II. Indications
- See Second Generation Broad-spectrum Cephalosporin
- Community Acquired Pneumonia
- Urinary Tract Infection
- Skin and Soft Tissue Infection
- Bone or joiint infection
- Surgical Prophylaxis
- Streptococcal Pharyngitis
- Lyme Disease (alternative agent)
III. Medications
- Parenteral Cefuroxime (IV or IM, Zinacef)
- Oral Cefuroxime Axetil (Ceftin)
- Tablets: 250 or 500 mg
- Do not crush
- Suspension: 125 or 250 mg/5 ml
- Suspension reported to have unpleasant taste
- Cefprozil may be better tolerated
- Tablets: 250 or 500 mg
IV. Dosing: Adult (or child age >=13 years)
-
Parenteral Cefuroxime (IV or IM, Zinacef)
- Mild to Moderate Infection
- Give 750 mg IM or IV every 8 hours
- Severe Infection (includes bone and joint infections)
- Give 1.5 g IM or IV every 8 hours
- Sepsis
- Give 1.5 g IV every 6 hours OR
- Give 3 g IV every 8 hours
- General Surgery Prophylaxis
- Give 1.5 g IV at 30 to 60 min before surgery, then 750 mg every 8 hours during procedure
- Open Heart Surgery Prophylaxis
- GIve 1.5 g IV every 12 hours for 4 doses (start with first dose at Anesthesia induction)
- Mild to Moderate Infection
- Oral Cefuroxime Axetil (Ceftin)
- Typical Dosing
- Take 250 to 500 mg orally twice daily with food
- Streptococcal Pharyngitis
- Take 250 mg orally twice daily for 10 days
- Typical Dosing
-
Renal Dosing
- eGFR 10 to 30 ml/min: Give typical dose every 24 hours
- eGFR <10 ml/min: Give typical dose every 48 hours
- Give dose after Hemodialysis
V. Dosing: Child (or age <13 years)
-
Parenteral Cefuroxime (IV or IM, Zinacef)
- Mild to Moderate Infection (typical infections)
- Give 50-100 mg/kg/day IM or IV divided every 6 to 8 hours (max: 1.5 g/dose)
- Severe Infection (includes bone and joint infections)
- Give 150 mg/kg/day IM or IV divided every 6 to 8 hours (max: 1.5 g/dose)
- Mild to Moderate Infection (typical infections)
- Oral Cefuroxime Axetil (Ceftin)
- Suspension reported to have unpleasant taste (Cefprozil may be better tolerated)
- Typical Dosing
- Give 20 to 30 mg/kg/day orally (up to 1 g/day) divided twice daily with food
- Streptococcal Pharyngitis
- Give 20 mg/kg/day (max 500 mg/day) orally divided twice daily for 10 days
- Otitis Media or Acute Sinusitis
- Give 30 mg/kg/day (max 1 g/day) orally divided twice daily
VII. Safety
- Pregnancy Category B
- Safe in Lactation
VIII. Drug Interactions
-
Antacids (e.g. H2 Blockers, Proton Pump Inhibitors)
- Decrease Cefuroxime absorption
- Avoid with Proton Pump Inhibitors or H2 Blockers
- Take at least 1 hour before or 2 hours after other Antacids
IX. Resources
- Cefuroxime Axetil (DailyMed)
- Cefuroxime Injection (DailyMed)
X. References
- (2012) Presc Lett, Resource #280706, Comparison of Cephalosporins
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- Dellamonica (1994) Int J Antimicrob Agents 4(1):23-36 +PMID: 18611587 [PubMed]
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Related Studies
| cefuroxime (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| CEFUROXIME AXETIL 250 MG TAB | Generic | $0.32 each |
| CEFUROXIME AXETIL 500 MG TAB | Generic | $0.48 each |