Cefuroxime

dr.joan

Cefuroxime :
Trade name: Zinacef
Class: Antibiotic "cephalosporines"(second generation)
Pregnancy: (Category
Action: Bind to bacterial cell wall membrane, causing cell death.
Uses:

• Pharyngitis, tonsillitis , Otitis media ,Lower respiratory tract infections, UTIs Dermatologic infections, Treatment of early Lyme disease ,Lower respiratory tract infections, influenza, Septicemia, Meningitis Bone and joint infections, Perioperative prophylaxis .

Dose : by mouth (as cefuroxime axetil), 250 mg twice daily in most infections including mild to moderate lower respiratory-tract infections (e.g. bronchitis); doubled for more severe lower respiratory-tract infections or if pneumonia suspected
Urinary-tract infection, 125 mg twice daily, doubled in pyelonephritis
Gonorrhea, 1 g as a single dose
Child over 3 months, 125 mg twice daily, if necessary doubled in child over 2 years with otitis media
Lyme disease, adult and child over 12 years, 500 mg twice daily for 20 days By intramuscular injection or intravenous injection or infusion, 750 mg every 6–8 hours; 1.5 g every 6–8 hours in severe infections; single doses over 750 mg intravenous route only
Child usual dose 60 mg/kg daily (range 30–100 mg/kg daily) in 3–4 divided doses (2–3 divided doses in neonates)
Gonorrhea, 1.5 g as a single dose by intramuscular injection (divided between 2 sites)
Surgical prophylaxis, 1.5 g by intravenous injection at induction; up to 3 further doses of 750 mg may be given by intramuscular or intravenous injection every 8 hours for high-risk procedures
Meningitis, 3 g intravenously every 8 hours; Child 200–240 mg/kg daily (in 3–4 divided doses) reduced to 100 mg/kg daily after 3 days or on clinical improvement; Neonate 100 mg/kg daily reduced to 50 mg/kg daily
Contraindications:
Allergy to cephalosporin or penicillins, renal failure, lactation, pregnancy
Side effects:

• CNS: Headache, dizziness, lethargy, paresthesias
• GI: Nausea, vomiting, diarrhea, anorexia, abdominal pain, flatulence, pseudo membranous colitis, liver toxicity
• Hematologic: Bone marrow depression: decreased WBC, decreased platelets, decreased Hct.
• GU: Nephrotoxicity
• Hypersensitivity: Ranging from rash to fever to anaphylaxis, serum sickness reaction.

Nursing considerations:

• Culture infection, arrange for sensitivity tests before and during therapy if expected response is not seen.
• Give oral drug with food to decrease GI upset and enhance absorption.
• Give oral drug to children who can swallow tablets; crushing the drug results in a bitter, unpleasant taste.
• Have vitamin K available in case hypoprothrombinemia occurs.
• Discontinue if hypersensitivity reaction occurs.