Cefuroxime (Injection, Intravenous)

Generic name:

Cefuroxime

Drug class:

Second-generation cephalosporin antibiotic

Dosage form:

Lyophilized powder for injection (vial)

Root of administration:

Intravenous

Dose:

Adults: 750 mg–1.5 g IV every 8 hours; maximum 6 g/day. Pediatric: 30–100 mg/kg/day divided every 8 hours. Renal impairment: adjust dose and/or interval per creatinine clearance. Varies by indication; consult label.

Mechanism of action:

Cefuroxime inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins, leading to cell lysis and death.

Drug usage cases:

• Acute bacterial sinusitis
• Acute otitis media
• Lower respiratory tract infections (e.g., bronchitis, pneumonia)
• Skin and soft tissue infections
• Urinary tract infections (including pyelonephritis)
• Bone and joint infections
• Septicemia
• Lyme disease (early localized and disseminated)
• Uncomplicated gonorrhea
• Perioperative prophylaxis for certain surgeries (off-label)
• Helicobacter pylori eradication in combination therapy (off-label)

Drug contra indications:

• Hypersensitivity to cefuroxime or other cephalosporins
• History of severe immediate hypersensitivity reactions to penicillins
• Known allergy to beta-lactam antibiotics

Side effects:

• Gastrointestinal: diarrhea, nausea, vomiting, abdominal pain
• Pseudomembranous colitis (Clostridioides difficile-associated diarrhea)
• Injection site reactions: pain, phlebitis
• Hypersensitivity: rash, urticaria, pruritus, anaphylaxis
• Hematologic: neutropenia, thrombocytopenia, eosinophilia, hemolytic anemia
• Hepatic: elevated transaminases, cholestatic jaundice
• Renal: interstitial nephritis, elevated BUN/creatinine
• Neurologic: headache, dizziness, seizures (high doses/renal impairment)
• Overgrowth of non-susceptible organisms (e.g., yeasts)

Warnings:

• Monitor for signs of hypersensitivity; discontinue if severe reaction occurs
• Cross-reactivity may occur in penicillin-allergic patients
• C. difficile-associated diarrhea can range from mild diarrhea to fatal colitis
• Adjust dose in renal impairment; monitor renal function
• Prolonged use may result in fungal or bacterial superinfection
• Use with caution in patients with a history of gastrointestinal disease, especially colitis
• Contains sodium; monitor in patients on sodium-restricted diets
• Use caution in neonates: risk of bilirubin displacement and kernicterus

Use during pregnancy or breastfeeding:

Pregnancy: Classified as FDA Pregnancy Category B. Animal studies have not demonstrated fetal risk. Use only if clearly needed and benefit outweighs risk.

Breastfeeding: Cefuroxime is excreted in human milk in low concentrations. Caution advised; monitor breastfed infants for diarrhea, candidiasis, or sensitization reactions. Benefits of breastfeeding should be weighed against maternal need for cefuroxime.