Cefuroxime (Ceftin (po), Kefurox, Zinacef)

Category:

Antibiotic

Description:

Cephalosporin, Second Generation

Indications:

  • Oral tablets/suspension:

    • pharyngitis/tonsillitis (S. pyogenes)

    • otitis media (S. pneumoniae, H. influenzae, M. catarrhalis, S. pyogenes)

    • acute bacterial maxillary sinusitis (S. pneumoniae, H. influenzae)

    • acute bacterial exacerbation of chronic bronchitis, secondary infections due to acute bronchitis (S. pneumoniae, H. influenzae, H. parainfluenzae)

    • urinary tract infections (E. coli, K. pneumoniae)

    • skin infections (S. aureus, S. pyogenes)

    • uncomplicated gonorrhea (N. gonorrhoeae)

    • early Lyme disease (Borrelia burgdorferi)

  • Parenteral

    • lower respiratory tract (S. pneumoniae, H. influenzae, Klebsiella species, S. aureus, S. pyogenes, E. coli)

    • urinary tract infections (E. coli, K. pneumoniae)

    • septicemia (S. pneumoniae, H. influenzae, Klebsiella species, S. aureus, S. pyogenes, E. coli)

    • meningitis (N. meningitidis)

    • gonorrhea (N. gonorrhoeae)

    • skin, bone and joint infections (S. aureus, S. pyogenes, Enterobacter species, Klebsiella species, E. coli)

Contraindications:

  • Cross sensitivity with penicillin allergies

Precautions:

  • Pregnancy category B

  • Use with caution in patients with penicillin allergy (5-10% chance of cross-reactivity)

  • Dosage modifications are generally only required in patients with severe renal impairment

  • Counsel patient to finish all medication to prevent development of resistance

  • Do not crush tablets, swallow whole or use suspension dosing

  • NOTE: oral tablets and suspension are NOT bioequivalent

Adverse Reactions (Side Effects):

  • Hypersensitivity reactions

  • Gastrointestinal: nausea, vomiting, diarrhea

  • Vaginitis

Dosage:

  • Administered orally (tablets and suspension) and by injection (IV or IM)

  • Pharyngitis/tonsillitis:

    • Adults (> 13 years): 250mg bid for 10 days

    • Children: 125mg tablets bid for 10 days or 20mg/kg/day (susp) divided bid for 10 days

  • Otitis media:

    • Adults (>13 years): 250mg bid for 10 days

    • Children: 250mg tablets bid for 10 days or 30mg/kg/day (susp) divided bid for 10 days

  • Impetigo:

    • 30mg/kg/day (susp) divided bid for 10 days

  • Acute bacterial exacerbation of chronic bronchitis/secondary infections of to acute bronchitis:

    • Adults (> 13 years): 250-500mg bid for 5-10 days

  • Urinary tract infections:

    • Adults: 125-250mg bid tablets for 7-10 days or 2.25 grams per day (750mg q8h IV)

  • Uncomplicated skin infections:

    • Adults: 250-500mg bid tablets for 10 days or 2.25 grams per day (750mg q8h IV)

  • Uncomplicated gonorrhea infections:

    • 1000mg tablets one dose or 1.5 grams IM one dose

  • Disseminated gonococcal:

    • 2.25 grams per day (750mg q8h IV)

  • Early Lyme disease:

    • Adults: 500mg bid for 20 days

  • Uncomplicated pneumonia:

    • 2.25 grams per day (750mg q8h IV)

  • Severe or complicated infections and bone or joint infections:

    • 4.5 grams per day (1.5 grams q8h IV)

  • Life-threatening infections:

    • 6 grams per day (1.5 grams q6h IV)

  • Bacterial meningitis:

    • 9 grams per day (<3 grams q8h IV)

Source: Operational Medicine 2001,  Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300  


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