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cefuroxime

Pronunciation

Generic Name: cefuroxime (SEF ue ROX eem)
Brand Name: Ceftin, Kefurox, Zinacef, Zinacef ADD-Vantage, Zinacef TwistVial

What is cefuroxime?

Cefuroxime is a cephalosporin (SEF a low spor in) antibiotic. It works by fighting bacteria in your body.

Cefuroxime is used to treat many kinds of bacterial infections, including severe or life-threatening forms.

Cefuroxime may also be used for purposes not listed in this medication guide.

What is the most important information I should know about cefuroxime?

You should not use this medicine if you are allergic to cefuroxime or to similar antibiotics, such as cefdinir (Omnicef), cefprozil (Cefzil), cephalexin (Keflex), and others.

What should I discuss with my healthcare provider before taking cefuroxime?

Do not take this medicine if you are allergic to cefuroxime, or to other cephalosporin antibiotics, such as:

  • cefaclor (Raniclor);

  • cefadroxil (Duricef);

  • cefazolin (Ancef);

  • cefdinir (Omnicef);

  • cefditoren (Spectracef);

  • cefpodoxime (Vantin);

  • cefprozil (Cefzil);

  • ceftibuten (Cedax);

  • cephalexin (Keflex); or

  • cephradine (Velosef).

To make sure cefuroxime is safe for you, tell your doctor if you have:

  • an allergy to penicillin;

  • kidney disease;

  • liver disease;

  • a history of intestinal problems, such as colitis;

  • diabetes; or

  • if you are malnourished.

The liquid form may contain phenylalanine. Talk to your doctor before using this form of cefuroxime if you have phenylketonuria (PKU).

This medicine is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Cefuroxime can make birth control pills less effective. Ask your doctor about using a non hormonal birth control (condom, diaphragm with spermicide) to prevent pregnancy.

Cefuroxime can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Cefuroxime is not approved for use by anyone younger than 3 months old.

How should I take cefuroxime?

Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.

You may take cefuroxime tablets with or without meals. Do not crush the tablet or it could have an unpleasant bitter taste.

Cefuroxime oral suspension (liquid) must be taken with food.

Shake the liquid well just before you measure a dose. Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

If you switch from using the tablet form to using the liquid form of cefuroxime, you may not need to use the same exact dosage in number of milligrams. This medicine may not be as effective unless you use the exact form and strength your doctor has prescribed.

Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Cefuroxime will not treat a viral infection such as the flu or a common cold.

This medicine can cause unusual results with certain lab tests for glucose (sugar) in the urine. Tell any doctor who treats you that you are using cefuroxime.

Store cefuroxime tablets at room temperature away from moisture and heat. Keep the bottle tightly closed when not in use.

Store cefuroxime liquid in the refrigerator. Do not allow it to freeze. Throw away any unused cefuroxime liquid that is older than 10 days.

What happens if I miss a dose?

Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include seizure (black-out or convulsions).

What should I avoid while taking cefuroxime?

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Cefuroxime side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • severe stomach pain, diarrhea that is watery or bloody;

  • jaundice (yellowing of the skin or eyes);

  • skin rash, bruising, severe tingling, or numbness;

  • seizure (black-out or convulsions);

  • kidney problems--little or no urination, painful or difficult urination, swelling in your feet or ankles, feeling tired or short of breath; or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • diarrhea;

  • nausea, vomiting;

  • unusual or unpleasant taste in your mouth; or

  • diaper rash in an infant taking liquid cefuroxime.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Cefuroxime dosing information

Usual Adult Dose for Bacterial Infection:

Oral (tablets): 250 or 500 mg orally every 12 hours

Parenteral: 750 mg to 1.5 g IV or IM every 8 hours
-Life-threatening infections or infections due to less susceptible organisms: 1.5 g IV every 6 hours may be needed

Comments:
-Dose depends on the nature and severity of the infection.

