Cefuroxime dosing

The comorbid conditions that can affect therapy and outcomes in patients with CAP include diabetes mellitus, COPD, congestive heart failure, and renal failure.27,28 If the patient has not received antibiotics in the past 3 months, then clarithromycin or azithromycin is the recommended first-line therapy by the IDSA. If the patient has received antibiotics in the last 3 months, then the IDSA recommends using either a respiratory fluoroquinolone alone or a combination of an oral P-lactam and an advanced macrolide/azalide (e.g., clarithromycin/azithromydn). The ATS recommends combination therapy or monotherapy with a respiratory fluoroquinolone for all patients with comorbidities. The p-lactam agents recommended include high-dose amoxicillin, high-dose amoxicillin-clavulanate, cefpodoxime, cefprozil, and cefuroxime. 

Cefuroxime axetil 30 mg/kg per day in 2 doses (max 1 g/day with suspension adult 250 mg twice daily) Nausea, vomiting, diarrhea, rash, diaper rash Suspension gritty and bitter tasting, not interchangeable with tablets (less bioavailable)... 

Cefdinir Cefpodoxime proxetil Cefuroxime axetil 600 mg/day in 1-2 doses 200 mg twice daily 250-500 mg twice daily 14 mg/kg per day in 1-2 doses 1 0 mg/kg per day in 2 doses 1 5-30 mg/kg per day in 2 doses Preferred oral liquid cephalosporin owing to palatability... 

Cefuroxime axetil 250 mg twice daily 20 mg/kg per day in 2 doses 10 days ... 

Ceftriaxone0 or cefuroxime axeti l,° doxycycline,6 amoxicillin High-dose penicillin, cefotaxime,0 or azithromycin... 

If treatment failure occurs with amoxicillin, an agent should be chosen with activity against /1-lactamase-producing H. influenzae and M. catar-rhalis as well as drug-resistant S. pneumoniae (such as high-dose amoxicil-lin-clavulanate (recommended), or, cefuroxime, cefdinir, cefpodoxime, cefprozil, or intramuscular ceftriaxone). 

Cefuroxime axetil 20-30 rng/kg in two divided doses + metronidazole 30 mg/kg in three to four divided doses or clindamycin 10-30 mg/kg/day in three to four divided doses... 

Cefaclor 20-40 mg/kg/day (not to exceed I g) orally in three divided doses or cefuroxime axetil 0.125-0.25 g (tablets) orally every 12 hours... 

Because cefuroxime is dialyzable, give patients on hemodialysis a further dose at the end of the dialysis. 

Cefaclor, cefuroxime axetil, cefprozil, and loracarbef can be given orally. The usual dosage for adults is 10-15 mg/kg/d in two to four divided doses children should be given 20-40 mg/kg/d up to a maximum of 1 g/d. Except for cefuroxime axetil, these drugs are not predictably active against penicillin-resistant pneumococci and should be used cautiously, if at all, to treat suspected or proved pneumococcal infections. Cefaclor is more susceptible to 13-lactamase hydrolysis compared with the other agents, and its usefulness is correspondingly diminished. 

Spirochetes Borrelia burgdorferi Lyme disease Amoxicillin doxycycline ceftriaxone cefuroxime Azithromycin cefotaxime clarithromycin penicillin (high dose)... 

For premedication aspirin 300 mg twice a day 48 hours prior to the procedure and a loading dose of clopidogrel 300 mg (or ticlopidine 250 mg) is recommended. Endocarditis prophylaxis with a first generation cephalosporin (e.g., cefuroxime, 1, 5 g, i.v.) should be administered before and after intervention. After transseptal puncture, 10,000 units of heparin are administered. An activated clotting time of 200-300 seconds is desirable. 

During all valvuloplasty interventions antibiotics (e.g., cefuroxime, I, 5 g, i.v.) are administered. Patients allergic to penicillin should receive vancomycin I g intravenously. Most physicians perform transcatheter valvuloplasty in the fasting state under mild sedation, Substances that are frequently used are meperidine, promethazine, and chlorpromazine, given intramuscularly or intermittent doses of midazolam (0.05 to 0.1 mg/kg, i.v.) and/or fentanyl (0.5 to 1.0 Lig/kg, i.v.). Some operators also apply ketamine or general anesthesia for all interventional cases. 

Garton AM, Rennie RP, Gilpin J, et al. Comparison of dose doubling with probenecid for sustaining serum cefuroxime levels. J Antimicrob Chemother 1997 40 903-906. 

High-dose amoxiciiiin, high-dose amoxidiiin-davuianate, cefpodoxine, cefprozii, or cefuroxime. 

Finn A, Straughn A, Meyer M, Chubb J. Effect of dose and food on the bioavailabihty of cefuroxime axetU. Biopharm Drug Dispos 1987 8(6) 519-26. 

Sjolin J, Goscinski G, Lundholm M, Bring J, Odenholt I. Endotoxin release from Escherichia coli after exposure to tobramycin dose-dependency and reduction in cefuroxime-induced endotoxin release Clin Microbiol Infect 2000 6(2) 74-81. 

Cefuroxime axetii 250-500 mg a. 8 hr 90% 100% 100% 100% Malabsorbed in presence of blockers absorbed better with food Dose after dialysis Dose for GFR<10 ml/min No data... 

Cefuroxime sodium 0.75-1.5 g iVq. Shr 90% q.Shr q.S-12hr q.12-24 hr Absorbed weii when giyen intraperito-neaiiy may cause rare aiiergic interstitial nephritis may cause bleeding from impaired prothrombin biosynthesis Dose after dialysis Dose for GFR <10 1.0 g q. 12 hr... 

Ceftriaxone or cefuroxime axetil, doxycycline, amoxicillin High-dose penicillin, cefotaxime, azithromycin, or clarithromycW... 

No Amoxicillin usual dose 40-45 mg/kg/day Amoxicillin high dose 80-90 mg/kg/day (high-risk patients) Amoxicillin-clavulanate high dose Amoxicillin component 80-90 mg/kg/day clavulanate component 6.4 mg/kg/day Cefuroxime axetil Suspension 30 mg/kg/day divided twice daily (max 1 g) Tablets 250 mg twice daily Intramuscular ceftriaxone 1 g (50 mg/kg) daily for 3 days Same as day 3... 

Amoxicillin-clavulanate high dose Clindamycin - Cefuroxime axetil... 

For infections developing more than 36 to 48 hours after the bite, the risk of P. multocida being involved decreases dramatically. In these patients, staphylococci or streptococci are the most likely causative pathogens. Therapy in this instance includes a penicillinase-resistant penicillin (dicloxacillin 250-500 mg orally four times daily in children, 25-50 mg/kg per day oraUy divided into four doses) or a cephalosporin (cefuroxime axetil 500 mg orally twice daily in children, 20-30 mg/kg per day orally divided into two doses) and should be given for a full 10 to 14 days. ... 

Cefuroxime is equipotent to cefamandole in the killing of gram-negative organisms (including beta-lactamase strains of H. influenzae) but has a longer half-life and can be dosed less frequently. It does not produce hypoprothrombinemia. 

Cefuroxime axetil is the 1 -acetyloxyethyl ester of cefuroxime. Between 30% and 50% of an oral dose is absorbed and then hydrolyzed to cefuroxime resulting concentrations in plasma are variable. 

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