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10 X 10 ml
General Dosage Recommendations
Adults: Many infections will respond to 750 mg three times daily by IM or IV injection. For more severe infections, this dose should be increased to 1.5 g three times daily. IV. The frequency of IM or IV injections can be increased to six-hourly if necessary, giving total doses of 3 g – 6 g daily.
Infants and Children: Doses of 30 -100 mg/kg/day given as three or four divided doses. A dose of 60 mg/kg/day will be appropriate for most infections.
Neonates: Doses of 30 – 100 mg/kg/day given as two or three divided doses. In the first weeks of life the serum half-life of cefuroxime can be three to five times that in adults.
Gonorrhoea: 1.5 g should be given as a single dose. This may be given as 2×750 mg injections (intramuscularly) into different sites, e.g. each buttock.
Meningitis: Cefuroxime is suitable for sole therapy of bacterial meningitis due to sensitive strains. The following doses are recommended:
Infants and Children: 200 -240 mg/kg/day IV in three or four divided doses. This dosage may be reduced to 100 mg/kg/day IV after three days or when clinical improvement occurs.
Neonates: The initial dosage should be 100 mg/kg/day IV. A reduction to 50 mg/kg/day IV may be made when clinically indicated.
Adults: 3 g IV every eight hours. Data are not yet sufficient to recommend a dose for intrathecal administration.
Prophylaxis: The usual dose is 1.5 g IV with induction of anaesthesia for abdominal, pelvic and orthopedic operations, but may be supplemented with two 750 mg IM doses 8 and 16 hours later. In cardiac, pulmonary, oesophageal and vascular operations, the usual dose is 1.5 g IV with induction of anaesthesia continuing with 750 mg IM three times daily for a further 24- 48 hours.
In Total Joint Replacement: 1.5 g cefuroxime powder may be mixed dry with each pack of methyl methacrylate cement polymer before adding the liquid monomer.
Dosage in Impaired Renal Function: Cefuroxime is excreted by the kidneys. Therefore, as with all such antibiotics, in patients with markedly impaired renal function it is recommended that the dosage of cefuroxime should be reduced to compensate for its slower excretion. However, it is not necessary to reduce the standard dose (750 mg- 1.5 g three times daily) until the creatinine clearance falls to 20 ml/min or below. In adults with marked impairment (creatinine clearance 10 to 20 ml/min) 750 mg twice daily is recommended and with severe impairment (creatinine clearance <10 ml/min) 750 mg once daily is adequate. For patients on haemodialysis a further 750-mg dose should be given IV or IM at the end of each dialysis. In addition to parenteral use, cefuroxime can be incorporated into the peritoneal dialysis fluid, usually 250 mg for every 2 litres of dialysis fluid given IV.
Dosage in Continuous Arteriovenous Haemodialysis (CAVHD) or Haemofiltration (CAVH): For patients in renal failure on continuous arteriovenous haemodialysis or highflux haemofiltration in intensive therapy units a suitable dosage is 750 mg twice daily.
See prescribing information for full details.
Infections caused by susceptible microorganisms, prophylaxis against post operative infections in a variety of operations.
Patients with hypersensitivity to the active substance or any cephalosporin antibiotics.
This product should not ordinarily be given to those known to be allergic to penicillin or to cephalosporins, especially if they have experienced an allergic or urticarial reaction. Cefuroxime does not interfere in enzyme-based tests for glycosuria. Slight interference with copper reduction methods (Benedict’s, Fehling’s, Clinitest) may be observed. However, this should not lead to falsepositive results, as may be experienced with some other cephalosporins.
It is recommended that either the glucose oxidase or hexokinase methods are used to determine blood/plasma glucose levels in patients receiving cefuroxime. This antibiotic does not interfere in the alkaline picrate assay for creatinine.
Pseudomembranous colitis has been associated with the use of cefuroxime and may occur during or after treatment.
See prescribing information for full details.
In vitro the activities of cefuroxime and aminoglycoside antibiotics in combination have been shown to be at least additive with occasional evidence of synergy.
Cephalosporin antibiotics at high dosage should be given with caution to patients receiving concurrent treatment with potent diuretics such as furosemide or aminoglycosides, as renal impairment has been reported with these combinations. Renal function should be monitored in these patients, the elderly and those with pre-existing renal impairment.
Cefuroxime does not interfere in the alkaline picrate assay for creatinine.
Pregnancy and Lactation
Pregnancy: There is no experimental evidence of embryopathic or teratogenic effects attributable to cefuroxime but, as with all medicines, it should be administered with caution during the early months of pregnancy.
Lactation: Cefuroxime is excreted in human milk, and consequently caution should be exercised when cefuroxime is administered to a nursing mother.
Overdosage of cephalosporins can cause cerebral irritation leading to convulsions. Serum levels of cefuroxime can be reduced by haemodialysis or peritoneal dialysis.