CefUROXime intravenous for adults

Who can administer

May be administered by registered competent doctor or nurse/midwife

Important information

• If documented immediate, or severe delayed hypersensitivity reaction to penicillin - DO NOT GIVE THIS DRUG
• See under 'Dose' for adjustments required in renal impairment

Available preparations

Cefuroxime 750mg vial (FlynnPharma)

Cefuroxime 1.5g vial (FlynnPharma)

Cefuroxime 1.5g vial (Fresenius Kabi)

Zinacef 1.5g vial (if above brand in short supply)

Reconstitution

Water for Injections

At least 6ml to 750mg vial

At least 15ml to 1.5g vial

Infusion fluids

Sodium chloride 0.9% or Glucose 5%

Methods of intravenous administration

Slow intravenous injection (for all doses, but preferable to use infusion if dose greater than 750mg)

• Administer over 3 to 5 minutes

Intermittent intravenous infusion (all doses)

• Add required dose to 100ml and administer over 30 to 60 minutes
• A 50ml infusion may be used if required (eg fluid restriction) but the residual volume in the infusion line must be flushed through at the same rate to avoid significant underdosing

Dose in adults

Usual dose

• Give 750mg every eight hours.

Dose range

• Give 750mg every six to eight hours, up to 1.5g every eight hours

Surgical prophylaxis

• For gastrointestinal surgery, gynaecological, orthopaedic surgery, cardiothoracic surgery: - see GUH antimicrobial guidelines
• Dose: Cefuroxime 1.5g stat
• If the procedure lasts for longer than 4 hours, or if major blood loss (>1.5L), administer a repeat dose intraoperatively
• Commence prophylaxis within 60 minutes before incision

Renal impairment (ref 1)

eGFR (ml/minute/1.73m2)	Dose	Frequency
20 to 50	Usual dose
10 to 20	750mg to 1.5g	every 12 hours
less than 10	750mg to 1.5g	every 24 hours
Renal replacement therapy	Consult pharmacy/specialist literature

Hepatic impairment

• Not expected to have an effect on the pharmacokinetics of cefuroxime

Further information

• Cefuroxime may be added to a metronidazole 500mg bag

Storage

• Store below 25⁰C

References

Cefuroxime (Mayne/Flynn pharma) SPC Feb 2019

Zinacef 4th November 2019

1:GUH antimicrobial guidelines

Therapeutic classification

Cephalosporin antibiotic