CEFUROXIME

Third generation broad spectrum cephalosporin antibacterial

Dosage Forms

Tablet

500 mg

Oral Suspension

125 mg/ml

Powder for solution for injection

750 mg

Uses

  • Respiratory tract infections
  • Urinary tract infections
  • Otitis media
  • Skin and soft-tissue infections
  • Sinusitis
  • Pre- and post-surgery prophylaxis

Dose and Duration

All infections

Treat for 5–10 days. Treatment may be extended to 14 21 days in some severe cases

Adult and child above 12 years: 250 mg every 12 hours (500 mg every 12 hours in more severe lower respiratory tract infections or if pneumonia suspected)
Child 2–12 years: 15 mg/kg (max 250 mg) every 12 hours
Child 3 months–2 years: 10 mg/kg (max 125 mg) every 12 hours
Pre- and post-surgery prophylaxis

Give by deep IM or IV injection (over 3–5 minutes) or infusion (over 30 to 60 minutes). In neonates or for doses above 750 mg, use IV route only

Adult:1.5 g by IV injection up to 30 minutes before the procedure. 3 more doses of 750 mg IM or IV may be given every 8 hours for high-risk procedures
Child: 50–100 mg/kg daily in 1 or 2 divided doses for 10 days
Child 1month - 18 years: 50 mg/kg (max 1500 mg) up to 30 minutes before the procedure. 3 more doses of 30 mg/kg (max 750 mg) may be given by IM or IV injection every 8 hours for high-risk procedures
Severe infections
Adult:750 mg every 6–8 hours ( max 1500 mg)
Child 1 month - 18 years: 20 mg/kg (max 750 mg) every 8 hours
Neonate 21 -28 days: 25 mg/kg every 6 hours
Neonate 7 -21 days: 25 mg/kg every 8 hours
Neonate <7 days: 25 mg/kg every 12 hours

Double the dose in very severe infections

Note: In renal failure, increase dosing interval to every 12 hours; in severe renal failure, give once daily

Contraindications

  • Allergy to cephalosporin
  • History of severe hypersensitivity to other beta-lactam antibacterial agents

Side Effects

  • Candida overgrowth
  • Eosinophilia
  • Dizziness, headache
  • Transient rise in liver enzymes
  • Diarrhoea, nausea, abdominal discomfort
  • Stevens-Johnson syndrome

Interactions

  • Warfarin (possibly enhanced anticoagulant effect)

Patient Instructions

  • Take your medication after food for optimum absorption
  • Do not crush the tablets. Swallow them whole
  • Shake the reconstituted suspension well before use
  • Store the reconstituted suspension in a refrigerator. Do not freeze. Discard any remaining suspension after 10 days (3 days if stored at room temperature)

Pregnancy

  • Can be used

Breastfeeding

  • Can be used

Storage

  • After reconstitution, store in a refrigerator between 2–8°C for not more than 10 days

⚠️ Caution

  • Reduce dose in severe renal impairment.
  • Use with caution in patients with non-severe hypersensitivity to penicillins and other beta-lactam agents
  • Prolonged use may result in the overgrowth of other non susceptible microorganisms like enterococci and clostridium difficile, which may require interruption of treatment