects of Ceftum 500:
Common Side Effects (≥1% to <10%)
Gastrointestinal Disturbances: Diarrhea, nausea, vomiting, abdominal pain, and dyspepsia.
Allergic Reactions: Rash, itching, urticaria, and angioedema.
Central Nervous System: Headache, dizziness, and somnolence.
Hematological: Eosinophilia and thrombocytopenia.
Hepatic: Elevated liver enzymes (ALT, AST) and bilirubin.
Uncommon Side Effects (≥0.1% to <1%)
Pseudomembranous Colitis: A condition characterized by inflammation of the colon and diarrhea.
Anaphylaxis: A severe, life-threatening allergic reaction.
Stevens-Johnson Syndrome: A rare skin and mucous membrane disorder.
Toxic Epidermal Necrolysis: A rare skin condition characterized by widespread skin necrosis.
Agranulocytosis: A potentially life-threatening reduction in white blood cells.
Rare Side Effects (<0.1%)
Hemolytic Anemia: A condition characterized by the destruction of red blood cells.
Thrombocytopenic Purpura: A condition characterized by low platelet count and bleeding.
Seizures: Convulsions or seizures, especially in patients with a history of seizure disorders.
Post-Marketing Surveillance
Clostridioides difficile-associated diarrhea: Diarrhea caused by the bacterium Clostridioides difficile.
Liver failure: Rare cases of liver failure have been reported in patients taking cefuroxime axetil.
Important Note
If you experience any side effects, consult your doctor or healthcare professional immediately.
Ceftum 500 is contraindicated in patients with a history of hypersensitivity to cefuroxime axetil or other cephalosporins.
Before taking Ceftum 500, inform your doctor about any pre-existing medical conditions, medications, or allergies.
Clinical studies of Ceftum 500 (Cefuroxime Axetil )
Ceftum 500, containing cefuroxime axetil, has been evaluated in several clinical trials for its efficacy and safety in treating various bacterial infections. Notable studies include:
Acute Bronchitis Treatment: A study involving 537 patients compared 5-day and 10-day courses of cefuroxime axetil (250 mg twice daily) with a 10-day course of amoxicillin-clavulanate (500 mg three times daily) for secondary bacterial infections of acute bronchitis.
The results indicated that both 5-day and 10-day cefuroxime axetil regimens were as effective as the 10-day amoxicillin-clavulanate regimen. Additionally, patients treated with cefuroxime axetil experienced fewer drug-related adverse events, particularly gastrointestinal issues like diarrhea and nausea. 1
Acute Exacerbations of Chronic Bronchitis (AECB): A clinical trial assessed the efficacy of levofloxacin (250 mg and 500 mg once daily) versus cefuroxime axetil in treating AECB in adults. The study concluded that levofloxacin was effective and well-tolerated, providing an alternative treatment option. 2
Skin and Skin Structure Infections: Research has demonstrated that cefuroxime axetil is an effective antibacterial agent for treating common skin infections. A clinically beneficial outcome was achieved in 92% of patients treated with cefuroxime axetil, indicating its efficacy in managing cutaneous infections. 3
These studies highlight the clinical utility of cefuroxime axetil in managing various bacterial infections, supporting its use in appropriate clinical scenarios.
1. ASM (American Society for Microbiology)
Cefuroxime Axetil in Acute Bronchitis - ASM Journal
2. Oxford Academic (Journal of Antimicrobial Chemotherapy)
Efficacy of Levofloxacin vs. Cefuroxime Axetil in AECB
3. Wiley Online Library
Cefuroxime Axetil for Skin and Skin Structure Infections
What are the Contraindications of Ceftum 500 ?
Ceftum 500 (cefuroxime axetil) has specific contraindications, which include the following:
1. Hypersensitivity to Cefuroxime or Cephalosporins:
Patients with a known allergy to cefuroxime or other cephalosporin antibiotics should avoid taking Ceftum 500.
2. Severe Hypersensitivity to Penicillins or Beta-Lactam Antibiotics:
There is a possibility of cross-reactivity between cephalosporins and penicillins. Patients with a history of severe hypersensitivity reactions (e.g., anaphylaxis) to penicillins should not use this medication.
3. Neonates with Hyperbilirubinemia:
Cefuroxime may displace bilirubin from albumin, increasing the risk of kernicterus in neonates. It should not be used in such cases.
