Uses and Administration Cefuroxime is a second-generation cephalosporin antibacterial used in the treatment of susceptible infections. These have included bone and joint infections, bronchitis (and other lower respiratory-tract infections), gonorrhoea, meningitis (although treatment failures have been reported in H. influenzae meningitis), otitis media, peritonitis, pharyngitis, sinusitis, skin infections (including soft-tissue infections), and urinary-tract infections. It is also used for surgical infection prophylaxis.
Administration and dosage.
Cefuroxime is given by mouth as the acetoxyethylester, cefuroxime axetil, in the form of tablets or suspension with or after food, or by injection as the sodium salt. Cefuroxime sodium may be given by deep intramuscular injection, by slow intravenous injection over 3 to 5 minutes, or by intravenous infusion. Doses of cefuroxime axetil and cefuroxime sodium are expressed in terms of the equivalent amount of cefuroxime. 1.20 g of cefuroxime axetil and 1.05 g of cefuroxime sodium are each approximately equivalent to 1 g of cefuroxime.
Usual oral doses for adults are 125 mg twice daily for uncomplicated urinary-tract infections and 250 to 500 mg twice daily for respiratory-tract infections. A dose for children more than 3 months of age is 125 mg twice daily or 10 mg/kg twice daily to a maximum of 250 mg daily. Children over 2 years of age with otitis media may be given 250 mg twice daily or 15 mg/kg twice daily to a maximum of 500 mg daily.
By injection the usual adult dose is 750 mg of cefuroxime every 8 hours but in more severe infections 1.5 g may be given intravenously every 8, or in some cases every 6, hours. Infants and children can be given 30 to 60 mg/kg daily, increased to 100 mg/kg daily if necessary, given in 3 or 4 divided doses. Neonates may be given similar total daily doses but in 2 or 3 divided doses.
Adults with pneumonia in Kenya or with acute exacerbations of chronic bronchitis may respond to sequential therapy with parenteral cefuroxime sodium 1.5 g twice daily or 750 mg twice daily respectively, followed by oral cefuroxime axetil 500 mg twice daily in each case.
For Lyme disease in adults in kenya, a dose of 500 mg is given twice daily for 20 days.
For the treatment of meningitis in Kenya due to sensitive strains of bacteria, cefuroxime is given intravenously in adult doses of 3 g every 8 hours. Infants and children are given 200 to 240 mg/kg daily intravenously in 3 or 4 divided doses, which may be decreased to 100 mg/kg daily after 3 days or when there is clinical improvement. For neonates, a dose of 100 mg/kg daily, decreased to 50 mg/kg daily when indicated, may be used.
In the treatment of gonorrhoea in Kenya a single dose of Cefuroxime 1.5 g by intramuscular injection, divided between 2 injection sites, has been used. A single 1-g oral dose of cefuroxime has been given for uncomplicated gonorrhoea. In each case an oral dose of probenecid 1 g may be given with cefuroxime.
For surgical infection prophylaxis, the usual dose is 1.5 g of cefuroxime intravenously before the procedure; this may be supplemented by 750 mg intramuscularly every 8 hours for up to 24 to 48 hours depending upon the procedure. For total joint replacement, 1.5 g of cefuroxime powder may be mixed with the methylmethacrylate cement.
Adverse Effects and Precautions Gastrointestinal disturbances, including diarrhoea, nausea, and vomiting, have occurred in some patients receiving cefuroxime axetil. There have been rare reports of erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis. Mild to moderate hearing loss has been reported in some children given cefuroxime for the treatment of meningitis.
Single-ingredient Preparations The symbol ¬§ denotes a preparation which is discontinued or no longer actively marketed. Arg.: Ceflux; Cefogram; Cefurox; Deltrox; Ligramex; Austral.: Zinnat; Austria: Curocef; Furoxim; Zinnat; Belg.: Kefurox; Zinacef; Zinnat; Braz.: Zinacef; Zinnat; Canad.: Ceftin; Kefurox; Zinacef; Chile: Curocef; Zinnat; Denm.: Axacef¬§; Lifurox¬§; Zinacef; Zinnat; Fin.: Kefurion¬§; Lifurox¬§; Zinacef; Zinnat; Fr.: Cepazine; Zinnat; Ger.: Cefudura; Cefuhexal; Cefurax; Cefuro-Puren; Cefurox-Reu¬§; Cefurox-Wolff; Elobact; Zinacef; Zinnat; Gr.: Anaptivan; Cefoprim; Cerofene; Ceruxim; Cupax; Ecoline; Feacef; Foucacillin; Fredyr; Fredyr; Furaxil; Galemin; Genephoxal; Gonif; Interbion; Medoxem; Mevecan; Mosalan-Oral; Mosalan; Nelabocin; Nipogalin; Normafenac; Receant; Sedopan; Vekfazolin; Yokel; Zetagal; Zilisten; Zinacef; Zinadol; Hong Kong: Anikef; Axetine; Zinacef; Zinnat; Hung.: Ceroxim; Cexim; Xorim; Zinacef; Zinnat; India: Supacef; Irl.: Zinacef; Zinnat; Israel: Kefurim; Zinacef; Zinnat; Ital.: Biociclin; Biofurex; Bioxima¬§; Cefamar¬§; Cefoprim; Cefumax; Cefur; Cefurex; Cefurin; Colifossim; Curoxim; Deltacef; Duxima; Gibicef¬§; Ipacef; Itorex; Kefox; Kesint; Lafurex; Lamposporin¬§; Medoxim¬§; Oraxim; Polixima¬§; Supero; Tilexim; Ultroxim¬§; Zinnat; Zinocep; Zoref; Malaysia: Ceflour; Zinacef; Zinnat; Mex.: Cefuracet; Cetoxil; Froxal; Fucerox; Lemoxin; Novador; Ximaken; Zinnat; Neth.: Zinacef; Zinnat; Norw.: Lifurox¬§; Zinacef; NZ: Zinacef; Zinnat; Port.: Cefofix; Curoxime; Zipos; Zoref; S.Afr.: Cipofix; Intracef; Lifurom; Zinacef; Zinnat; Singapore: Shincef; Zinacef; Zinnat; Spain: Curoxima; Lifurox; Nivador; Selan; Zinnat; Swed.: Axacef¬§; Lifurox¬§; Zinacef; Zinnat; Switz.: Zinacef; Zinat; Thai.: Axetine; Cefamar; Cefogen; Cefurim; Furoxime; Magnaspor; Zinacef; Zinnat; UAE: Cefuzime; UK: Zinacef; Zinnat; USA: Ceftin; Kefurox¬§; Zinacef;