Cefuroxime

Cefuroxime - a second generation cephalosporin widely used in combination with metronidazole in the postoperative period following most abdominal procedures. Has greater activity against Staphylococcus aureus (including penicillinase-producing strains) compared with the third-generation cephalosporins,but not active against MRSA, enterococcus, Pseudomonas aeruginosa or Bacteroides spp. It also has poor activity against penicillinresistant strains of Streptococcus pneumoniae.

Uses:
Surgical prophylaxis
Acute epiglottitis due to Haemophilus influenzae
Intra-abdominal infections including peritonitis
Community-acquired and nosocomial pneumonia
Urinary tract infections
Patients admitted from the community with sepsis of unknown origin
Soft tissue infections

Contraindications:
Hypersensitivity to cephalosporins
Serious penicillin hypersensitivity (10% cross-sensitivity)
Meningitis (high relapse rate)
Porphyria

Administration:
• IV: 0.75–1.5 g 6–8 hourly

Reconstitute with 20 ml WFI, given over 3–5 min In renal impairment:

CC (ml/min)	Dose (g)	Interval (h)
20–50	0.75–1.5	8
10–20	0.75–1.5	8–12
< 10	0.75–1.5	12–24

Adverse effects:
Hypersensitivity
Transient LFTs
Clostridium difficile-associated diarrhoea

Cautions:
Hypersensitivity to penicillins
Renal impairment

Renal replacement therapy:
CVVH dialysed, dose as for GFR 10–20 ml/min, i.e. 750 mg–1.5 g IV 8–12 hourly. For PD and HD dose as in CC < 10 ml/min, i.e. 750 mg to 1.5 g IV every 12–24 hours.