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Healthcare Communications

Cefuroxime

 

Cephalosporins

* Derived from Cephalosporium acremonium
* Possess a beta-lactam ring and a dihydrothiazine ring in the nucleus; can be inactivated by beta-lactamases
* Activity against wide range of Gm(+ve) and Gm(-ve) bacteria
* Classified as
First generation :Cephaloridine, Cephalothin, Cephalexin , Cephazolin, Cephapirin, Cephradine, Cefadroxil
Second generation : Cefamandole, Cefoxitin , Cefuroxime , Cefaclor, Cefonicid, Ceforanide
Third generation : Cefotaxime , Cefoperazone , Cefsulodin, Ceftriazone , Ceftizoxime, Ceftazidime , Cefixime

 

 

Cefuroxime

* a semisynthetic, broad-spectrum, second generation cephalosporin
* activity against a wide range of gram- positive and gram-negative organisms

 

Mechanism of Action

* Bactericidal
* Inhibits of cell-wall synthesis

Antibacterial Spectrum

Aerobes, Gram-positive: Staph. aureus, Staph. epidermidis, Strep. pneumoniae, and Strep. pyogenes
Aerobes Gram-negative: Citrobacter spp., Enterobacter spp., E. coli, H. influenzae, H. parainfluenzae, Klebsiella spp. , Moraxella catarrhalis, Morganella morganii,
N. gonorrhoeae, N. meningitidis, P. mirabilis, Providencia rettgeri, Salmonella spp., and Shigella spp.
Anaerobes: Peptococcus, Peptostreptococcus spp., Clostridium spp., Bacteroides and Fusobacterium spp.

 

Pharmacokinetics

- Cmax 27 mcg/ml. in 45 minutes & 50 mcg/ml. in 15 mins. with 750-mg IM and IV respectively.
- Approx. 89% excreted by the kidneys over an 8-hour period, Following IM & IV administration of a 750-mg single dose, urinary concentrations averaged 1300 mcg/mL & 1150 mcg/mL during the first 8 hours
- Distributed in pleural fluid, joint fluid, bile, sputum, bone, & aqueous humor. Detected in therapeutic concentrations in cerebrospinal fluid (CSF) of adults and pediatric with meningitis.
- The serum half-life after either IM or IV injections is approx 80 mins.

 

 

Indications

* LRTI including pneumonia
* Urinary Tract Infections
* Skin and Skin-Structure Infections
* Septicemia
* Meningitis
* Gonorrhea : Uncomplicated and disseminated gonococcal infections in both males and females
* Bone and Joint Infections
* Prevention of surgical infections

 

Adverse Reactions

- Generally well tolerated
- Local reactions, GI disturbance, hypersensitivity reactions

Precautions & Contraindications

- Caution in patients with transient or persistent renal insufficiency
- No evidence of harm in pregnancy or lactation, however as with other drugs, use with caution in pregnant & lactating women
- Safety and effectiveness in pediatric patients below 3 months of age have not been established
- Contraindicated in patients with known allergy to cephalosporin

 

Dosage

Adults : 750 mg to 1.5 grams every 8 hours, usually for 5 to 10 days
Children : 200 to 230 mg/kg/day, in divided doses every 6-8 hrs.
Uncomplicated, skin and skin-structure infections, disseminated gonococcal infections, uncomplicated pneumonia :
750-mg dose every 8 hours
Severe or complicated infections : 1.5-gram dose every 8 hours
Bone and Joint infections : 1.5-gram dose every 8 hours
Bacterial meningitis : Adult dosage should not exceed 3 grams every 8 hours
Uncomplicated gonococcal infection :
1.5 grams IM as a single dose at two different sites with 1 gram of oral probenecid
Prevention of Surgical Infections : 1.5-gram dose administered intravenously just before surgery (approximately one-half to 1 hour before the initial incision) Thereafter, give 750 mg intravenously or intramuscularly every 8 hours when the procedure is prolonged

 

 

Salient Features

- Activity against a wide range of gram-positive and gram-negative organisms therefore of value for the initial ‘blind’ therapy of undiagnosed infections
- Wide distribution in the body
- Effective in LRTI, skin & skin structures, UTI, septicemia, meningitis, gonorrhoea and bone & bone joint infections, prevention of surgical infections
- Well tolerated