Uses:
-Oral: For the treatment of pharyngitis/tonsillitis, sinusitis, bronchitis, uncomplicated skin and skin structure infections, uncomplicated urinary tract infections, and early Lyme disease
-Parenteral: For the treatment of lower respiratory tract infections, urinary tract infections, skin and skin structure infections, septicemia, meningitis, bone and joint infections, and disseminated gonorrhea

Usual Adult Dose for Bronchitis:

Oral (tablets): 250 or 500 mg orally every 12 hours for 10 days
Parenteral: 750 mg to 1.5 g IV or IM every 8 hours

Comments:
-Oral: Safety and efficacy of administration for less than 10 days have not been established.

Uses:
-Oral: For the treatment of mild to moderate acute bacterial exacerbations of chronic bronchitis due to Streptococcus pneumoniae, Haemophilus influenzae (beta-lactamase-negative strains), or H parainfluenzae (beta-lactamase-negative strains)
-Parenteral: For the treatment of lower respiratory tract infections due to S pneumoniae, H influenzae (including ampicillin-resistant strains), Klebsiella species, Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains), S pyogenes, and Escherichia coli

Usual Adult Dose for Pneumonia:

Uncomplicated infections: 750 mg IV or IM every 8 hours
Severe or complicated infections: 1.5 g IV or IM every 8 hours

Use: For the treatment of lower respiratory tract infections (including pneumonia) due to S pneumoniae, H influenzae (including ampicillin-resistant strains), Klebsiella species, S aureus (penicillinase- and non-penicillinase-producing strains), S pyogenes, and E coli

Infectious Diseases Society of America (IDSA) and American Thoracic Society (ATS) Recommendations: 500 mg orally twice a day

Comments:
-Recommended as an alternative agent for outpatient treatment of community-acquired pneumonia
-This drug has been recommended as an alternative agent (oral or parenteral) for penicillin-nonresistant S pneumoniae (MIC less than 2 mcg/mL).
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Urinary Tract Infection:

Uncomplicated infections:
-Oral (tablets): 250 mg orally every 12 hours for 7 to 10 days
-Parenteral: 750 mg IV or IM every 8 hours

Severe or complicated infections: 1.5 g IV or IM every 8 hours

Comments:
-Bacteriologic and clinical appraisal recommended frequently during treatment of chronic infections; may be necessary for several months after therapy has ended

Uses:
-Oral: For the treatment of uncomplicated urinary tract infections due to E coli or Klebsiella pneumoniae
-Parenteral: For the treatment of urinary tract infections due to E coli and Klebsiella species

Usual Adult Dose for Skin or Soft Tissue Infection:

Oral (tablets): 250 to 500 mg orally every 12 hours for 10 days

Parenteral: 750 mg IV or IM every 8 hours
-Severe or complicated infections: 1.5 g IV or IM every 8 hours

Comments:
-Microbiological tests often show growth of aerobic and anaerobic organisms in these infections; this drug has been used successfully in such mixed infections.

Uses:
-Oral: For the treatment of uncomplicated skin and skin structure infections due to S aureus (including beta-lactamase-producing strains) or S pyogenes
-Parenteral: For the treatment of skin and skin structure infections due to S aureus (penicillinase- and non-penicillinase-producing strains), S pyogenes, E coli, Klebsiella species, and Enterobacter species

Usual Adult Dose for Skin and Structure Infection:

Oral (tablets): 250 to 500 mg orally every 12 hours for 10 days

Parenteral: 750 mg IV or IM every 8 hours
-Severe or complicated infections: 1.5 g IV or IM every 8 hours

Comments:
-Microbiological tests often show growth of aerobic and anaerobic organisms in these infections; this drug has been used successfully in such mixed infections.

Uses:
-Oral: For the treatment of uncomplicated skin and skin structure infections due to S aureus (including beta-lactamase-producing strains) or S pyogenes
-Parenteral: For the treatment of skin and skin structure infections due to S aureus (penicillinase- and non-penicillinase-producing strains), S pyogenes, E coli, Klebsiella species, and Enterobacter species

Usual Adult Dose for Septicemia:

Life-threatening infections or infections due to less susceptible organisms: 1.5 g IV every 6 hours

Use: For the treatment of septicemia due to S aureus (penicillinase- and non-penicillinase-producing strains), S pneumoniae, E coli, H influenzae (including ampicillin-resistant strains), and Klebsiella species

