Cefuroxime
General
- Type: 2nd generation cephalosporin
- Dosage Forms: tablet, powder for injection
- Dosage Strength: tablet: 250mg, 500mg; powder for injection: 750mg, 1.5g, 7.5g, 75g, 225g
- Routes of Administration: PO, IV, IM
- Common Trade Names: Ceftin, Zinacef
Adult Dosing
Mild-Moderate Bacterial infections
- 250-500mg PO BID x5-10 days
Steptococcal Pharyngitis/Tonsillitis
- 250mg PO BID x10 days
Acute Maxillary Sinusitis
- 250mg PO BID x10 days; Info: not recommended per IDSA guidelines
Uncomplicated Gonococcal Infections
- 1000mg PO x1; Info: for infections of cervix, urethra, rectum; dual treatment for chlamydial co-infection recommended
Early Lyme Disease
- 500mg 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: 30mg/kg/day susp PO divided q12h x10 days; Max: 1000mg/day; Alt: 250mg tab PO BID x10 days; Info: give susp with food
- >13 yo: Dose: 250-500mg tab PO BID x5-10 days; Info: dose, duration varies by infection type, severity
Acute Otitis Media
- 2 mo-5 yo Dose: 30mg/kg/day susp PO divided q12h x10 days; Max: 1000mg/day; Alt: 250mg tab PO BID x10 days; Info: give susp with food
- 6-12 yo: Dose: 30mg/kg/day susp PO divided q12h x5-10 days; Max: 1000mg/day; Alt: 250mg tab PO BID x5-10 days; Info: give susp with food
Acute Maxillary Sinusitis
- 3 mo-12 yo: Dose: 30mg/kg/day susp PO divided q12h x10 days; Max: 1000mg/day; Alt: 250mg tab PO BID x10 days; Info: not recommended per IDSA guidelines; give susp with food
- >13 yo: Dose: 250mg tab PO BID x10 days; Info: not recommended per IDSA guidelines
Streptococcal Pharyngitis/Tonsillitis
- 3 mo-12 yo: Dose: 20mg/kg/day susp PO divided q12h x10 days; Max: 500mg/day; Info: give with food
- >13 yo: Dose: 250mg tab PO BID x10 days
Uncomplicated Gonococcal Infections
- adolescents: Dose: 1000mg tab PO x1; Info: for infections of cervix, urethra, rectum; dual treatment for chlamydial co-infection recommended
Early Lyme Disease
- >13 yo: Dose: 500mg tab PO BID x20 days
Renal Dosing
- 3 mo-12 yo: CrCl <10: 15mg/kg PO 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: 15mg/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 antibiotic-associated colitis history
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 reaction
- Vaginitis
- Diaper Rash
- ALT, AST elevated
- Renal Impairment
- Anemia
Pharmacology
- Half-life: 1.4 hours, 3.5 hours (CrCl 35),
- Metabolism: Minimal; CYP 450: unknown
- Excretion: Urinary primarily (Up to 100% unchanged)
- Mechanism of Action: Bactericidal; inhibits cell wall mucopeptide synthesis
Antibiotic Sensitivities[1]
Key
- S susceptible/sensitive (usually)
- I intermediate (variably susceptible/resistant)
- R resistant (or not effective clinically)
- S+ synergistic with cell wall antibiotics
- U sensitive for UTI only (non systemic infection)
- X1 no data
- X2 active in vitro, but not used clinically
- X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
- X4 active in vitro, but not clinically effective for strep pneumonia
See Also
References
- ↑ Sanford Guide to Antimicrobial Therapy 2014