Second-generation Cephalosporins

Antibacterial (Systemic)

Bone and joint infections, Gonorrhea, Lower respiratory tract infections, including pneumonia, Meningitis, Septicemia, Skin and Skin-Structure infections, Urinary tract infections

FDA Pregnancy Category B

Adequate and well controlled studies in humans have not been done.

Breast-feeding

Cefuroxime is distributed into breast milk in low concentrations 0.5 mg per L. Caution should be used when cefuroxime is administered to nursing mothers.

Pediatrics

Safety and effectiveness in pediatric patients three months of age and below has not been established.

Geriatrics

Elderly patients are more likely to have decreased renal function; care should be taken in dose selection and it may be useful to monitor renal function.

Contraindications

Except under special circumstances, this medication should not be used when the following medical problem exists:

Hypersensitivity to cefuroxime or any other cephalosporin.

Risk-benefit should be considered when the following medical problems exist:

Colitis, history of or Gastrointestinal disease, history of (may aggravate symptoms) ;Hepatic impairment or;Poor nutritional state or

Renal impairment (may be associated with a fall in prothrombin activity; exogenous Vitamin K should be administered as indicated);Hypersensitivity to penicillins or Allergic reaction to other agents or other drug;Renal insufficiency, transient or persistent

Drug interactions

Combinations containing any of the following medications, de­pending on the amount present, may also interact with this medication. Aminoglycoside antibiotics (may result in nephrotoxicity), Diuretics, potent (administration may adversely affect renal function thereby affecting cefuroxime elimination), Probenecid (concomitant administration with probenecid slows tubular secre­tion, decreases renal clearance by approximately 40%, increases peak serum levels by approximately 30%, and increases the se­rum half life by approximately 30%.)

Intravenous or intramuscular:

750 mg to 1.5 g of cefuroxime every 8 hours, usually for 5 to 10 days. 

Bone and joint infections (treatment),Gonococcal infections, disseminated, severe or complicated, Pneumonia, severe or complicated, Skin and skin-structure infections, severe or complicated,Urinary tract infections, severe or complicated-

Intravenous, 1.5 g eyery 8 hours                

Gonococcal infections, disseminated- Pneumonia uncomplicated,Skin and skin-structure infections, Urinary tract infections,uncomplicated-

Intravenous, 750 mg every 8 hours                                        

Gonococcal infection,uncomplicated-lntramuscular, 1.5 g given as one dose at 2 different sites; administer with 1 g of oral probenecid   Meningitis, bacterial -Intravenous, up to 3 g every 8 hour Perioperative prophylaxis- Open heart surgery patients:

Intravenous,1.5 g at the induction of anesthesia, then 1.5 g every twelve hours, for a total of 6 g.

Surgical procedures, clean-contaminated or potentially contaminated:

Intravenous 1.5 g dose just before surgery (0.5 to 1 hour prior to initial incision). Thereafter, 750 mg intravenously or intramuscu­larly every 8 hours when the procedure is prolonged.

Other infections- Less susceptible organisms or life-threatening infections:

Intrave­nous, 1.5 g every 6 hours. Note: A minimum of 10 days of treatment is recommended in infections caused by Streptococcus pyrogens in order to guard against the risk of rheumatic fever or glomerulonephritis.

Usual adult prescribing limits

Bacterial Meningitis-Up to 3 g  of cefuroxime every 8 hours.

 Above 3 Months of Age: Administration of 50 to 100 mg/kg/day in equally divided doses every 6 to 8 hours has been successful for most infections susceptible to cefuroxime. The higher dosage of 100 mg/kg/day (not to exceed the maximum adult dosage) should be used for the more severe or serious infections.

In bone and joint infections, 150 mg/kg/day (not to exceed the maximum adult dosage) is recommended in equally divided doses every 8 hours.

Those indicating need for medical attention

Incidence more frequent:

Eosinophilia,

Incidence less frequent:

Hypersensitivity reaction, pseudomembranous colitis, seizure, thrombophlebitis, Urticaria

Incidence rare:

Anaphylaxis, epidermal necrolysis, toxic, erythema multiforme, hearing loss,mild to moderate, interstitial nephritis,  leukopenia or neutropenia, Stevens-Johnson syndrome,  thrombocytopenia

Incidence unknown-reported during post marketing:

Agranulocytosis, angioedema, seizures, pancytopenia

Those indicating need for medical attention only if they continue or are bothersome

Incidence less frequent:

Diarrhea; gastrointestinal problems,nausea; pruritus

Incidence rare:

Drug fever

Before adding solvent store below 30 °C (86°F), protect from light and keep the medicine in the box.

Box of 10 Cefuroxim (as sodium) vials 750 mg