Cefuroxime

Cephalosporin · Cephalosporin

Indications

Respiratory tract, skin and soft tissue infections; serious infections pending bacteriology. Meningitis. Prophylaxis against infection in surgical procedures. UTI and gonorrhoea.

Dosage

ORAL: Adults: Most infections and bronchitis, usually 250 mg twice daily. Severe infections and pneumonia: 500 mg twice daily. Gonorrhoea: 1 gm as a single dose. Children: 3-6 mth (4-6 kg body wt): 40-60 mg; 6 mth-2 yr, 60-120 mg; 2-12 yr: 125 mg. All twice daily. Lower Respiratory Infection: Adults & Children: >13 yr: 250-500 mg twice daily for 5-10 days. Upper Respiratory Infection: Pharyngitis/Tonsillitis/ Sinusitis: Adults: 250 mg every 12 hr for 10 days. Children: >13 yr: 250 mg every 12 hr for 10 days. Pharyngitis/Tonsillitis: Children: 3 mth-12 yr, 125 mg every 12 hr for 10 days or 10 mg/kg every 12 hr for 10 days. Max: 500 mg/day. Sinusitis: Children: 3 mth-12 yr, 250 mg every 12 hr for 10 days or 15 mg/kg every 12 hr for 10 days. Max: 1 gm/day. Otitis Media: Children: 3 mth-12 yr: 15 mg/kg every 12 hr for 10 days. Max: 1 gm/day. Urinary Tract Infection: Adults & Children: > 13…

Administration

IM: Inject deep IM into large muscle mass. IV: Inject direct IV over 3-5 min. Infuse intermittent infusion over 15-30 min. Reconstitution: IM: Add 3 or 3.6 mL SWFI to each 750 mg vial to yield 220 mg/mL. Compatibility: Stable in D5¼NS, D5½NS, D5NS, D5W, D10W, LR, NS. Stability: Reconstituted solution is stable for 24 hours at room temperature and 48 hours when refrigerated. For IV infusion in NS or D5W, solution is stable for 24 hours at room temperature, 1 week when refrigerated, or 26 weeks when frozen.

Adverse Effects

Hypersensitivity reactions, Gl disturbances. Rarely pain at inj site, candidiasis, eosinophilia, neutropenia, leucopenia, transient rise in liver enzymes, blood urea. Positive Coomb's test, headache, dizziness, candida overgrowth, decreased haemoglobin, pseudomembranous colitis, haemolytic anaemia.

Risk Factor (Pregnancy/Lactation)

Pregnancy: No evidence of risk in humans. Lactation: Contraindicated or not recommended. Precautions: Penicillin hypersensitivity. Renal impairment (CrCl<20 mL/min). Suspension may contain aspartame; caution in phenylketonuria. Lyme disease, warn patient of Jarisch-Herxheimer reaction.

Interactions

Loop diuretics, aminoglycosides. Probenecid, combined oral contraceptives, drugs affecting gastric acidity, oral anticoagulants.

Advice to Patient

Take with or without meals. Take at regular intervals, as scheduled. Shake oral suspension well before measuring and use a calibrated measuring device to ensure accurate dose. To improve flavour of oral suspension, refrigerate it but do not freeze. For using single-dose packet, empty contents of one packet into a glass and add at least 10 mL (2 tsp) of cold water, apple, grape or orange juice or lemonade. Stir well and take whole mixture at once. Contact prescriber if there is burning/swelling/redness/pain at injection or infusion site or if there is chest pain, difficulty in breathing or swallowing, severe unrelieved diarrhoea, vaginal drainage or itching, mouth sores, bloody stool, bloody urine. Watery or bloody stools can occur 2 or more months after therapy and can be serious, requiring immediate treatment. Complete full course of therapy even if you feel better. Take sufficient…

Pharmacokinetics

Absorption: Oral tab: Increases with food. Metabolism: Cefuroxime axetil (oral) is hydrolyzed in the intestinal mucosa and blood to cefuroxime. Bioavailability: Tab: Fasting: 37%; Following food: 52%. Half-life elimination: Premature neonates: PNA =3 days: Median: 5.8 hrs. PNA =8 days: Median: 1.6-3.8 hrs. Children and Adolescents: 1.4-1.9 hrs. Adults: Approx. 1-2 hrs; prolonged with renal impairment. Time to peak, serum: IM: Approx, 15-60 mins. IV: 2-3 mins. Oral: Children: Approx. 3-4 hrs. Adults: Approx. 2-3 hrs. Excretion: Urine.

Brands with this active ingredient

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