4. Severe Renal Impairment (without dose adjustment):
In patients with significantly impaired kidney function, cefuroxime can accumulate, leading to toxicity. Proper dosage adjustments must be made.
5. Intolerance to Certain Ingredients:
Some formulations of cefuroxime axetil may contain inactive ingredients (e.g., lactose). Patients with lactose intolerance or other ingredient sensitivities should consult their doctor.
Warnings and Precautions
Clostridioides difficile-associated Diarrhea: Prolonged antibiotic use may cause overgrowth of resistant organisms, leading to severe diarrhea.
Pregnancy and Breastfeeding: Use with caution and under medical advice, as cefuroxime crosses the placenta and is excreted in breast milk.
Gastrointestinal Conditions: Patients with a history of colitis should use Ceftum cautiously.
What are the different forms available in Ceftum 500 ?
Ceftum 500, containing Cefuroxime Axetil, is available in various forms to cater to different patient needs and preferences. Here are some of the different forms available:
Oral Forms
Tablets: Ceftum 500 tablets are available in strengths of 250 mg and 500 mg.
Capsules: Some brands offer cefuroxime axetil capsules in strengths of 250 mg and 500 mg.
Oral Suspension: Ceftum 500 oral suspension is available in strengths of 125 mg/5 mL and 250 mg/5 mL.
Parenteral Forms
Injectable Solution: Cefuroxime axetil injectable solution is available in strengths of 750 mg and 1.5 g.
Powder for Injection: Some brands offer cefuroxime axetil powder for injection in strengths of 750 mg and 1.5 g.
Other Forms
Dry Syrup: Ceftum 500 dry syrup is available in strengths of 125 mg and 250 mg.
Sachets: Some brands offer cefuroxime axetil sachets in strengths of 125 mg and 250 mg.
Important Note
The choice of formulation depends on the patient's age, weight, and ability to swallow tablets or capsules.
Always consult a healthcare professional before administering any medication, especially in pediatric or geriatric patients.
Pharmacokinetics of Ceftum 500
Ceftum 500, containing Cefuroxime Axetil, exhibits pharmacokinetic properties that enable it to effectively combat bacterial infections. Here's an overview of its pharmacokinetics:
Absorption
Oral Bioavailability: Cefuroxime axetil has an oral bioavailability of approximately 30-50%.
Peak Plasma Concentration: The peak plasma concentration (Cmax) of cefuroxime axetil is reached within 2-3 hours after oral administration.
Food Effect: Food enhances the absorption of cefuroxime axetil, increasing its bioavailability by approximately 30-40%.
Distribution
Volume of Distribution: The volume of distribution (Vd) of cefuroxime axetil is approximately 0.2-0.3 L/kg.
Protein Binding: Cefuroxime axetil is approximately 33-50% bound to plasma proteins.
Tissue Penetration: Cefuroxime axetil penetrates well into various tissues, including lung, skin, and urinary tract tissues.
Metabolism
Metabolic Pathway: Cefuroxime axetil is metabolized by the liver enzyme CYP1A2 to its active metabolite, cefuroxime.
Metabolite Concentration: The concentration of cefuroxime, the active metabolite, is approximately 2-4 times higher than that of cefuroxime axetil.
Excretion
Renal Excretion: Cefuroxime axetil and its metabolites are primarily excreted in the urine.
Elimination Half-Life: The elimination half-life (t1/2) of cefuroxime axetil is approximately 1.3-1.7 hours.
Total Clearance: The total clearance (Cl) of cefuroxime axetil is approximately 150-200 mL/min.
Special Populations
Pediatric Patients: The pharmacokinetics of cefuroxime axetil in pediatric patients are similar to those in adults.
Geriatric Patients: The pharmacokinetics of cefuroxime axetil in geriatric patients are similar to those in younger adults, but may be affected by age-related changes in renal function.
Renal Impairment: The pharmacokinetics of cefuroxime axetil are altered in patients with renal impairment, requiring dose adjustments.
Hepatic Impairment: The pharmacokinetics of cefuroxime axetil are not significantly altered in patients with hepatic impairment.
Clinical unique selling points (USPs) of Ceftum 500 (cefuroxime axetil)
1. Broad-Spectrum Antibacterial Activity
Effective against a wide range of gram-positive and gram-negative bacteria, including beta-lactamase-producing strains.