Usual Adult Dose for Meningitis:

Life-threatening infections or infections due to less susceptible organisms: 1.5 g IV every 6 hours
-Maximum dose: 3 g IV every 8 hours

Use: For the treatment of meningitis due to S pneumoniae, H influenzae (including ampicillin-resistant strains), Neisseria meningitidis, and S aureus (penicillinase- and non-penicillinase-producing strains)

Usual Adult Dose for Joint Infection:

1.5 g IV or IM every 8 hours

Comments:
-In clinical trials, adjunctive therapy included surgical intervention when indicated; when appropriate, oral antibiotics were administered after this parenteral therapy was completed.

Uses: For the treatment of bone and joint infections due to S aureus (penicillinase- and non-penicillinase-producing strains)

Usual Adult Dose for Osteomyelitis:

1.5 g IV or IM every 8 hours

Comments:
-In clinical trials, adjunctive therapy included surgical intervention when indicated; when appropriate, oral antibiotics were administered after this parenteral therapy was completed.

Uses: For the treatment of bone and joint infections due to S aureus (penicillinase- and non-penicillinase-producing strains)

Usual Adult Dose for Surgical Prophylaxis:

Clean-contaminated or potentially contaminated surgical procedures:
-Preoperative: 1.5 g IV 30 to 60 minutes before the initial incision
-Intraoperative (for prolonged procedures): 750 mg IV or IM every 8 hours

Open heart surgery: 1.5 g IV at induction of anesthesia and every 12 hours thereafter
-Maximum dose: 6 g total

Comments:
-Preoperative prophylactic use of this drug may prevent growth of susceptible pathogenic bacteria; this may reduce the incidence of certain postoperative infections in patients undergoing surgical procedures classified as clean-contaminated or potentially contaminated (e.g., vaginal hysterectomy).
-Prophylactic efficacy depends on timing of administration; the preoperative dose should be administered 30 to 60 minutes before surgery to allow enough time to attain effective antibiotic levels in the wound tissues during surgery; dosing should be repeated during prolonged procedures.
-Prophylaxis usually unnecessary postoperatively and should be stopped within 24 hours; in most surgeries, continued prophylaxis does not reduce incidence of subsequent infections but increases likelihood of side effects and bacterial resistance developing.
-Perioperative use during open heart surgery has been effective in surgical patients for whom infection at the operative site would present serious risk; for such patients, this drug should be continued for at least 48 hours after the end of surgery. If signs of infection observed, specimens for culture and susceptibility testing should be obtained to isolate and identify infecting organisms in order to start appropriate therapy.

Uses: For preventive use (for clean-contaminated/potentially contaminated surgical procedures; during open heart surgery)

American Society of Health-System Pharmacists (ASHP), IDSA, Surgical Infection Society (SIS), and Society for Healthcare Epidemiology of America (SHEA) Recommendations:
-Preoperative dose: 1.5 g IV as a single dose
-Redosing interval (from start of preoperative dose): 4 hours

Comments:
-This drug should be started within 60 minutes before surgical incision.
-A single prophylactic dose is usually sufficient; if prophylaxis is continued postoperatively, duration should be less than 24 hours.
-To ensure adequate serum and tissue drug levels, readministration may be needed if the procedure duration exceeds the recommended redosing interval.
-Redosing may be needed if drug half-life is shortened (e.g., extensive burns) or if prolonged/excessive bleeding during surgery; redosing may not be needed if drug half-life is prolonged (e.g., renal dysfunction).
-Coadministration with other agents may be recommended, depending on type of procedure.
-Current guidelines should be consulted for additional information.

Uses: Recommended for surgical prophylaxis for the following procedures:
-Cardiac: Coronary artery bypass; cardiac device insertion procedures (e.g., pacemaker implantation); ventricular assist devices
-Head and neck: Clean with placement of prosthesis (excludes tympanostomy tubes); clean-contaminated cancer surgery; other clean-contaminated procedures (excluding tonsillectomy, functional endoscopic sinus procedures)

Usual Adult Dose for Tonsillitis/Pharyngitis:

Tablets: 250 mg orally every 12 hours for 10 days

Comments:
-Efficacy in the prevention of rheumatic fever not established in clinical trials.
-Efficacy in the treatment of penicillin-resistant strains of S pyogenes not established in clinical trials.

