Antimicrobials
Cefuroxime

Cefuroxime

C difficile risk
Medium
Oral Bioavailability
Low
Cost
IV: $$ PO:$$

Spectrum Of Activity

Dosing

25-50 mg/kg/dose IV/IM q8h Dose limit: 6 g/day; 2 g/dose

Otitis media, pneumoniaUpper respiratory tract infections (eg, sinusitis, pharyngitis)Sickle cell patients with fever (Outpatient Management) Other susceptible infections (≥12 yrs)- 15 mg/kg/dose PO bid as suspension

OR

  • ≥12 yrs: 250 mg PO bid as tablets

Dose limit: 1 g/day10 mg/kg/dose PO bid as suspension Dose limit: 500 mg/day- 15 mg/kg/dose PO bid as suspension

OR

  • 250-500 mg PO bid as tablets

Dose limit: 1 g/dayMild-moderate: 125-250 mg PO bid as tablets Moderate-severe: 250-500 mg PO bid as tablets

ModerateSevereq12hq24h

Severeq24h

General Information

ODB Funded (tablets)

>10%:

  • Gastrointestinal: Diarrhea (4% to 11%, duration dependent)

1% to 10%:

  • Cardiovascular: Local thrombophlebitis (2%)

  • Dermatologic: Diaper rash (children 3%)

  • Endocrine & metabolic: Increased lactate dehydrogenase (1%)

  • Gastrointestinal: Nausea and vomiting (3% to 7%), unpleasant taste (children 5%)

  • Genitourinary: Vaginitis (≤5%)

  • Hematologic & oncologic: Decreased hematocrit (≤10%), decreased hemoglobin (≤10%), eosinophilia (1% to 7%)

  • Hepatic: Increased serum transaminases (2% to 4%), increased serum alkaline phosphatase (2%)

  • Immunologic: Jarisch-Herxheimer reaction (6%)

With prolonged therapy, monitor renal, hepatic, and hematologic function periodically; number and type of stools/day for diarrhea; and prothrombin time. Observe for signs and symptoms of anaphylaxis during first dose.

Suspension:

  • Give with food

  • Food increases absorption. Suspension may be mixed with a small amount of orange juice, grape juice or chocolate milk immediately prior to administration

Tablet:

  • Give with food, milk or formula. Do not crush tablets – taste is very bitter

Cefuroxime, as sodium:

  • Not to be used for the treatment of meningitis

  • Cefuroxime + Cloxacillin is an inappropriate combination – both are efficacious vs S. aureus

Cefuroxime, as axetil:

  • Dosage for liquid and tablets is not interchangeable