Neonatal Drug Therapy Manual

Cefuroxime

Disclaimer: Official controlled document is the CHEO and Ottawa Hospital online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Updated March 5, 2024 - 2:36pm

Alternate Name(s): 
Zinacef
Classification: 
Antibiotic Cephalosporin
Original Date: 
August 2003
Revised Date: 
April 2017
Indications: 
  • Treatment of infections due to susceptible organisms
Administration: 
  • IV direct: over 3 - 5 minutes
  • IV intermittent infusion: over 15 - 30 minutes
Dosage: 
  • Neonates:
    • 50 - 100 mg/kg/day divided Q12H
  • Infants (corrected GA > 42 weeks and PNA > 4 weeks):
    • 75 - 150 mg/kg/day divided Q8H

Dosage adjustment required in renal impairment.  Refer to available references or clinical pharmacist for dosage adjustment.

Side Effects: 
  • Hematologic: transient neutropenia and leukopenia, decreased hemoglobin, eosinophilia
  • Hepatic: transient elevation of liver enzymes
  • Renal: increased BUN and serum creatinine
Parameters to Monitor: 
  • CBC
  • BUN and serum creatinine
  • Liver function tests
Reconstitution and Stability: 

CHEO:

  • Cefuroxime 750 mg vial (doses < 200 mg)
    • Add 7 mL SWFI to vial
    • Take 4 mL (400 mg) and add to 16 mL D5W
    • Final concentration: 20 mg/mL
  • Cefuroxime 750 mg vial (doses > 200 mg)
    • Add 7 mL SWFI to vial
    • Final concentration: 100 mg/mL

TOH:

  • Cefuroxime 750 mg vial

    • Add 7 mL SWFI to vial

    • Take 4 mL (400 mg) and add to 16 mL D5W

    • Final concentration: 20 mg/mL

Compatibility: 

- Solutions Compatible: D5W, D10W, 0.9% NaCl, dextrose-saline combinations

- Y-site Compatible: acyclovir, dexmedetomidine, famotidine, hydromorphone, metronidazole, milrinone, morpine, TPN

Incompatible: fluconazole, midazolam, vancomycin

References: 

-Taketomo CK, Hodding JH, Kraus DM. Pediatric Dosage Handbook 22nd Edition. Hudson: Lexi-Comp Inc.; 2015.

-American Society on Health-System Pharmacists (ASHP). Handbook on Injectable Drugs. 19th Edition. Bethesda: American Society of Health-System Pharmacists; 2017

 

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