Use: For the treatment of mild to moderate pharyngitis/tonsillitis due to S pyogenes

Usual Adult Dose for Sinusitis:

Tablets: 250 mg orally every 12 hours for 10 days

Comments:
-Efficacy for sinus infections due to beta-lactamase-producing H influenzae or Moraxella catarrhalis in patients with acute bacterial maxillary sinusitis not established in clinical trials.

Use: For the treatment of mild to moderate acute bacterial maxillary sinusitis due to S pneumoniae or H influenzae (non-beta-lactamase-producing strains only)

Usual Adult Dose for Lyme Disease:

Tablets: 500 mg orally every 12 hours for 20 days

Use: For the treatment of early Lyme disease (erythema migrans) due to Borrelia burgdorferi

IDSA Recommendations: 500 mg orally twice a day

Duration of therapy:
-Erythema migrans: 14 to 21 days
-Lyme arthritis: 28 days
-Acrodermatitis chronica atrophicans: 21 days

Comments:
-Recommended for the treatment of early localized or early disseminated Lyme disease associated with erythema migrans when specific neurologic symptoms or advanced atrioventricular heart block absent, uncomplicated Lyme arthritis in patients without clinical evidence of neurologic disease, and acrodermatitis chronica atrophicans
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Gonococcal Infection -- Disseminated:

750 mg IV or IM every 8 hours
-Severe or complicated infections: 1.5 g IV or IM every 8 hours

Comments:
-The patient's sexual partner(s) should also be evaluated/treated.
-According to the US CDC, the recommended regimen for disseminated gonococcal infection includes ceftriaxone plus azithromycin.
-Current guidelines should be consulted for additional information.

Use: For the treatment of disseminated gonococcal infections due to N gonorrhoeae (penicillinase- and non-penicillinase-producing strains)

Usual Adult Dose for Gonococcal Infection -- Uncomplicated:

Oral (tablets): 1 g orally as a single dose
Parenteral: 1.5 g IM as a single dose

Comments:
-The IM dose should be administered as a single dose at 2 separate sites; 1 g oral probenecid should be coadministered
-The patient's sexual partner(s) should also be evaluated/treated.
-Due to inferior efficacy and less favorable pharmacodynamics, most oral cephalosporins (including this drug) are not recommended by the US CDC for the treatment of uncomplicated gonococcal infections.
-Current guidelines should be consulted for additional information.

Uses:
-Oral: For the treatment of uncomplicated endocervical and urethral gonorrhea due to N gonorrhoeae (penicillinase- and non-penicillinase-producing strains); for the treatment of uncomplicated rectal gonorrhea in females due to N gonorrhoeae (non-penicillinase-producing strains)
-Parenteral: For the treatment of uncomplicated gonococcal infections due to N gonorrhoeae (penicillinase- and non-penicillinase-producing strains)

Usual Adult Dose for Cholecystitis:

SIS and IDSA Recommendations: 1.5 g IV every 8 hours

Comments:
-Recommended as an initial IV regimen for empiric treatment of complicated intraabdominal infection
-With metronidazole, may be used for empiric treatment of mild to moderate community-acquired infection (e.g., perforated or abscessed appendicitis)
-May be used for empiric treatment of mild to moderate community-acquired acute cholecystitis
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Intraabdominal Infection:

SIS and IDSA Recommendations: 1.5 g IV every 8 hours

Comments:
-Recommended as an initial IV regimen for empiric treatment of complicated intraabdominal infection
-With metronidazole, may be used for empiric treatment of mild to moderate community-acquired infection (e.g., perforated or abscessed appendicitis)
-May be used for empiric treatment of mild to moderate community-acquired acute cholecystitis
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Appendicitis:

SIS and IDSA Recommendations: 1.5 g IV every 8 hours

Comments:
-Recommended as an initial IV regimen for empiric treatment of complicated intraabdominal infection
-With metronidazole, may be used for empiric treatment of mild to moderate community-acquired infection (e.g., perforated or abscessed appendicitis)
-May be used for empiric treatment of mild to moderate community-acquired acute cholecystitis
-Current guidelines should be consulted for additional information.

