Cefuroxime is an antibiotic used to treat infections, like bronchitis; gonorrhea; Lyme disease; and infections of the ears, throat, sinuses, urinary tract, and skin. Common brand names are Aeruginox, Altacef, Ambixime, Bactipoz, Cefogen, Ceftin, Cefucil, Cefuzime, Zefur, Zinacef, and Zinnat. Cefuroxime is classified as a second-generation cephalosporin and antibiotic.

Indication for Cefuroxime

Cefuroxime is used to treat otitis media, respiratory tract, genitourniary tract, gynecologic, skin, and bone infections. It is also used in the treatment of speticemia, bacterial meningitis, gonorrhea, and other gonococcal infections.

Cefuroxime can also be used for ampicillin-resistant influenza, perioperative prophylaxis, impetigo, acute bacterial maxillary sinusitis, and early Lyme disease.

Routes and Dosage of Cefuroxime

IM/IV: ADULTS, ELDERLY: 750 mg to 1.5 g every 8 hours. CHILDREN: 75-100 mg/kg/day divided every 8 hours. Maximum: 8 g/day. NEONATES: 50-100 mg/kg/day divided every 12 hours.

PO: ADULTS, ELDERLY: 125-500 mg 2 times a day depending on the infection.

Pharyngitis, Tonsillitis

PO: CHILDREN 3 MONTHS-12 YEARS: Tablet: 125 mg every 12 hours. Suspension: 20 mg/kg/day in 2 divided doses.

Acute Otitis Media, Acute Bacterial Maxillary Sinusitis, Impetigo

PO: CHILDREN 3 MONTHS-12 YEARS: Tablet: 250 mg every 12 hours. Suspension: 30 mg/kg/day in 2 divided doses.

Bacterial Meningitis

IV: CHILDREN 3 MONTHS-12 YEARS: 200-240 mg/kg/day in divided doses every 6-8 hours

Perioperative Prophylaxis

IV: ADULTS, ELDERLY: 1.5 g 30-60 minutes before surgery and 750 mg every 8 hours post operative.

IM/IV: NEONATES: 20-100 mg/kg/day in divided doses every 12 hours.

Dosage in Renal Impairment

Adult dosage is modified based on creatinine clearance and/or severity of infection.

Action of Cefuroxime

Cefuroxime binds to bacterial membranes. It inhibits synthesis of bacterial cell wall.

Side Effects and Adverse Reactions of Cefuroxime

Side Effects of Cefuroxime

  • Discomfort with IM administration
  • Oral candidiasis (mouth and/or tongue sores)
  • Mild diarrhea
  • Mild abdominal cramping
  • Vaginal candidiasis
  • Nausea
  • Serum sickness reaction (joint pain, fever)
  • Allergic reactions
  • Thrombophlebitis

Adverse Reactions of Cefuroxime

  • Antibiotic-associated colitis
  • Superinfection
  • Nephrotoxicity
  • Severe hypersensitivity reactions

Nursing Considerations for Clients Taking Cefuroxime

  • Question for history of allergies, particularly cephalosporins and penicillins.
  • Give without regards to meals. If GI upset occurs give with food or milk.
  • Avoid crushing tablets due to bitter taste.
  • Suspension must be given with food.
  • Intramuscular injections must be administered deep IM to minimize discomfort.
  • Assess mouth for white patches on mucous membranes and tongue.
  • Monitor bowel activity and stool consistency carefully.
  • Mild GI effects may be tolerable but increasing severity may indicate onset of antibiotic-associated colitis.
  • Monitor input and output and renal function reports for nephrotoxicity.
  • Be alert for superinfection: severe genital or anal pruritus, abdominal pain, severe mouth soreness, moderate to severe diarrhea.

Patient Teachings for Clients Taking

  • Discomfort may occur with IM injection.
  • Doses should be evenly spaced.
  • Continue antibiotic therapy for full length of treatment.
  • May cause GI upset (may take with food or milk).