It is used for the treatment of infections caused by susceptible bacteria:

• Pharyngitis and tonsillitis caused by Streptococcus pyogenes.
• Acute bacterial otitis media caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis (including β-lactamase producing strains) or Streptococcus pyogenes.

Cefuroxime is a well-established and effective antibacterial agent with broad-spectrum bactericidal activity against a variety of common pathogens, including β-lactamase producing organisms. It is highly stable against bacterial β-lactamase enzymes and, therefore, remains effective against many strains that are resistant to ampicillin and amoxicillin.

Tablet or Suspension-

Adolescents and adults (13 years and older)-

• Pharyngitis/tonsillitis: 250 mg b.i.d. for 5-10 days
• Acute bacterial maxillary sinusitis: 250 mg b.i.d. for 10 days
• Acute bacterial exacerbation of chronic bronchitis: 250-500 mg b.i.d. for 10 days
• Secondary bacterial infections of acute bronchitis: 250-500 mg b.i.d. for 5-10 days
• Uncomplicated skin and skin structure infections: 250-500 mg b.i.d. for 10 days
• Uncomplicated urinary tract infections: 250 mg b.i.d. for 7-10 days
• Uncomplicated Gonorrhoea: 1000 mg Single dose
• Community acquired pneumonia: 250-500 mg b.i.d. for 5-10 days
• MDR Typhoid Fever: 500 mg b.i.d. for 10-14 days
• Early Lyme disease: 500 mg b.i.d. for 20 days

Paediatric Patients (3 months to 12 years)-

• Pharyngitis/Tonsillitis: 20 mg/kg/day b.i.d for 5-10 days
• Acute otitis media: 30 mg/kg/day b.i.d for 10 days
• Acute bacterial maxillary sinusitis: 30 mg/kg/day b.i.d for 10 days
• Impetigo: 30 mg/kg/day b.i.d for 10 days

Parenteral-

• Adult: 750 mg three times daily by IM or IV injection. In severe infections, dose can be increased upto 1.5 gm three times daily by IV injection. The frequency may be increased to four times daily, if necessary, giving total daily doses of 3 to 6 gms.
• Children (above 3 months of age): 30 - 100 mg/kg/day given in 3 or 4 equally divided doses. A dose of 60 mg/kg/day is appropriate for most infections.
• Neonate: 30 - 100 mg/kg/day given in 2 or 3 equally divided doses.
• Surgical prophylaxis: 1.5 gm by IV injection at induction of anaesthesia; up to 3 further doses of 750 mg may be given by IV/IM injection every 8 hours for high risk procedures.
• Pneumonia: 1.5 gm IV injection twice daily for 2-3 days, followed by 500 mg twice daily (oral) for 7-10 days.
• Acute exacerbations of chronic bronchitis: 750 mg twice daily (IM or IV injection) for 2-3 days, followed by 500 mg twice daily (oral) for 5-10 days. (Duration of both parenteral and oral therapy is determined by the severity of the infection and the clinical status of the patient.)
• In Gonorrhoea: Adult: 1.5 gm as a single dose (as 2 x 750mg injections intramuscularly with different sites, e.g. each buttock).

In Meningitis:

• Adult: 3 gm IV injection three times daily.
• Children (above 3 months of age): 200-240 mg/kg/day by IV injection in 3 or 4 divided doses reduced to 100 mg/kg/day after 3 days or on clinical improvement.
• Neonate: 100 mg/kg/day by IV injection at initial dose, reduced to 50 mg/kg/day, When clinically indicated.

In bone and joint infections:

• Adult: 1.5 gm IV injection four times daily.
• Children (above 3 months of age): 150 mg/kg/day (not to exceed the maximum adult dose) in equally divided doses every 8 hours.

Administration

The use of freshly reconstituted solution is recommended. However, it maintains potency for at least 24 hours at room temperature or 48 hours at 5°C

No clinically significant or potentially hazardous drug interactions have been reported.

Cefuroxime should not be used in patients with known hypersensitivity to cephalosporin antibiotics.

Adverse reactions to Cefuroxime are uncommon and generally mild and short-lived. Reported effects include skin rashes and gastrointestinal disturbances. As with other antibiotics, prolonged use may lead to overgrowth of non-susceptible organisms such as Candida.

According to the US FDA, Cefuroxime is classified as pregnancy category B. However, adequate and well-controlled studies in pregnant women are lacking. Since animal studies do not always predict human response, the drug should be used during pregnancy only when clearly necessary. Cefuroxime is excreted in human breast milk; therefore, caution should be exercised when administered to breastfeeding mothers.

Cefuroxime should be used cautiously in patients receiving strong diuretics and in those with a history of colitis. Cephalosporins can generally be used safely in patients with penicillin hypersensitivity, although cross-reactivity has been reported. At recommended doses, Cefuroxime is unlikely to cause significant issues.

Second generation Cephalosporins

Store in a cool, dry place below 30°C, protected from light and moisture. Keep out of reach of children.