Usual Adult Dose for Wound Infection:

IDSA Recommendations:
-Oral: 500 mg orally twice a day
-Parenteral: 1 g IV every 12 hours

Comments:
-Recommended as an alternative regimen for infected animal bite-related wound
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Bacterial Infection:

ORAL:
3 months to 12 years:
-Oral suspension: 10 to 15 mg/kg orally twice a day
---Maximum dose: 1 g/day
-Tablets: 250 mg orally every 12 hours

13 years or older:
-Tablets: 250 or 500 mg orally every 12 hours

PARENTERAL:
3 months or older: 50 to 100 mg/kg/day IV or IM in equally divided doses every 6 to 8 hours
-Maximum dose: 1.5 g/dose

Comments:
-Dose depends on the nature and severity of the infection.

Uses:
-Oral: For the treatment of pharyngitis/tonsillitis, otitis media, sinusitis, bronchitis, uncomplicated skin and skin structure infections, uncomplicated urinary tract infections, early Lyme disease, and impetigo
-Parenteral: For the treatment of lower respiratory tract infections (including pneumonia), urinary tract infections, skin and skin structure infections, septicemia, meningitis, bone and joint infections, and disseminated gonorrhea

American Academy of Pediatrics (AAP) Recommendations:
ORAL:
1 month or older:
-Mild to moderate infections: 20 to 30 mg/kg/day orally in 2 divided doses
---Maximum dose: 1 g/day

PARENTERAL:
7 days or younger: 50 mg/kg IV or IM every 12 hours

8 to 28 days:
-Up to 2 kg: 50 mg/kg IV or IM every 8 to 12 hours
-Greater than 2 kg: 50 mg/kg IV or IM every 8 hours

1 month or older:
-Mild to moderate infections: 75 to 100 mg/kg/day IV or IM in 3 divided doses
---Maximum dose: 4.5 g/day
-Severe infections: 100 to 200 mg/kg/day IV or IM in 3 to 4 divided doses
---Maximum dose: 6 g/day

Comments:
-The oral route is inappropriate for severe infections.
-The longer dosing interval (every 12 hours) may be used in extremely low birth weight neonates (less than 1 kg) until 2 weeks of life.
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Pneumonia:

3 months or older: 50 to 100 mg/kg/day IV or IM in equally divided doses every 6 to 8 hours
-Maximum dose: 1.5 g/dose

Uses: For the treatment of lower respiratory tract infections (including pneumonia) due to S pneumoniae, H influenzae (including ampicillin-resistant strains), Klebsiella species, S aureus (penicillinase- and non-penicillinase-producing strains), S pyogenes, and E coli

US CDC, National Institutes of Health (NIH), HIV Medicine Association of the IDSA (HIVMA/IDSA), Pediatric Infectious Diseases Society (PIDS), and AAP Recommendations for HIV-exposed and HIV-infected Children: 35 to 50 mg/kg IV 3 times a day
-Maximum dose: 6 g/day

Comments:
-Recommended as an alternative regimen for bacterial pneumonia due to S pneumoniae (occasionally S aureus, H influenzae)
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Bronchitis:

Oral (tablets):
13 years or older: 250 or 500 mg orally every 12 hours for 10 days

Parenteral:
3 months or older: 50 to 100 mg/kg/day IV or IM in equally divided doses every 6 to 8 hours
-Maximum dose: 1.5 g/dose

Comments:
-Oral: Safety and efficacy of administration for less than 10 days have not been established.

