Top 300 Pharmacy Drug Cards

CEFUROXIME: Ceftin, Various

Class: Second-Generation Cephalosporin

Dosage Forms. Powder for Suspension: 125 mg/5 mL, 250 mg/5 mL; Tablet: 125 mg, 250 mg, 500 mg

Image

Common FDA Label Indication, Dosing, and Titration.

1. Acute infective exacerbation of COPD, uncomplicated skin and/or subcutaneous tissue infection, acute bacterial maxillary sinusitis, uncomplicated urinary tract infection: Adults, 250-500 mg po bid × 10 d

2. Acute otitis media: Children who are able to swallow tablets, 250 mg po bid × 10 d

3. Bronchitis, acute, secondary bacterial infection: Adults, 250-500 mg po bid × 5-10 d; Children 13 y and older, 250-500 mg po bid × 5-10 d

4. Gonorrhea, uncomplicated: 1 g po × 1 dose

5. Impetigo: Children 3 mo to 12 y, suspension 30 mg/kg/d po in 2 divided doses × 10 d, max 1 g/d

6. Lyme disease: 500 mg po bid × 14-21 d

7. Pharyngitis, tonsillitis: Adults: 250 mg po bid × 10 d; Children 3 mo to 12 y, suspension 20 mg/kg/d po in 2 divided doses for 10 d, max 500 mg/d

Off-Label Uses. None

MOA. Cefuroxime is a second-generation cephalosporin whose activity is better than cefazolin but less than cefotaxime, against Haemophilus influenzae, including β-lactamase-producing strains. The activity of cefuroxime against Staphylococcus aureus is slightly less than that of cefazolin. Its activity against anaerobes is poor, similar to the first-generation cephalosporins.

Drug Characteristics: Cefuroxime

Image

Medication Safety Issues: Cefuroxime

Image

Drug Interactions: Cefuroxime

Image

Adverse Reactions: Cefuroxime

Image

Efficacy Monitoring Parameters. Resolution of infection.

Toxicity Monitoring Parameters. Yellowing of the eyes, blistering skin rash or extreme fatigue, unusual bruising or bleeding, shortness of breath.

Key Patient Counseling Points. Seek medical attention if rash develops. Complete full course of therapy. For the suspension, shake well and store in the refrigerator. Note short expiration after reconstitution. Avoid mixing suspension with food or beverages, but food can be taken afterward. Symptoms should improve within 2-3 d; if they worsen, seek follow-up with healthcare practitioner.

Clinical Pearls. May resume normal activities after 24 h of antibiotics if afebrile. Ten percent of patients allergic to penicillins are also allergic to cephalosporins; use with caution in penicillin-allergic patients. Dosing of suspension and tablets are not interchangeable.