Cerox-A

Indications

Cefuroxime is prescribed for treating infections caused by susceptible bacteria, including:

• Pharyngitis/Tonsillitis: Infections caused by Streptococcus pyogenes.
• Acute Bacterial Otitis Media: Caused by Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis (beta-lactamase producing strains), or Streptococcus pyogenes.
• Acute Bacterial Maxillary Sinusitis: Caused by Streptococcus pneumoniae or Haemophilus influenzae (non-beta-lactamase producing strains).
• Lower Respiratory Tract Infections: Including pneumonia, caused by Streptococcus pneumoniae, Haemophilus influenzae (including beta-lactamase-producing strains), Klebsiella spp., Staphylococcus aureus (both penicillinase- and non-penicillinase-producing strains), Streptococcus pyogenes, and E. coli.
• Acute Bacterial Exacerbation of Chronic Bronchitis and Secondary Infections of Acute Bronchitis: Caused by Streptococcus pneumoniae, Haemophilus influenzae (beta-lactamase negative strains), or Haemophilus parainfluenzae (beta-lactamase negative strains).
• Skin and Skin Structure Infections: Caused by Staphylococcus aureus (including beta-lactamase producing strains) or Streptococcus pyogenes.
• Urinary Tract Infections: Caused by E. coli or Klebsiella pneumoniae.
• Bone and Joint Infections: Caused by Staphylococcus aureus (penicillinase- and non-penicillinase-producing strains).
• Gonorrhoea: Caused by penicillinase-producing and non-penicillinase-producing strains of Neisseria gonorrhoeae.
• Early Lyme Disease (Erythema Migrans): Caused by Borrelia burgdorferi.

Please follow the advice of a registered healthcare professional when using this medication.

Pharmacology

Cefuroxime is a highly effective broad-spectrum antibacterial agent known for its bactericidal properties. It combats a wide range of common pathogens, including those producing beta-lactamase. Cefuroxime’s resistance to bacterial beta-lactamase makes it effective against strains resistant to ampicillin and amoxicillin.

Dosage

Tablet or Suspension:

Adults and Adolescents (13 years and older):

• Pharyngitis/Tonsillitis: 250 mg twice daily for 5-10 days.
• Acute Bacterial Maxillary Sinusitis: 250 mg twice daily for 10 days.
• Acute Bacterial Exacerbation of Chronic Bronchitis: 250-500 mg twice daily for 10 days.
• Secondary Infections of Acute Bronchitis: 250-500 mg twice daily for 5-10 days.
• Uncomplicated Skin Infections: 250-500 mg twice daily for 10 days.
• Uncomplicated Urinary Tract Infections: 250 mg twice daily for 7-10 days.
• Uncomplicated Gonorrhoea: 1000 mg as a single dose.
• Community Acquired Pneumonia: 250-500 mg twice daily for 5-10 days.
• MDR Typhoid Fever: 500 mg twice daily for 10-14 days.
• Early Lyme Disease: 500 mg twice daily for 20 days.

Paediatric (3 months to 12 years):

• Pharyngitis/Tonsillitis: 20 mg/kg/day, twice daily for 5-10 days.
• Acute Otitis Media: 30 mg/kg/day, twice daily for 10 days.
• Acute Bacterial Maxillary Sinusitis: 30 mg/kg/day, twice daily for 10 days.
• Impetigo: 30 mg/kg/day, twice daily for 10 days.

Parenteral:

Adults:

• For severe infections, administer 750 mg three times daily by IM or IV injection, up to 1.5 gm three times daily if necessary. Frequency may be increased to four times daily, up to a total dose of 3-6 gm per day.

Children (above 3 months):

• Typically, 30-100 mg/kg/day, divided into 3 or 4 doses.

Neonates:

• 30-100 mg/kg/day, divided into 2-3 doses.

Surgical Prophylaxis:

• 1.5 gm IV at the time of anesthesia induction, followed by 750 mg every 8 hours for high-risk procedures.

In Gonorrhoea:

• 1.5 gm as a single dose (administered as two 750 mg IM injections at different sites).

In Meningitis:

• Adults: 3 gm IV three times daily.
• Children (above 3 months): 200-240 mg/kg/day IV, divided into 3 or 4 doses. This is reduced to 100 mg/kg/day after 3 days or upon clinical improvement.
• Neonates: 100 mg/kg/day IV, reduced to 50 mg/kg/day once clinically stable.

In Bone and Joint Infections:

• Adults: 1.5 gm IV four times daily.
• Children (above 3 months): 150 mg/kg/day (maximum adult dose) in divided doses every 8 hours.

Please follow the advice of a registered healthcare professional when using this medication.

Administration

It is recommended to use the freshly reconstituted solution. However, it remains potent for 24 hours at room temperature or up to 48 hours if stored at 5°C.

Interactions

No significant hazardous drug interactions have been reported with Cefuroxime.

Contraindications

Cefuroxime should not be used in patients who have a known allergy to cephalosporin antibiotics.

Side Effects

Side effects with Cefuroxime are generally rare, mild, and transient. Reported effects include rashes and gastrointestinal disturbances. As with all antibiotics, prolonged use may lead to the overgrowth of non-susceptible organisms, such as Candida.

Pregnancy & Lactation

Cefuroxime is classified as FDA Pregnancy Category B. While no well-controlled studies are available in pregnant women, animal studies have shown no harm. It is excreted in human milk, so it should be used with caution in nursing mothers.

Precautions & Warnings

Cefuroxime should be used cautiously in patients on potent diuretics or with a history of colitis. Although cross-reactions with penicillin may occur, Cefuroxime can generally be safely administered to penicillin-hypersensitive patients at recommended doses.

Therapeutic Class

Second-generation Cephalosporin antibiotics.

Reconstitution

For a 750 mg intramuscular injection, add 3 ml of water for injection and shake gently.
For intravenous administration, add 8 ml of water for injection to the vial and shake gently. Administer slowly over 3-5 minutes.
For a 1.5 gm intravenous injection, add 16 ml of water for injection and shake gently, then administer slowly over 3-5 minutes.

Storage Conditions

Store in a cool, dry place (below 30°C), away from light and moisture. Keep out of reach of children.