Uses:
-Oral: For the treatment of mild to moderate acute bacterial exacerbations of chronic bronchitis due to S pneumoniae, H influenzae (beta-lactamase-negative strains), or H parainfluenzae (beta-lactamase-negative strains)
-Parenteral: For the treatment of lower respiratory tract infections due to S pneumoniae, H influenzae (including ampicillin-resistant strains), Klebsiella species, S aureus (penicillinase- and non-penicillinase-producing strains), S pyogenes, and E coli

Usual Pediatric Dose for Urinary Tract Infection:

Oral (tablets):
13 years or older: 250 mg orally every 12 hours for 7 to 10 days

Parenteral:
3 months or older: 50 to 100 mg/kg/day IV or IM in equally divided doses every 6 to 8 hours
-Maximum dose: 1.5 g/dose

Uses:
-Oral: For the treatment of uncomplicated urinary tract infections due to E coli or K pneumoniae
-Parenteral: For the treatment of urinary tract infections due to E coli and Klebsiella species

Usual Pediatric Dose for Skin and Structure Infection:

Oral (tablets):
13 years or older: 250 or 500 mg orally every 12 hours for 10 days

Parenteral:
3 months or older: 50 to 100 mg/kg/day IV or IM in equally divided doses every 6 to 8 hours
-Maximum dose: 1.5 g/dose

Uses:
-Oral: For the treatment of uncomplicated skin and skin structure infections due to S aureus (including beta-lactamase-producing strains) or S pyogenes
-Parenteral: For the treatment of skin and skin structure infections due to S aureus (penicillinase- and non-penicillinase-producing strains), S pyogenes, E coli, Klebsiella species, and Enterobacter species

Usual Pediatric Dose for Septicemia:

3 months or older: 50 to 100 mg/kg/day IV in equally divided doses every 6 to 8 hours
-Maximum dose: 1.5 g/dose

Use: For the treatment of septicemia due to S aureus (penicillinase- and non-penicillinase-producing strains), S pneumoniae, E coli, H influenzae (including ampicillin-resistant strains), and Klebsiella species

Usual Pediatric Dose for Meningitis:

3 months or older: 200 to 240 mg/kg/day IV in divided doses every 6 to 8 hours
-Maximum dose: 9 g/day

Use: For the treatment of meningitis due to S pneumoniae, H influenzae (including ampicillin-resistant strains), N meningitidis, and S aureus (penicillinase- and non-penicillinase-producing strains)

Usual Pediatric Dose for Joint Infection:

3 months or older: 50 mg/kg IV or IM every 8 hours
-Maximum dose: 1.5 g/dose

Comments:
-In clinical trials, oral antibiotics were administered after this parenteral therapy was completed.

Uses: For the treatment of bone and joint infections due to S aureus (penicillinase- and non-penicillinase-producing strains)

Usual Pediatric Dose for Osteomyelitis:

3 months or older: 50 mg/kg IV or IM every 8 hours
-Maximum dose: 1.5 g/dose

Comments:
-In clinical trials, oral antibiotics were administered after this parenteral therapy was completed.

Uses: For the treatment of bone and joint infections due to S aureus (penicillinase- and non-penicillinase-producing strains)

Usual Pediatric Dose for Tonsillitis/Pharyngitis:

3 months to 12 years:
-Oral suspension: 10 mg/kg orally twice a day
---Maximum dose: 500 mg/day

13 years or older:
-Tablets: 250 mg orally every 12 hours

Duration of therapy: 10 days

Comments:
-Efficacy in the prevention of rheumatic fever not established in clinical trials.
-Efficacy in the treatment of penicillin-resistant strains of S pyogenes not established in clinical trials.

Use: For the treatment of mild to moderate pharyngitis/tonsillitis due to S pyogenes

Usual Pediatric Dose for Otitis Media:

3 months to 12 years:
-Oral suspension: 15 mg/kg orally twice a day
---Maximum dose: 1000 mg/day
-Tablets: 250 mg orally every 12 hours

Duration of therapy: 10 days

Use: For the treatment of acute bacterial otitis media due to S pneumoniae, H influenzae (including beta-lactamase-producing strains), M catarrhalis (including beta-lactamase-producing strains), or S pyogenes

Usual Pediatric Dose for Sinusitis:

3 months to 12 years:
-Oral suspension: 15 mg/kg orally twice a day
---Maximum dose: 1000 mg/day
-Tablets: 250 mg orally every 12 hours

13 years or older:
-Tablets: 250 mg orally every 12 hours

Duration of therapy: 10 days

Comments:
-Efficacy for sinus infections due to beta-lactamase-producing H influenzae or M catarrhalis in patients with acute bacterial maxillary sinusitis not established in clinical trials.

