Indication

Pharyngitis, Acute otitis media, Lyme disease, Susceptible infections, Sinusitis,Otitis media, Skin and skin structure infections,Tonsillitis, Respiratory tract infections, Acute Maxillary Sinusitis, MDR Typhoid fever, Urinary tract infections, Acute bacterial exacerbation of chronic bronchitis, Surgical Prophylaxis

Administration

Tab: May be taken with or without food. Oral susp: Should be taken with food.

Adult dose

Adolescents & adults: Pharyngitis or Tonsillitis: 250 mg twice daily 5-10 days Acute bacterial maxillary sinusitis: 250 mg twice daily 10 days Acute bacterial exacerbation of chronic bronchitis: 250-500 mg twice daily 10 days Secondary bacterial infections of acute bronchitis: 250-500 mg twice daily 5-10 days Community acquired pneumonia: 250-500 mg twice daily 5-10 days Uncomplicated skin & skin-structure infections: 250-500 mg twice daily 10 days MDR Typhoid fever: 500 mg twice daily 10-14 days Uncomplicated urinary tract infection: 250 mg twice daily 7-10 days Uncomplicated gonorrhea: 1000 mg single dose Lyme disease: 500 mg twice daily 20 days

Child dose

Paediatric patients (3 months to 12 years) Pharyngitis or Tonsillitis: 20 mg/kg/day in two divided doses 5-10 days Acute otitis media: 30 mg/kg/day in two divided doses 10 days Acute bacterial maxillary sinusitis: 30 mg/kg/day in two divided doses 10 days Community acquired pneumonia: 30 mg/kg/day in two divided doses 5-10 days MDR Typhoid fever: 30 mg/kg/day in two divided doses 10-14 days Uncomplicated skin & skin-structure infections: 30 mg/kg/day in two divided doses 10 days Uncomplicated urinary tract infection: 20 mg/kg/day in two divided doses 7-10 days

Contraindication

Hypersensitivity to cephalosporins.

Mode of action

Cefuroxime binds to one or more of the penicillin-binding proteins (PBPs) which inhibits the final transpeptidation step of peptidoglycan synthesis in bacterial cell wall, thus inhibiting biosynthesis and arresting cell wall assembly resulting in bacterial cell death. Addition of clavulanate inhibits beta-lactamase-producing bacteria; Clavulanic acid has a high affinity for and binds to certain ?-lactamases that generally inactivate Cefuroxime by hydrolyzing its ?-lactam ring. Combining clavulanate potassium with Cefuroxime extends the antibacterial spectrum of Cefuroxime to include many bacteria normally resistant to Cefuroxime and other penicillins and cephalosporins.

Precaution

Severe renal impairment; pregnancy, lactation; hypersensitivity to penicillins. Lactation: Drug excreted in breast milk; use with caution

Side effect

>10% Diarrhea (4-11%; depends on duration) 1-10% Decreased hemoglobin or hematocrit (10%),Eosinophilia (7%),Nausea or vomiting (3-7%),Vaginitis (<5%),Transient rise in hepatic transaminases (2-4%),Diaper rash (3%),Increase in alkaline phosphatase (2%),Thrombophlebitis (2%),Increase in lactate dehydrogenase (1%) <1% Anemia,Cholestasis,Colitis,Dyspnea,Epidermal necrolysis,Increase in blood urea nitrogen (BUN) and creatinine,Jaundice,Nephritis,Prolonged prothrombin time (PT)/international normalized ratio (INR),Rash,Stevens-Johnson syndrome,Stomach cramps,Transient neutropenia and leukopenia,Urticaria Potentially Fatal: Anaphylaxis, nephrotoxicity, pseudomembranous colitis.

Interaction

May enhance the nephrotoxic effect of strong-acting diuretics (e.g. furosemide) and aminoglycosides. May enhance the effect of oral anticoagulants. May reduce the efficacy of OCs. Probenecid prolongs the excretion of cefuroxime and elevated peak serum level.