Useful in treating infections resistant to other classes of antibiotics.
2. Proven Efficacy in Respiratory Tract Infections
Widely prescribed for bacterial infections like community-acquired pneumonia, acute exacerbations of chronic bronchitis, and sinusitis.
Offers reliable outcomes in both upper and lower respiratory tract infections.
3. Beta-Lactamase Stability
Unlike some other antibiotics, Ceftum 500 is resistant to beta-lactamase enzymes produced by certain bacteria, making it effective against resistant strains.
4. Well-Tolerated with a Favorable Safety Profile
Exhibits lower rates of gastrointestinal side effects, such as diarrhea and nausea, compared to some other antibiotics.
Safe for use in children, elderly patients, and individuals with mild to moderate renal impairment (with adjusted dosing).
5. Convenient Dosing Regimen
Twice-daily oral administration ensures better patient adherence compared to antibiotics requiring more frequent dosing.
6. Versatility in Treating Diverse Infections
Indicated for skin and soft tissue infections, urinary tract infections, and sexually transmitted infections like gonorrhea.
Can be used in combination with other antibiotics for severe infections.
7. Pediatric and Geriatric Suitability
Available in formulations suitable for children, such as suspensions, ensuring its use in a wide demographic.
8. Well-Researched Molecule
Supported by numerous clinical trials and studies demonstrating its efficacy and safety across a variety of conditions.
Ceftum 500's combination of broad-spectrum activity, resistance to beta-lactamases, and proven clinical efficacy makes it a reliable choice for healthcare professionals.
Other brands of Cefuroxime:
Zinacef by GlaxoSmithKline
Ceftin by GlaxoSmithKline
Kefurox by AstraZeneca
Cefuroxime by Ranbaxy Laboratories
Cefril by Cipla Limited
Oraspor by Orchid Chemicals & Pharmaceuticals
Pulmocef by Lupin Limited
Cefox by Alkem Laboratories
Ceflum by Emcure Pharmaceuticals
Uroxime by UPL Limited (formerly known as Universal Pharmaceuticals Ltd)
Frequently asked questions (FAQs) about Ceftum 500
Q: What is Ceftum 500?
A: Ceftum 500 is a broad-spectrum antibiotic containing Cefuroxime Axetil, used to treat various bacterial infections.
Q: What is Cefuroxime Axetil?
A: Cefuroxime Axetil is a second-generation cephalosporin antibiotic, effective against a wide range of Gram-positive and Gram-negative bacteria.
Q: How should I take Ceftum 500?
A: Take Ceftum 500 tablets orally with food, twice a day, or as directed by your doctor.
Q: What is the recommended dosage of Ceftum 500?
A: The recommended dosage of Ceftum 500 varies depending on the infection type and severity. Consult your doctor for specific dosage instructions.
Q: Is Ceftum 500 safe for everyone?
A: Ceftum 500 is contraindicated in patients with a history of hypersensitivity to cefuroxime axetil or other cephalosporins. Consult your doctor before taking Ceftum 500.
Q: Can I take Ceftum 500 during pregnancy or breastfeeding?
A: Consult your doctor before taking Ceftum 500 during pregnancy or breastfeeding, as it may pass into breast milk.
Q: What are the common side effects of Ceftum 500?
A: Common side effects of Ceftum 500 include diarrhea, nausea, vomiting, abdominal pain, and allergic reactions.
Q: Can Ceftum 500 interact with other medications?
A: Ceftum 500 may interact with certain medications, such as antacids, warfarin, and probenecid. Consult your doctor before taking Ceftum 500 with other medications.
Q: How should I store Ceftum 500?
A: Store Ceftum 500 tablets at room temperature (15-30°C) in a dry place, away from direct sunlight.
Q: What is the expiration date of Ceftum 500?
A: Check the expiration date on the packaging or consult your pharmacist for more information.
Q: Can I crush or chew Ceftum 500 tablets?
A: No, do not crush or chew Ceftum 500 tablets, as this may affect the absorption and efficacy of the medication.
Q: Can I take Ceftum 500 for viral infections?
A: No, Ceftum 500 is ineffective against viral infections and should only be used to treat bacterial infections.
Q: Can I take Ceftum 500 with food?
