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Paul A. Pham, Pharm.D. and John G. Bartlett, M.D.
09-03-2009
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Available formulation in Zambia: Tablets, film coated: 250mg, 500mg. Tablets: 125mg, 250mg, 500mg. Powder for injection: 250mg, 750mg, 1.5gm (as sodium salt) vial.
- Second generation cephalosporin with activity against PCN-susceptible S. pneumoniaeand H. influenzae.
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Sinusitis & acute or chronic bronchitis: 250 mg twice-daily x 7-10 d
- Acute - uncomplicated cystitis: 125 mg 250 mg twice-daily x 7-10 d
- Lyme disease: Adults and children over 12 years of age: 500 mg twice daily for 20 days
Zambia Information Author: Paul A. Pham Pharm.D.
- Uncomplicated urinary tract infections caused by E. colior K. pneumoniae. (PO andIV)
- Uncomplicated skin and skin-structure infections caused by S. aureusor S. pyogenes(PO and IV)E. coli, Klebsiella spp., and . (IV)
- Uncomplicated urethral and endocervical gonorrhea and ano-rectal gonorrhea (females) caused by N. gonorrhoeae(oral and IV)
- Upper respiratory tract infections including acute otitis media, acute maxillary sinusitis, acute exacerbation of chronic bronchitis, and secondary infections of acute bronchitis (PO)
- Early Lyme disease (erythema migrans) caused by B. burgdorferi(PO)
- Lower respiratory tract infections including community-acquired pneumonia (CAP, IV)
- Septicemia caused by S. aureus, S. pneumoniae, E. coli, H. influenzae, Klebsiella spp.(IV only)
- Meningitis , , , and (MSSA) (IV only). Author's comment: nafcillin preferred for MSSA meningitis.
- Bone and joint infections caused by MSSA (IV)
- Late Lyme arthritis
- CAP (oral cefuroxime)
brand
name
| generic
| Mfg
| brand
forms
| cost*
|
| Ceftin | Cefuroxime axetil | ~GlaxoSmithKline and generic manufacturers | PO
tab
250mg | $4.38 |
|
|
|
| PO
tab
500mg | $7.88 |
|
|
|
| PO
suspension
125mg/5mL | $68.51 per 100mL |
|
|
|
| PO
suspension
250mg/5ml | $116.61 per 100mL |
| Zinacef | Cefuroxime sodium | ~GlaxoSmithKline and generic manufacturers | IV
vial
750mg | $3.75 |
|
|
|
| IV
vial
1.5g | $7.38 |
|
|
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| IV
vial
7.5g | $30.00 |
*Prices represent cost per unit specified and are representative of "Average Wholesale Price" (AWP).
AWP Prices were obtained and gathered by Lakshmi Vasist Pharm D using the Red Book, manufacturer's
information, and the McKesson database.
^Dosage is indicated in mg unless otherwise noted.
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Parenteral dosing(mild to moderate infections): 0.75 gm IM or IV q8h.
- Bone/joint and severe infections: 1.5 gm IV q8h or 1.5 grams IV q6h.
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Oral dosing: 250-500mg PO twice daily.
- CAP: treatment should be for a minimum of 5 days and pts should be afebrile for 4872 h.
- Uncomplicated GC: 1000mg x 1 (but cefixime preferred) OR 1.5 grams IM plus probenecid 1 gm x 1 (ceftriaxone preferred).
- Surgical prophylaxis: 1.5 g IV x 1.
- Obese patients: consider 1.5 gm IV q6h.
Usual dose.
0.75Gm-1.5Gm IV q8-12h; no dosage change for oral administration.
0.75Gm IV q24h; 250 mg PO q24h.
750mg post dialysis.
750 mg q24h.
No data. Consider 1.5gm IV q12h.
- Phlebitis at infusion sites
- Allergic reactions
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Diarrhea and C. difficile colitis
- Eosinophilia
- Positive Coombs' test
- Drug fever
- CNS: convulsions (high dose with renal failure), confusion, disorientation, and hallucinations
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Neutropenia and thrombocytopenia
- Hepatitis
- Interstitial nephritis
- Anaphylaxis reaction
- Hemolytic anemia
Probenecid:increased cefuroxime serum concentration due to inhibition of tubular secretion by probenecid (no dose adjustment needed).
- MIC breakpoint for S. pneumoniae: 0.5 mcg/mL (IV) and 1 mcg/mL (oral).
2nd generation oral and parenteral cephalosporin with convenient twice a day dosing schedule. One of the IDSA-ATS recommended 2nd generation cephalosporin for the treatment of CAP caused by PCN-susceptible S. pneumoniae.
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