Use: For the treatment of mild to moderate acute bacterial maxillary sinusitis due to S pneumoniae or H influenzae (non-beta-lactamase-producing strains only)

Usual Pediatric Dose for Lyme Disease:

13 years or older:
-Tablets: 500 mg orally every 12 hours for 20 days

Use: For the treatment of early Lyme disease (erythema migrans) due to B burgdorferi

IDSA Recommendations for Children: 15 mg/kg orally twice a day
-Maximum dose: 500 mg/dose

Duration of therapy:
-Erythema migrans: 14 to 21 days
-Lyme arthritis: 28 days
-Acrodermatitis chronica atrophicans: 21 days

Comments:
-Recommended for the treatment of early localized or early disseminated Lyme disease associated with erythema migrans when specific neurologic symptoms or advanced atrioventricular heart block absent, uncomplicated Lyme arthritis in patients without clinical evidence of neurologic disease, and acrodermatitis chronica atrophicans
-Current guidelines should be consulted for additional information.

Usual Pediatric Dose for Impetigo:

3 months to 12 years:
-Oral suspension: 15 mg/kg orally twice a day for 10 days
---Maximum dose: 1000 mg/day

Uses: For the treatment of impetigo due to S aureus (including beta-lactamase-producing strains) or S pyogenes

Usual Pediatric Dose for Gonococcal Infection -- Uncomplicated:

13 years or older:
-Tablets: 1 g orally as a single dose

Comments:
-The patient's sexual partner(s) should also be evaluated/treated.
-Due to inferior efficacy and less favorable pharmacodynamics, most oral cephalosporins (including this drug) are not recommended by the US CDC for the treatment of uncomplicated gonococcal infections.
-Current guidelines should be consulted for additional information.

Uses: For the treatment of uncomplicated endocervical and urethral gonorrhea due to N gonorrhoeae (penicillinase- and non-penicillinase-producing strains); for the treatment of uncomplicated rectal gonorrhea in females due to N gonorrhoeae (non-penicillinase-producing strains)

Usual Pediatric Dose for Surgical Prophylaxis:

ASHP, IDSA, SIS, and SHEA Recommendations:
-Preoperative dose: 50 mg/kg IV as a single dose
---Maximum dose: 1.5 g/dose
-Redosing interval (from start of preoperative dose): 4 hours

Comments:
-This drug should be started within 60 minutes before surgical incision.
-A single prophylactic dose is usually sufficient; if prophylaxis is continued postoperatively, duration should be less than 24 hours.
-To ensure adequate serum and tissue drug levels, readministration may be needed if the procedure duration exceeds the recommended redosing interval.
-Redosing may be needed if drug half-life is shortened (e.g., extensive burns) or if prolonged/excessive bleeding during surgery; redosing may not be needed if drug half-life is prolonged (e.g., renal dysfunction).
-Coadministration with other agents may be recommended, depending on type of procedure.
-Current guidelines should be consulted for additional information.

Uses: Recommended for surgical prophylaxis for the following procedures:
-Cardiac: Coronary artery bypass; cardiac device insertion procedures (e.g., pacemaker implantation); ventricular assist devices
-Head and neck: Clean with placement of prosthesis (excludes tympanostomy tubes); clean-contaminated cancer surgery; other clean-contaminated procedures (excluding tonsillectomy, functional endoscopic sinus procedures)

Usual Pediatric Dose for Intraabdominal Infection:

SIS and IDSA Recommendations: 150 mg/kg/day IV in divided doses every 6 to 8 hours

Comments:
-Recommended as an initial IV regimen for treatment of complicated intraabdominal infection
-Current guidelines should be consulted for additional information.

What other drugs will affect cefuroxime?

Tell your doctor about all your current medicines and any you start or stop using, especially:

  • probenecid (Benemid);

  • a blood thinner such as warfarin (Coumadin, Jantoven); or

  • a diuretic or "water pill."

This list is not complete. Other drugs may interact with cefuroxime, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about cefuroxime.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 7.01.

Date modified: July 02, 2017
Last reviewed: May 27, 2016

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