Cefuroxime Dosage and Administration

Pronunciation: (SEFF-yur-OX-eem) Infection

Class: Antibiotic, Cephalosporin Adults and Children 12 yr of age and older
Trade Names: PO 125 to 500 mg twice daily. IV / IM 750 mg to 1.5 g every
Ceftin 8 h.
- Tablets 125 mg Children younger than 12 yr of age
- Tablets 250 mg PO 125 to 250 mg twice daily.
- Tablets 500 mg Infants and Children older than 3 mo of age
- Suspension 125 mg/5 mL IV / IM 50 to 150 mg/kg/day (not to exceed adult dose) in
- Suspension 250 mg/5 mL equally divided doses every 6 to 8 h.
Trade Names: Bacterial Meningitis
Zinacef Adults and Children 12 yr of age and older
- Powder for Injection 750 mg (2.4 mEq sodium/g) IV / IM Up to 3 g every 8 h.
- Powder for Injection 1.5 g (2.4 mEq sodium/g) Infants and Children 3 mo to 12 yr of age
- Powder for Injection 7.5 g (2.4 mEq sodium/g) IV / IM 200 to 240 mg/kg/day in divided doses every 6 to 8 h.
- Injection 750 mg (2.4 mEq sodium/g) Uncomplicated Gonorrhea
- Injection 1.5 g (2.4 mEq sodium/g) Adults and Children 12 yr of age and older
Apo-Cefuroxime (Canada) PO 1 g as single dose. IM 1.5 g as single dose.
ratio-Cefuroxime (Canada) Preoperative Prophylaxis
Adults
Pharmacokinetics IV / IM 1.5 g 30 min to 1 h before surgery then 750 mg every
Absorption 8 h for duration of surgery.
Tablets General Advice
C max is 2.1 mcg/mL (125 mg dose) to 13.6 mcg/mL (1,000 mg  Administer oral form with food to enhance
dose). T max is 2.2 to 3 h. AUC is 6.7 mcg•h/mL (125 mg dose) absorption.
to 50 mcg•h/mL (1,000 mg dose).  May crush and mix with food or beverages;
Suspension (10 to 20 mg/kg) however, crushed tablets have strong, persistent bitter
C max is 3.3 to 7 mcg/mL. T max is 2.7 to 3.6 h. AUC is 12.4 to taste. Consider alternative therapy if children cannot
32.8 mcg•h/mL. swallow whole tablets.
IM (750 mg dose)  Reconstituted solution should be light yellow to
C max is 27 mcg/mL. T max is about 45 min. amber. Do not administer if solution is cloudy or
IV precipitate is present.
C max is about 50 mcg/mL (750 mg dose) and about 100  When giving by IM route, shake IM suspension
mcg/mL (1.5 g dose). T max is 15 min. gently before administration. Aspirate to prevent
Distribution injection into blood vessel. Inject deeply into large
Cefuroxime is detectable in therapeutic concentrations in muscle (eg, upper outer quadrant of gluteus muscle or
pleural and joint fluid, bile, sputum, bone, aqueous humor, and lateral thigh); massage well. Rotate injection sites.
CSF (in those with meningitis). It is 50% protein bound.  When giving by IV route, use direct intermittent
Elimination infusion. Administer slowly over 3 to 5 min. Change
The t ½ is 1.2 to 1.3 h (tablets), 1.4 to 1.9 h (suspension), and IV sites every 48 to 72 h.
about 80 min (IV/IM). About 50% is excreted unchanged in  For intermittent IV infusion with Y-type
the urine within 12 h (tablets/suspension) and about 89% over administration set, administer over 30 min. and
8 h (IV/IM). temporarily stop other solutions at Y-site.
Special Populations  For continuous infusion, reconstituted solution
Renal Function Impairment may be further diluted with D5W or sodium chloride
The t ½ is prolonged. Dosage reduction is recommended. 0.9%.
Indications and Usage Storage/Stability
Oral form
 Reconstituted solution is stable for 24 h at room
Treatment of infections of lower respiratory tract, urinary
temperature. When refrigerated, solution in vials is
tract, skin and skin structures; treatment of uncomplicated
stable for 48 h; IV solution is stable for 7 days when
gonorrhea, otitis media, pharyngitis, and tonsillitis caused by
refrigerated.
susceptible strains of specific microorganisms. Treatment of
 Completely thaw frozen solution at room
early Lyme disease, pharyngitis/tonsillitis, and impetigo.
temperature before use; do not refreeze.
Parenteral form
Treatment of infections of lower respiratory tract, urinary  Store sterile powder at room temperature and
tract, skin and skin structures, bone and joint; preoperative protect from light.
prophylaxis; treatment of septicemia, gonorrhea, and  Store tablets at room temperature.
meningitis caused by susceptible strains of specific
microorganisms.
Contraindications
Hypersensitivity to cephalosporins.