LAVINA CEFUROXIME FOR INJECTION

Indications

• Community-acquired pneumonia
• Acute exacerbations of chronic bronchitis
• Sinusitis
• Otitis media
• Skin and soft tissue infections
• Urinary tract infections
• Bone and joint infections

Dosage

Children: Refer to the BNF for Children for appropriate dosing based on the child's age and weight.

Adults: Refer to specific clinical guidelines or the BNF for standard dosing recommendations based on the type and severity of infection.

Mechanism of action

Cefuroxime works by inhibiting the synthesis of bacterial cell walls, which is crucial for bacterial growth and replication. It binds to penicillin-binding proteins (PBPs) located inside the bacterial cell wall, leading to the disruption of cell wall integrity, resulting in cell lysis and death. This action is particularly effective against rapidly dividing bacteria.

Pharmacodynamics

Cefuroxime exhibits time-dependent bactericidal activity, meaning its effectiveness is related to the duration that the drug concentration remains above the minimum inhibitory concentration (MIC) for the target organism. It has a broader spectrum of activity compared to first-generation cephalosporins, covering more gram-negative pathogens and some anaerobes. Resistance mechanisms include beta-lactamase production, which can hydrolyze the beta-lactam ring of cefuroxime, rendering it ineffective against certain resistant strains.

Pharmacokinetics

Cefuroxime is well absorbed after oral administration, with a bioavailability of approximately 50%. It is widely distributed in body tissues and fluids, including the lungs, bile, and synovial fluid. The drug is primarily eliminated by the kidneys, with a half-life of about 1 to 2 hours in patients with normal renal function. Dosage adjustments may be necessary in patients with renal impairment to prevent accumulation and toxicity.

Contra-indications

• Hypersensitivity to cefuroxime or any other cephalosporin antibiotic
• History of severe allergic reactions to penicillins or other beta-lactam antibiotics

Adverse effects

• Nausea
• Diarrhea
• Rash
• Allergic reactions including anaphylaxis
• Elevated liver enzymes
• Nephrotoxicity
• Colitis (including Clostridium difficile-associated diarrhea)

Interactions

• Probenecid may increase serum levels of cefuroxime
• Anticoagulants may have altered effects when combined with cefuroxime
• Aminoglycosides may have additive nephrotoxic effects

Precautions

• Use with caution in patients with renal impairment
• Monitor for signs of anaphylaxis in patients with allergies
• Caution in patients with a history of gastrointestinal disease, particularly colitis

Pregnancy

Cefuroxime is classified as category B for pregnancy. Animal studies have not demonstrated a risk to the fetus, but there are no well-controlled studies in pregnant women.

Breast-feeding

Cefuroxime is excreted in breast milk, but is considered safe for use during breastfeeding, with minimal risk to the infant.

Storage

Store at room temperature, away from light and moisture. Reconstituted solutions should be refrigerated and used within a specific time frame as indicated by the manufacturer.

Formulations

• Oral tablets
• Oral suspension
• Intravenous injection
• Intramuscular injection