Cefuroxime

DEA Class; Rx

Common Brand Names; Ceftin, Zinacef

Indicated for the treatment of Pharyngitis/Tonsillitis

Indicated for the treatment of Acute Bacterial Maxillary Sinusitis

Indicated for the treatment of Acute Bacterial Exacerbations of Chronic Bronchitis

Indicated for the treatment of Secondary Bacterial Infections of Acute Bronchitis

Also indicated in Uncomplicated Pneumonia, Uncomplicated Skin/Skin Structure Infections,  Uncomplicated Urinary Tract Infections, Gonorrhea, Early Lyme Disease, Severe or Complicated Infections

Documented hypersensitivity

• Diarrhea (4-11%; depends on duration)
• Decreased hemoglobin or hematocrit (10%)
• Eosinophilia (7%)
• Nausea or vomiting (3-7%)
• Vaginitis (<5%)
• Transient rise in hepatic transaminases (2-4%)
• Diaper rash (3%)
• Increase in alkaline phosphatase (2%)
• Thrombophlebitis (2%)
• Increase in lactate dehydrogenase (1%)
• Anemia
• Cholestasis
• Colitis
• Dyspnea
• Epidermal necrolysis
• Increase in blood urea nitrogen (BUN) and creatinine
• Jaundice
• Nephritis
• Prolonged prothrombin time (PT)/international normalized ratio (INR)
• Rash
• Stevens-Johnson syndrome
• Stomach cramps
• Transient neutropenia and leukopenia
• Urticaria

Do not crush tablet

Prolonged INR in nutritionally deficient patients, prolonged treatment, and hepatic and renal disease reported

Film-coated tablet and oral solution are not bioequivalent; tablets should not be crushed

Use caution in patients with history of colitis, renal impairment, or with a history of seizure disorders

Use with caution in patients with history of penicillin allergy

Reduce dosage by 50% if CrCl is 10-30 mL/min and by 75% if CrCl <10 mL/min (high doses may cause CNS toxicity)

Some products may contain phenylalanine

Bacterial or fungal overgrowth of nonsusceptible organisms may occur with prolonged or repeated therapy

Available data from published epidemiologic studies, case series, and case reports over several decades in pregnant women have not established drug-associated risks of major birth defects, miscarriage, or adverse maternal or fetal outcomes

Based on several published case reports describing multiple lactating women receiving therapy via intravenous, intramuscular, and oral routes, drug is present in human milk; the highest maternal milk concentration described occurred in lactating women 8 hours after an intramuscular administration of 750 mg; allowing for an infant milk consumption of 150 mL/kg/day, the estimated breastfed infant dose would be less than 1% of adult dose