Parenteral Manual

Cefuroxime

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

Alternate Name(s): 
ZINACEF®
Classification: 
Antibiotic
Original Date: 
August 2005
Revised Date: 
December 2019
Indications: 
  • Second generation cephalosporin for the treatment of infections caused by susceptible organisms
Reconstitution and Stability: 

VIAL SIZE

STERILE WATER for INJECTION

FINAL CONCENTRATION

750 mg

7 mL

100 mg/mL

1500 mg

14 mL

100 mg/mL

7500 mg

70 mL

100 mg/mL
  • Store unreconstituted vial at room temperature, protect from light 
  • Reconstituted vial is stable for 24 hours at room temperature and 7 days refrigerated
  • Diluted solutions stable 24 hours at room temperature and 7 days refrigerated
  • Solutions may range in colour from light yellow to amber.  Both the powder and solutions of cefuroxime darken, depending on storage conditions, without affecting their potency
Compatibility: 

- Solutions Compatible:  dextrose up to D10W, 0.9% NaCl, dextrose-saline combinations, ringer's solutions, ringer's lactate

- Additives/Above Cassette Compatible: KCl (up to 40 mmol/L), clindamycin, metronidazole

- Y-site Compatible: morphine, TPN (amino acids/dextrose), acyclovir

- Incompatible: vancomycin, aminoglycosides antibiotics; administration of beta lactam and aminoglycoside antibiotics should be separated

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM

YES, deep into large muscle
Usual dilution: 220 mg/mL
IV Direct

YES
Usual dilution: 100 mg/mL

- 20 mg/mL for dose less than 200 mg
Infusion time: 3-5 minutes
IV Intermittent Infusion

YES
Usual dilution: 100 mg/mL

- 20 mg/mL for dose less than 200 mg
Infusion time: 15-30 minutes
IV Continuous Infusion

YES
Usual dilution: 7.5-15 mg/mL
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric:  

  • 150 mg/kg/day IV ÷ Q 8 hours
    Maximum dose:  2000 mg/dose

Adolescent/Adult:

  • Usual adult dose: 750-1500 mg IV/IM Q 8 hours
  • Maximum 2000 mg/dose IV/IM Q8H

DOSING ADJUSTMENT IN RENAL IMPAIRMENT:

  • CrCl 10-20 mL/minute:  Administer Q 12 hours
  • CrCl <10 mL/minute:  Administer Q 24 hours
Potential hazards of parenteral administration: 
  • Local reactions at the site of injection
  • Pain after IM administration (less painful when administered into the buttock rather than the thigh)
  • Transient increase in liver enzymes, bilirubin, BUN, and/or serum creatinine  
  • Anaphylaxis
  • Fever, headache, dizziness, seizures
  • Diarrhea, colitis, vomiting
  • Hematologic: transient neutropenia, thrombocytopenia, leukopenia
Notes: 
  • False positive Coombs test has been reported
  • Contains 2.4 mmol Na+ per gram of cefuroxime activity
  • Monitor renal, hepatic and hematologic function

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