Cefuroxime

2nd Gen Cephalosporin·Infectious Diseases - Cephalosporins

Community-Acquired Pneumonia, exacerbations of COPD, surgical prophylaxis (cardiac/thoracic)

Authority requiredPBSCEPHALOSPORINZinnat (Oral), Zinacef (IV)250 mg tablet+2

Max Dose

4.5 g/day (IV)

Half-life

1.5 h

PO Bioavail.

POOR

Renal Adj.

DOSE RED.

Rapid Summary

Overview

Second-generation cephalosporin. Bridges the gap by maintaining good Gram-positive cover while expanding Gram-negative cover (Haemophilus, Moraxella).

Maximum Dose

Max 4.5 g/day (IV) or 1 g/day (PO).

Clinical Focus

The oral tablet (axetil) is notoriously bitter if crushed and has variable absorption; it must be taken with food.

Bottom Line

Cefuroxime is a second-generation cephalosporin bridging oral and IV therapy for respiratory and urinary infections, but has intermediate spectrum and is being replaced by more targeted agents.

Formulation & Access

Brand Names

Zinnat (Oral), Zinacef (IV)

Oral Routes

Do not crush

Tablets (250 mg). Do NOT crush (intensely bitter). Oral suspension.

Parenteral

Vials (750 mg, 1.5 g powder) for IV or IM use.

Prescribing & PBS

Authority Required (PBS) for oral. Hospital supply for IV.

Indications & Use

Primary

PBSTGA

Community-Acquired Pneumonia, exacerbations of COPD, surgical prophylaxis (cardiac/thoracic).

Clinical Place

A step-up from Cefazolin/Cephalexin when H. influenzae or resistant respiratory pathogens are suspected.

Quick reference

Class & Role

2nd Gen Cephalosporin — Second-generation cephalosporin.

Route / Formulation

Tablets (250 mg). Do NOT crush (intensely bitter). Oral suspension. (Zinnat (Oral), Zinacef (IV))

Usual Dose & Max

IV 1.5 g q8h. Max 4.5 g/day (IV) or 1 g/day (PO).

Key Indication Doses

Severe CAP / Intra-abdominal: IV 1.5 g q8h. LRTI / Lyme Disease (Oral): PO 500 mg BD with meals. Renal Impairment: Reduce IV frequency to q12h if eGFR 10-20, and q24h if eGFR < 10.

Best Uses

Cefuroxime is a second-generation cephalosporin bridging oral and IV therapy for respiratory and urinary infections, but has intermediate spectrum and is being replaced by more targeted agents.

Avoid / Cautions

Severe cephalosporin hypersensitivity. Pregnancy Category B1.

Key Risks

Gastrointestinal: Diarrhea, nausea (very common with the oral axetil formulation). Immunological: Hypersensitivity rash. Cross-reactivity with penicillin allergy is ~1%.

Key Interactions

Antacids and PPIs (Pantoprazole) raise gastric pH, which severely drops the absorption of the oral prodrug. Separate by 2 hours or avoid.

Monitoring

Ensure oral doses are taken with food to maximise absorption and reduce GI distress. Check eGFR for IV dosing.

Clinical Pearl

The oral liquid suspension has a gritty, terrible taste. Compliance in children is notoriously poor. Mixing it with chocolate milk or strong syrups is often required to get them to swallow it.

Access

Authority requiredZinnat (Oral), Zinacef (IV)250 mg tablet

Brand: Zinnat (Oral), Zinacef (IV)
PBS status: Authority required
Formulation: Tablets (250 mg)

Cefuroxime

2nd Gen Cephalosporin·Infectious Diseases - Cephalosporins

Community-Acquired Pneumonia, exacerbations of COPD, surgical prophylaxis (cardiac/thoracic)

Authority requiredPBSCEPHALOSPORINZinnat (Oral), Zinacef (IV)250 mg tablet+2

Max Dose

4.5 g/day (IV)

Half-life

1.5 h

PO Bioavail.

POOR

Renal Adj.

DOSE RED.

Rapid Summary

Overview

Second-generation cephalosporin. Bridges the gap by maintaining good Gram-positive cover while expanding Gram-negative cover (Haemophilus, Moraxella).

Maximum Dose

Max 4.5 g/day (IV) or 1 g/day (PO).

Clinical Focus

The oral tablet (axetil) is notoriously bitter if crushed and has variable absorption; it must be taken with food.

Bottom Line

Cefuroxime is a second-generation cephalosporin bridging oral and IV therapy for respiratory and urinary infections, but has intermediate spectrum and is being replaced by more targeted agents.

Formulation & Access

Brand Names

Zinnat (Oral), Zinacef (IV)

Oral Routes

Do not crush

Tablets (250 mg). Do NOT crush (intensely bitter). Oral suspension.

Parenteral

Vials (750 mg, 1.5 g powder) for IV or IM use.

Prescribing & PBS

Authority Required (PBS) for oral. Hospital supply for IV.

Indications & Use

Primary

PBSTGA

Community-Acquired Pneumonia, exacerbations of COPD, surgical prophylaxis (cardiac/thoracic).

Clinical Place

A step-up from Cefazolin/Cephalexin when H. influenzae or resistant respiratory pathogens are suspected.

Quick reference

Class & Role

2nd Gen Cephalosporin — Second-generation cephalosporin.

Route / Formulation

Tablets (250 mg). Do NOT crush (intensely bitter). Oral suspension. (Zinnat (Oral), Zinacef (IV))

Usual Dose & Max

IV 1.5 g q8h. Max 4.5 g/day (IV) or 1 g/day (PO).

Key Indication Doses

Severe CAP / Intra-abdominal: IV 1.5 g q8h. LRTI / Lyme Disease (Oral): PO 500 mg BD with meals. Renal Impairment: Reduce IV frequency to q12h if eGFR 10-20, and q24h if eGFR < 10.

Best Uses

Cefuroxime is a second-generation cephalosporin bridging oral and IV therapy for respiratory and urinary infections, but has intermediate spectrum and is being replaced by more targeted agents.

Avoid / Cautions

Severe cephalosporin hypersensitivity. Pregnancy Category B1.

Key Risks

Gastrointestinal: Diarrhea, nausea (very common with the oral axetil formulation). Immunological: Hypersensitivity rash. Cross-reactivity with penicillin allergy is ~1%.

Key Interactions

Antacids and PPIs (Pantoprazole) raise gastric pH, which severely drops the absorption of the oral prodrug. Separate by 2 hours or avoid.

Monitoring

Ensure oral doses are taken with food to maximise absorption and reduce GI distress. Check eGFR for IV dosing.

Clinical Pearl

The oral liquid suspension has a gritty, terrible taste. Compliance in children is notoriously poor. Mixing it with chocolate milk or strong syrups is often required to get them to swallow it.

Access

Authority requiredZinnat (Oral), Zinacef (IV)250 mg tablet

Brand: Zinnat (Oral), Zinacef (IV)
PBS status: Authority required
Formulation: Tablets (250 mg)