A: Yes, take Ceftum 500 with food to enhance absorption and reduce gastrointestinal side effects.
Q: What if I miss a dose of Ceftum 500?
A: If you miss a dose, take it as soon as you remember. However, if it's almost time for your next dose, skip the missed dose and continue with your regular schedule.
Q: Can I take Ceftum 500 for a longer duration than prescribed?
A: No, do not take Ceftum 500 for a longer duration than prescribed by your doctor, as this may increase the risk of antibiotic resistance and side effects.
Q: Can Ceftum 500 cause allergic reactions?
A: Yes, Ceftum 500 can cause allergic reactions, including anaphylaxis. If you experience any signs of an allergic reaction, such as rash, itching, or difficulty breathing, seek medical attention immediately.
Q: Can Ceftum 500 affect my blood sugar levels?
A: Ceftum 500 may affect your blood sugar levels. If you have diabetes, monitor your blood sugar levels closely while taking Ceftum 500.
Q: Can Ceftum 500 interact with my birth control pills?
A: Ceftum 500 may interact with certain birth control pills. Consult your doctor before taking Ceftum 500 if you are using birth control pills.
Q: Can Ceftum 500 cause diarrhea?
A: Yes, Ceftum 500 can cause diarrhea, which may be a sign of a new infection. If you experience diarrhea that is severe, bloody, or persistent, seek medical attention.
Q: Can Ceftum 500 interact with my antacids?
A: Yes, Ceftum 500 may interact with antacids, reducing its absorption. Take Ceftum 500 at least 1 hour before or 2 hours after taking antacids.
Q: Can Ceftum 500 interact with my blood thinners?
A: Yes, Ceftum 500 may interact with blood thinners, such as warfarin. Monitor your INR (International Normalized Ratio) closely while taking Ceftum 500.
Q: Can I store Ceftum 500 in the refrigerator?
A: No, do not store Ceftum 500 in the refrigerator, as this may affect its potency.
Q: What if I forget to take Ceftum 500 and it's past its expiration date?
A: Do not take expired Ceftum 500. Consult your pharmacist or doctor for advice on what to do next.
Q: Can I take Ceftum 500 for prophylaxis?
A: Ceftum 500 may be used for prophylaxis in certain situations, such as before surgery. However, this should only be done under the guidance of a healthcare professional.
Q: Can I crush or split Ceftum 500 tablets?
A: No, do not crush or split Ceftum 500 tablets, as this may affect the absorption and efficacy of the medication.
Q: Is Ceftum 500 safe to take during pregnancy?
A: Ceftum 500 is classified as a category B medication, which means that animal studies have not shown any harm to the fetus, but there are no adequate and well-controlled studies in pregnant women.
Q: Can Ceftum 500 harm my unborn baby?
A: There is no conclusive evidence that Ceftum 500 can harm the unborn baby. However, as with any medication, it's essential to consult your doctor before taking Ceftum 500 during pregnancy.
Q: What is the recommended dosage of Ceftum 500 during pregnancy?
A: The recommended dosage of Ceftum 500 during pregnancy is the same as for non-pregnant women. However, your doctor may adjust the dosage based on your individual needs.
Q: Can I take Ceftum 500 during pregnancy if I have a history of allergies?
A: If you have a history of allergies, consult your doctor before taking Ceftum 500 during pregnancy. Your doctor may recommend alternative treatments or monitor you closely for any signs of an allergic reaction.
Q: Can I take Ceftum 500 while breastfeeding?
A: Ceftum 500 is excreted in breast milk, but the amount is generally considered to be low. However, consult your doctor before taking Ceftum 500 while breastfeeding, as it may affect the baby.
Q: Will Ceftum 500 affect my milk supply?
A: There is no conclusive evidence that Ceftum 500 affects milk supply. However, if you experience any changes in your milk supply or the baby's behavior, consult your doctor.
Q: What should I monitor while taking Ceftum 500 during pregnancy?
A: Monitor your temperature, blood pressure, and any signs of infection or allergic reactions while taking Ceftum 500 during pregnancy.
Q: What precautions should I take while taking Ceftum 500 during pregnancy?
A: Take Ceftum 500 exactly as directed by your doctor, and complete the full course of treatment. Also, inform your doctor about any other medications or supplements you're taking.