Cefuroxime

Indications
Oral
Uncomplicated urinary tract infections
Adult: 125 mg bid.
Oral
Respiratory tract infections
Adult: 250-500 mg bid.
Child: >3 mth: 125 mg bid or 10 mg/kg bid. Max dose: 250 mg daily.
Oral
Uncomplicated gonorrhoea
Adult: 1 g as a single dose. 1 g oral probenecid may be given concurrently.
Oral
Otitis media
Child: >2 yr: 250 mg bid or 15 mg/kg bid up to 500 mg daily.
Intravenous
Meningitis
Adult: 3 g every 8 hr.
Child: 200-240 mg/kg/day in 3-4 divided doses, decreased to 100 mg/kg/day after 3 days or once symptoms have improved. Neonate: 100 mg/kg/day, decreased to 50 mg/kg/day when control has been achieved.
Renal impairment: Patients undergoing haemodialysis should receive an additional 750-mg dose after each dialysis; those undergoing continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)Dosage Recommendation
10-20750 mg bid.
<10750 mg once daily.

Intramuscular
Gonorrhoea
Adult: 1.5 mg as a single dose divided between 2 inj sites. 1 g oral probenecid may be given concurrently.
Renal impairment: Patients undergoing haemodialysis should receive an additional 750-mg dose after each dialysis; those undergoing continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)Dosage Recommendation
10-20750 mg bid.
<10750 mg once daily.

Parenteral
Prophylaxis of surgical infections
Adult: 1.5 g IV before the procedure followed by 750 mg IM every 8 hr for up to 24-48 hr depending on the procedure. For total joint replacement, 1.5 g of cefuroxime may be mixed with methylmethacrylate cement.
Renal impairment: Patients undergoing haemodialysis should receive an additional 750-mg dose after each dialysis; those undergoing continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)Dosage Recommendation
10-20750 mg bid.
<10750 mg once daily.

Parenteral
Susceptible infections
Adult: 750 mg every 8 hr given as deep IM or slow IV inj over 3-5 min or IV infusion, increased to 1.5 g every 6-8 hr in severe infections.
Child: 30-60 mg/kg/day, may increase to 100 mg/kg/day if necessary. To be given in 3-4 divided doses or 2-3 divided doses in neonates.
Renal impairment: Patients undergoing haemodialysis should receive an additional 750-mg dose after each dialysis; those undergoing continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)Dosage Recommendation
10-20750 mg bid.
<10750 mg once daily.


Incompatibility: Incompatible with aminoglycosides.
Contraindications
Hypersensitivity to cephalosporins.
Warnings / Precautions
Severe renal impairment; pregnancy, lactation; hypersensitivity to penicillins.
Adverse Reactions
Large doses can cause cerebral irritation and convulsions; nausea, vomiting, diarrhoea, GI disturbances; erythema multiforme, Stevens-Johnson syndrome, epidermal necrolysis.
Potentially Fatal: Anaphylaxis, nephrotoxicity, pseudomembranous colitis.
Drug Interactions
Probenecid decreases renal clearance of cefuroxime.
Potentially Fatal: Nephrotoxicity with aminoglycosides and furosemide.
See Below for More cefuroxime Drug Interactions
Lab Interactions
False-positive for Coombs' test. It may interfere with urine-sugar estimation.
Food Interactions
Oral cefuroxime axetil is better absorbed after food intake.
Mechanism of Actions
Cefuroxime binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.
Absorption: Absorbed from the GI tract with peak plasma concentrations after 2-3 hr (oral); may be enhanced by the presence of food.
Distribution: Pleural and synovial fluid, sputum, bone and aqueous fluids; CSF (therapeutic concentrations). Crosses the placenta and enters breast milk. Protein-binding: Up to 50%.
Metabolism: Rapidly hydrolysed (intestinal mucosa and blood).
Excretion: Via the urine by glomerular filtration and renal tubular secretion (as unchanged); via bile (small amounts); 70 min (elimination half-life); prolonged in neonates and renal impairment.
Administration
Should be taken with food.
Storage Conditions
Intramuscular: Store at 15-30°C. Intravenous: Store at 15-30°C. Oral: Store at 15-30°C. Parenteral: Inj: Store at 15-30°C.
ATC Classification
J01DC02 - cefuroxime ; Belongs to the class of second-generation cephalosporins. Used in the systemic treatment of infections.
Storage
Intramuscular: Store at 15-30°C. Intravenous: Store at 15-30°C. Oral: Store at 15-30°C. Parenteral: Inj: Store at 15-30°C.
Available As
  • Cefuroxime Axetil 100 mg
  • Cefuroxime 100 mg
  • Cefuroxime 1000 mg
  • Cefuroxime Sodium 125 mg
  • Cefuroxime 125 mg
  • Cefuroxime Axetil 125 mg
  • Cefuroxime Sodium 1500 mg
  • Cefuroxime 1500 mg
  • Cefuroxime Axetil 1500 mg
  • Cefuroxime 200 mg
  • Cefuroxime Axetil 200 mg
  • Cefuroxime Sodium 250 mg
  • Cefuroxime 250 mg
  • Cefuroxime Axetil 250 mg
  • Cefuroxime 450 mg
  • Cefuroxime 50 mg
  • Cefuroxime Axetil 50 mg
  • Cefuroxime Axetil 500 mg
  • Cefuroxime Sodium 500 mg
  • Cefuroxime 500 mg
  • Cefuroxime Sodium 750 mg
  • Cefuroxime Axetil 750 mg
  • Cefuroxime 750 mg
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