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cefuroxime axetil
Ceftin, Zinnat§

cefuroxime sodium
Kefurox, Zinacef

Pregnancy Risk Category B

How supplied
cefuroxime axetil

Tablets:
125 mg, 250 mg, 500 mg
Suspension:
125 mg/5 ml, 250 mg/5 ml
cefuroxime sodium

Injection:
750 mg, 1.5 g, 7.5 g
Infusion:
750 mg, 1.5-g premixed, frozen solution

Action
A second-generation cephalosporin that inhibits cell-wall synthesis, promoting osmotic instability; usually bactericidal.

Indications & dosage
Injectable form: Serious infections of the lower respiratory and urinary tracts; skin and skin-structure infections; bone and joint infections; septicemia; meningitis; and gonorrhea; and for perioperative prophylaxis. Oral form: Otitis media, pharyngitis, tonsillitis, infections of the urinary and lower respiratory tracts, and skin and skin-structure infections. Among susceptible organisms are Streptococcus pneumoniae and S. pyogenes, Haemophilus influenzae, Klebsiella, Staphylococcus aureus, Escherichia coli, Moraxella (Branhamella) catarrhalis (including beta-lactamase-producing strains), Enterobacter, and Neisseria gonorrhoeae-
Adults and children ages 12 and older:
usual dosage of cefuroxime sodium is 750 mg to 1.5 g I.M. or I.V. q 8 hours for 5 to 10 days. For life-threatening infections and infections due to less susceptible organisms, 1.5 g I.M. or I.V. q 6 hours; for bacterial meningitis, up to 3 g I.V. q 8 hours.
  Or, administer 250 mg of cefuroxime axetil P.O. q 12 hours. For severe infections, dosage may be increased to 500 mg q 12 hours.
Children and infants over age 3 months:
50 to 100 mg/kg/day of cefuroxime sodium I.M. or I.V. in equally divided doses q 6 to 8 hours. Higher dosage of 100 mg/kg/day (not to exceed maximum adult dosage) should be used for more severe or serious infections. For bacterial meningitis, 200 to 240 mg/kg I.V. in divided doses q 6 to 8 hours. For other infections, 125 to 250 mg of cefuroxime axetil P.O. q 12 hours for a child who can swallow pills.
Uncomplicated urinary tract infections-

Adults:
125 to 250 mg P.O. q 12 hours.
Otitis media-

Children ages 2 and older:
250 mg P.O. q 12 hours.
Children under age 2:
125 mg P.O. q 12 hours.
Perioperative prophylaxis-

Adults:
1.5 g I.V. 30 to 60 minutes before surgery; in lengthy operations, 750 mg I.V. or I.M. q 8 hours. For open-heart surgery, 1.5 g I.V. at induction of anesthesia and then q 12 hours for a total dosage of 6 g.
Early Lyme disease (erythema migrans) due to
Borrelia burgdorferi-
Adults and children ages 13 and older:
500 mg P.O. b.i.d. for 20 days.
Secondary bacterial infection of acute bronchitis-

Adults:
250 to 500 mg P.O. (tablets) b.i.d. for 5 to 10 days.
Acute bacterial maxillary sinusitis caused by Streptococcus pneumoniae or Haemophilus influenzae (non-beta-lactamase-producing strains only)--

Adults and children ages 13 and older:
250-mg tablet P.O. b.i.d. for 10 days.
Children ages 3 months to 12 years:
30 mg/kg/day oral suspension P.O. in two divided doses for 10 days.
Adjust-a-dose:
For parenteral administration in patients with renal failure, if creatinine clearance is 10 to 20 ml/minute, give 750 mg I.M. or I.V. q 12 hours; if clearance is below 10 ml/minute, give 750 mg I.M. or I.V. q 24 hours.

Adverse reactions
CV:
phlebitis, thrombophlebitis.
GI:
pseudomembranous colitis, nausea, anorexia, vomiting, diarrhea.
Hematologic: transient neutropenia,
eosinophilia, hemolytic anemia, thrombocytopenia, decreased hematocrit and hemoglobin levels.
Hepatic:
transient increases in liver enzymes.
Skin:
maculopapular and erythematous rashes, urticaria, pain, induration, sterile abscesses, temperature elevation, tissue sloughing at I.M. injection site.
Other
: hypersensitivity reactions, serum sickness, anaphylaxis.

Interactions
Drug-drug.
Aminoglycosides: synergistic activity against some organisms; potential for increased nephrotoxicity. Monitor closely.
Diuretics:
increased risk of adverse renal reactions. Monitor closely.
Probenecid:
may inhibit excretion and increase blood levels of cefuroxime. Sometimes used for this effect.
Drug-food.
Any food: increased absorption. Give drug with food.

Effects on diagnostic tests
Cefuroxime causes false-positive results in urine glucose tests using cupric sulfate (Benedict's reagent or Clinitest); use glucose oxidase tests (Diastix or Chemstrip uG) instead. Drug also causes false elevations in serum or urine creatinine levels in tests using Jaffé's reaction, and may cause positive Coombs' test results.

Contraindications
Contraindicated in patients with hypersensitivity to drug or other cephalosporins.

Nursing considerations

I.V. administration

Patient teaching

*Liquid contains alcohol. **May contain tartrazine.  †Canada  ‡Australia  §U.K.  OTCOver the counter
Reactions may be common, uncommon, life-threatening, or COMMON AND LIFE-THREATENING

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