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Dose and administration
- 25 mg/kg/dose
- Intravenous dose may be doubled to 50 mg/kg/dose in severe infections1,2,3
|Postnatal Age||Dosing Interval (hr)|
|< 7days||q 12 h|
|7-21 days||q 8 h|
|>21 to term + 28 Days||q 8 h|
- Infants with sepsis, or suspected sepsis.
- Cefuroxime should not be used when meningitis is suspected and cannot be ruled out.
Contraindications and precautions
- Hypersensitivity to penicillins / cephalosporins.
- Caution in preterm infants, especially extreme immaturity.
- Caution in infants with liver, renal or gastrointestinal disease.
Cefuroxime is a beta lactamase resistant second-generation cephalosporin which is active against most gram positive organisms (including group B streptococcus) and a wide variety of gram-negative organisms (including group B strep) and a wide variety of gram-negative organisms. It has poor penetration in the central nervous system. It is largely excreted by the kidneys. The plasma half-life falls from around 6 hours at birth to around 3 hours at 2 weeks of age. Babies more than a month old clear cefuroxime almost as quickly as adults (half life of 1 hour), but dosage intervals should be extended in babies with severe renal impairment.
Possible adverse effects
- Venous irritation, soft tissue injury at IV injection site.
- Diarrhoea, prolonged or significant, requires further investigation.
- Transient elevation of hepatic enzymes.
- Super-infection with non-susceptible organisms including fungi.
Reduce dose in suspected renal impairment2,4
Management of Cefuroxime administration
- Available as vials of 750 mg and 1.5 g
- White to pale yellow powder for reconstitution. Reconstituted solution is pale yellow.
- pH 6 - 8.5.
- Stat doses are charted on stat page of prescription chart in mg/dose.
- Maintenance doses are charted on the prescription chart in mg/dose.
- Dilute to 100 mg/ml with water for injection
Cefuroxime (Zinacef/Mylan) 750mg Cefuroxime (Zinacef/Mylan) 1.5g Powder Space 0.5ml 1ml Water to be added 7ml 14ml 100mg/ml 100mg/ml
- Shake vigorously.
- Administer over 3-5 minutes5,6. Filter before administration through a 0.2 micron Pall filter.
- Compatible with sodium chloride 0.9%, glucose 5% and glucose 10%
- Do NOT mix with other drugs, IV solutions, strongly alkaline solutions, blood or blood products.
- Do NOT mix with sodium bicarbonate solution, amikacin or gentamicin. These drugs are incompatible with cefuroxime when mixed together.
- Separate administration from aminoglycoside antibiotics by one hour eg. gentamicin, amikacin.
Store unopened vials at room temperature . Protect from light
- Taketomo CK, Hodding JH, Kraus DM, Editors. Pediatric & Neonatal Dosage Handbook. 19th Edition. Hudson (OH): Lexi-Comp; 2012
- Woods, DJ (editor), New Zealand Formulary for Children [Internet]. 2013 [updated 2013 Dec 1; cited 2013 Dec 6]. Available from: www.nzformulary.org
- Northern Neonatal Network. Neonatal Formulary. 6th edition. Oxford: Wiley-Blackwell Publishing; 2011.
- Phelps SJ, Hagemann TM, Lee KR, Thompson AJ. Pediatric Injectable Drugs, The Teddy Bear Book. 10th Edition. Bethesda: American Society of Health-System Pharmacists; 2013.
- Auckland District Health Board, Guardrails Administration Guidelines; Paediatrics. Last updated November 2011
- Cefuroxime data sheet. Auckland: Mylan New Zealand ltd., 2013.
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- Date last published: 31 January 2015
- Document type: Drug Dosage Guideline
- Services responsible: ADHB Pharmacy, Neonatology
- Editor: Sarah Bellhouse
- Review frequency: 2 years