CEFUROXIME

Indications & Dose:

Susceptible infections due to Gram-positive and Gramnegative bacteria 

• BY MOUTH 

Child 3 months–1 year: 10 mg/kg twice daily (max. per dose 125 mg) 

Child 2–11 years: 15 mg/kg twice daily (max. per dose 250 mg) 

Child 12–17 years: 250 mg twice daily, dose may be doubled in severe lower respiratory-tract infections or if pneumonia is suspected 

Adult: 250 mg twice daily, dose may be doubled in severe lower respiratory-tract infections or if pneumonia is suspected %

• BY INTRAVENOUS INFUSION, OR BY INTRAVENOUS INJECTION, OR BY INTRAMUSCULAR INJECTION 

Child: 20 mg/kg every 8 hours (max. per dose 750 mg); increased to 50–60 mg/kg every 6–8 hours (max. per dose 1.5 g), increased dose used for severe infection and cystic fibrosis 

Adult: 750 mg every 6–8 hours; increased if necessary up to 1.5 g every 6–8 hours, increased dose used for severe infections

Lyme disease 

• BY MOUTH 

Adult: 500 mg twice daily for 14–21 days (for 28 days in Lyme arthritis)

Lower urinary-tract infection 

• BY MOUTH 

Child 12–17 years: 125 mg twice daily 

Adult: 125 mg twice daily

Pyelonephritis 

• BY MOUTH 

Adult: 250 mg twice daily

Surgical prophylaxis

INITIALLY BY INTRAVENOUS INJECTION 

Adult: 1.5 g, to be administered up to 30 minutes before the procedure, then (by intravenous injection or by intramuscular injection) 750 mg every 8 hours if required for up to 3 doses (in high risk procedures)

Open fractures, prophylaxis 

• BY INTRAVENOUS INFUSION, OR BY INTRAVENOUS INJECTION 

Adult: 1.5 g every 8 hours until soft tissue closure (maximum duration 72 hours)

Children

Over 3 months125mg twice daily.

3 months-2 years 125mg twice daily after food, over 2 years 250mg twice daily

Meningitis:

200-400mg/kg body-wt. i.v. daily in 3-4 divided doses.

Neonates:

100mg/kg body-wt. i.v. daily.

NOTED:  Duration of treatment in Lyme disease is unlicensed.

Contraindications:

 Infants < 1 mo 

PREGNANCY Not known to be harmful.

 BREAST FEEDING Present in milk in low concentration, but appropriate to use.

 RENAL IMPAIRMENT 

In adults Use parenteral dose of 750mg twice daily if eGFR 10–20 mL/minute/1.73m2. 

In children Reduce parenteral dose if estimated glomerular filtration rate less than 20 mL/minute/ 1.73m2.

Side Effects:

Cautions:

Precautions:

Interaction:

Drugs

Aminoglycosides: Additive nephrotoxicity

Antacids, H2-blockers, omeprazole, .

lansoprazole: Decreased absorption of cefuroxime axetil

Loop diuretics: Increased nephrotoxicity 

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Chills, dizziness, fever, headache, paresthesia, weakness

GI: Abdominal pain, anorexia, bleeding; diarrhea, glossitis, increased LFTs; nausea, pseudomembranous colitis, vomiting

GU: Candidiasis, nephrotoxicity, vaginitis

HEME: Bone marrow suppression, eosinophilia, hemolytic anemia, lymphocytosis, thrombocytosis

RESE: Dyspnea

SKIN: Rash, urticaria 

Patient And Carer Advice: