Cefuroxime

General

• Type: 2nd generation cephalosporin
• Dosage Forms: PO
• Common Trade Names: Ceftin

Adult Dosing

Mild-Moderate Bacterial infections

• 250-500 mg PO bid x5-10 days

Steptococcal Pharyngitis/Tonsillitis

• 250 mg PO bid x10 days

Acute Maxillary Sinusitis

• 250 mg PO bid x10 days; Info: not recommended per IDSA guidelines

Uncomplicated Gonococcal Infections

• 1000 mg PO x1; Info: for infections of cervix, urethra, rectum; dual tx for chlamydial co-infection recommended

Early Lyme Disease

• 500 mg PO bid x20 days

Renal Dosing

• no adjustment; HD: give dose after dialysis, no supplement; PD: no supplement

Hepatic Dosing

• not defined

Pediatric Dosing

Mild-Moderate Bacterial Infections

• 3 mo-12 yo: Dose: 30 mg/kg/day susp PO divided q12h x10 days; Max: 1000 mg/day; Alt: 250 mg tab PO bid x10 days; Info: give susp w/ food
• >13 yo: Dose: 250-500 mg tab PO bid x5-10 days; Info: dose, duration varies by infection type, severity

Acute Otitis Media

• 2 mo-5 yo Dose: 30 mg/kg/day susp PO divided q12h x10 days; Max: 1000 mg/day; Alt: 250 mg tab PO bid x10 days; Info: give susp w/ food
• 6-12 yo: Dose: 30 mg/kg/day susp PO divided q12h x5-10 days; Max: 1000 mg/day; Alt: 250 mg tab PO bid x5-10 days; Info: give susp w/ food

Acute Maxillary Sinusitis

• 3 mo-12 yo: Dose: 30 mg/kg/day susp PO divided q12h x10 days; Max: 1000 mg/day; Alt: 250 mg tab PO bid x10 days; Info: not recommended per IDSA guidelines; give susp w/ food
• >13 yo: Dose: 250 mg tab PO bid x10 days; Info: not recommended per IDSA guidelines

Streptococcal Pharyngitis/Tonsillitis

• 3 mo-12 yo: Dose: 20 mg/kg/day susp PO divided q12h x10 days; Max: 500 mg/day; Info: give w/ food
• >13 yo: Dose: 250 mg tab PO bid x10 days

Uncomplicated Gonococcal Infections

• adolescents: Dose: 1000 mg tab PO x1; Info: for infections of cervix, urethra, rectum; dual tx for chlamydial co-infection recommended

Early Lyme Disease

• >13 yo: Dose: 500 mg tab PO bid x20 days

Renal Dosing

• 3 mo-12 yo: CrCl <10: 15 mg/kg susp q24h; HD: give dose after dialysis, no supplement; PD: no supplement
• >13 yo: renal impairment: no adjustment; HD: give dose after dialysis, no supplement; PD: no supplement

Hepatic Dosing

• not defined

Special Populations

• Pregnancy: B
• Lactation: Probably Safe
• Renal Dosing
  • Adult: no adjustment; HD: give dose after dialysis, no supplement; PD: no supplement
  • Pediatric: 3 mo-12 yo: CrCl <10: 15 mg/kg susp q24h; HD: give dose after dialysis, no supplement; PD: no supplement; >13 yo: renal impairment: no adjustment; HD: give dose after dialysis, no supplement; PD: no supplement
• Hepatic Dosing
  • Adult: Not defined
  • Pediatric: Not defined

Contraindications

• Allergy to class/drug (See Cephalosporin Cross-reactivity)
• Caution if hypersensitive to PCN
• Caution if renal impairment
• Caution if hepatic impairment
• Caution if seizure disorder
• Caution if malnutrition
• Caution if recent abx-assoc. colitis hx

Adverse Reactions

Serious

• Anaphylaxis
• Angioedema
• Toxic epidermal necrolysis
• Stevens-Johnson syndrome
• Interstitial nephritis
• Pancytopenia
• Thrombocytopenia
• Agranulocytosis
• Leukopenia
• Neutropenia
• Hemolytic Anemia
• Seizures
• Clostridium difficile associated diarrhea

Common

• Diarrhea
• Nausea/Vomiting
• Jarisch-Herxheimer rxn
• Vaginitis
• Diaper Rash
• ALT, AST elevated
• Renal Impairment
• Anemia

Pharmacology

• Half-life:
• Metabolism:
• Excretion:
• Mechanism of Action:

See Also

• Antibiotics (Main)