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]
Images: Related links to external sites (from Bing)
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 |
Ontology: Cefuroxime (C0007562)
Definition (NCI) | A semisynthetic, broad-spectrum, beta-lactamase-resistant, second-generation cephalosporin with antibacterial activity. Cefuroxime binds to and inactivates penicillin-binding proteins (PBPs) located on the inner membrane of the bacterial cell wall. PBPs are enzymes involved in the terminal stages of assembling the bacterial cell wall and in reshaping the cell wall during growth and division. Inactivation of PBPs interferes with the cross-linkage of peptidoglycan chains necessary for bacterial cell wall strength and rigidity. This results in the weakening of the bacterial cell wall and causes cell lysis. |
Definition (MSH) | Broad-spectrum cephalosporin antibiotic resistant to beta-lactamase. It has been proposed for infections with gram-negative and gram-positive organisms, GONORRHEA, and HAEMOPHILUS. |
Concepts | Antibiotic (T195) , Organic Chemical (T109) |
MSH | D002444 |
SnomedCT | 372833007, 73986003 |
LNC | LP32648-5, MTHU027952 |
English | Cefuroxime, Cephuroxime, 5-Thia-1-azabicyclo(4.2.0)oct-2-ene-2-carboxylic acid, 3-(((aminocarbonyl)oxy)methyl)-7-((2-furanyl(methoxyimino)acetyl)amino)-8-oxo-, (6R-(6alpha,7beta(Z)))-, cefuroxime (medication), Cefuroxime [Chemical/Ingredient], CEFUROXIME, cephuroxime, cefuroxime, Cefuroxime (product), Cefuroxime (substance) |
Swedish | Cefuroxim |
Czech | cefuroxim |
Finnish | Kefuroksiimi |
Russian | TSEFUROKSIM, ЦЕФУРОКСИМ |
Japanese | セフロキシム |
Croatian | CEFUROKSIM |
Polish | Cefuroksym |
Spanish | cefuroxima (producto), cefuroxima (sustancia), cefuroxima, Cefuroxima |
French | Céfuroxime |
German | Cefuroxim |
Italian | Cefuroxima |
Portuguese | Cefuroxima |
Ontology: cefuroxime axetil (C0055015)
Definition (NCI) | A second generation semi-synthetic cephalosporin and a beta-lactam antibiotic with bactericidal activity. Cefuroxime's effect is dependent on its binding to penicillin-binding proteins (PBPs) located in the bacterial cytoplasmic membrane. Binding results in the inhibition of the transpeptidase enzymes, thereby preventing cross-linking of the pentaglycine bridge with the fourth residue of the pentapeptide and interrupting consequent synthesis of peptidoglycan chains. As a result, cefuroxime inhibits bacterial septum and cell wall synthesis formation. |
Concepts | Antibiotic (T195) , Organic Chemical (T109) |
MSH | C040738 |
SnomedCT | 89678001 |
English | cefuroxime 1-acetoxyethyl ester, cefuroxime axetil, acetoxyethylcefuroxime, cefuroxime axetil (medication), Cefuroxime Axetil, CEFUROXIME AXETIL, cefuroxime axetil [Chemical/Ingredient], axetil cefuroxime, Cefuroxime axetil, Cefuroxime axetil (substance) |
Spanish | acetil cefuroxima (sustancia), acetil cefuroxima |
Ontology: Ceftin (C0719197)
Concepts | Antibiotic (T195) , Organic Chemical (T109) |
MSH | C040738 |
English | Ceftin, ceftin |