Cefuroxime axetil
Indication & Dosage Oral
Uncomplicated urinary tract infections
Adult: 125 mg bid.
Oral
Respiratory tract infections
Adult: 250-500 mg bid.
Child: >3 mth: 125 mg bid or 10 mg/kg bid. Max dose: 250 mg daily.
Oral
Uncomplicated gonorrhoea
Adult: 1 g as a single dose. 1 g oral probenecid may be given concurrently.
Oral
Otitis media
Child: >2 yr: 250 mg bid or 15 mg/kg bid up to 500 mg daily.
Intravenous
Meningitis
Adult: 3 g every 8 hr.
Child: 200-240 mg/kg/day in 3-4 divided doses, decreased to 100 mg/kg/day after 3 days or once symptoms have improved. Neonate: 100 mg/kg/day, decreased to 50 mg/kg/day when control has been achieved.
Renal impairment: Patients undergoing haemodialysis should receive an additional 750-mg dose after each dialysis; those undergoing continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)
10-20
<10
Dosage Recommendation
750 mg bid.
750 mg once daily.
Intramuscular
Gonorrhoea
Adult: 1.5 mg as a single dose divided between 2 inj sites. 1 g oral probenecid may be given concurrently.
Renal impairment: Patients undergoing haemodialysis should receive an additional 750-mg dose after each dialysis; those undergoing continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)
10-20
<10
Dosage Recommendation
750 mg bid.
750 mg once daily.
Parenteral
Prophylaxis of surgical infections
Adult: 1.5 g IV before the procedure followed by 750 mg IM every 8 hr for up to 24-48 hr depending on the procedure. For total joint replacement, 1.5 g of cefuroxime may be mixed with methylmethacrylate cement.
Renal impairment: Patients undergoing haemodialysis should receive an additional 750-mg dose after each dialysis; those undergoing continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)
10-20
<10
Dosage Recommendation
750 mg bid.
750 mg once daily.
Parenteral
Susceptible infections
Adult: 750 mg every 8 hr given as deep IM or slow IV inj over 3-5 min or IV infusion, increased to 1.5 g every 6-8 hr in severe infections.
Child: 30-60 mg/kg/day, may increase to 100 mg/kg/day if necessary. To be given in 3-4 divided doses or 2-3 divided doses in neonates.
Renal impairment: Patients undergoing haemodialysis should receive an additional 750-mg dose after each dialysis; those undergoing continuous peritoneal dialysis may be given 750 mg bid.
CrCl (ml/min)
10-20
<10
Dosage Recommendation
750 mg bid.
750 mg once daily.
Incompatibility: Incompatible with aminoglycosides. Administration Should be taken with food.
Contraindications Hypersensitivity to cephalosporins. Special Precautions Severe renal impairment; pregnancy, lactation; hypersensitivity to penicillins. Adverse Drug Reactions Large doses can cause cerebral irritation and convulsions; nausea, vomiting, diarrhoea, GI disturbances; erythema multiforme, Stevens-Johnson syndrome, epidermal necrolysis.Potentially Fatal: Anaphylaxis, nephrotoxicity, pseudomembranous colitis. Drug Interactions probenecid decreases renal clearance of cefuroxime.Potentially Fatal: Nephrotoxicity with aminoglycosides and furosemide.Food Interaction Oral cefuroxime axetil is better absorbed after food intake. Lab Interference False-positive for Coombs' test. It may interfere with urine-sugar estimation.
Storage Intramuscular: Store at 15-30°C. Intravenous: Store at 15-30°C. Oral: Store at 15-30°C. Parenteral: Inj: Store at 15-30°C.
Mechanism of Action Cefuroxime binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death.
Absorption: Absorbed from the GI tract with peak plasma concentrations after 2-3 hr (oral); may be enhanced by the presence of food.
Distribution: Pleural and synovial fluid, sputum, bone and aqueous fluids; CSF (therapeutic concentrations). Crosses the placenta and enters breast milk. Protein-binding: Up to 50%.
Metabolism: Rapidly hydrolysed (intestinal mucosa and blood).
Excretion: Via the urine by glomerular filtration and renal tubular secretion (as unchanged); via bile (small amounts); 70 min (elimination half-life); prolonged in neonates and renal impairment.
CEFTUM film-coated tab (GSK)
125 mg x 4's (80.91 INR)
250 mg x 4's (172.4 INR)
500 mg x 4's (341.5 INR)
CEFAKIND tab (Mankind)
250 mg x 10's (80 INR)
500 mg x 6's (95.04 INR)
CEFAKIND-CV film-coated tab (Mankind)
6's (173.94 INR)