CEFUROXIME SODIUM

m-Cefuroxime

Reviewed by Kiri Aikman & Clinical Practice Committee
January 2015
Administration Newborn Drug Protocol Index Newborn Services Home Page

Dose and Administration

 

Postnatal Age

Dosing Interval
(hr)

< 7days

q 12 h

7-21 days

q 8 h

>21 to term + 28 Days

q 8 h

Indications

  1. Infants with sepsis, or suspected sepsis.
  2. Cefuroxime should not be used when meningitis is suspected and cannot be ruled out.

Contraindications and Precautions

  1. Hypersensitivity to penicillins / cephalosporins.
  2. Caution in preterm infants, especially extreme immaturity.
  3. Caution in infants with liver, renal or gastrointestinal disease.

Clinical Pharmacology3

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 Effects4

  1. Venous irritation, soft tissue injury at IV injection site.
  2. Diarrhoea, prolonged or significant, requires further investigation.
  3. Neutropenia
  4. Transient elevation of hepatic enzymes.
  5. Super-infection with non-susceptible organisms including fungi.

 Special Considerations

  1.  Reduce dose in suspected renal impairment 2,4