How should cefuroxime meet these 3 special populations?

*For medical professionals only

Clinical decision-making can be simpler

Cefuroxime has excellent antibacterial activity, is often used clinically to fight a variety of infections caused by sensitive bacteria, and its dosage is also a topic that clinical workers need to focus on. So, when encountering the following special groups, how should we adjust the dosage of cefuroxime? Let's take a look at the collation of the world's small medicines!

Adults (renal impairment)

In patients with kidney damage or on renal dialysis, special precautions are not required when the maximum daily dose does not exceed 1 g [1-3].

The dosage of cephalosporins should be appropriately reduced according to the renal function, and the recommended adjustment methods are shown in the following table. Children with renal insufficiency should also refer to the following table for adjustment.

In patients with renal failure undergoing continuous arteriovenous hemodialysis or high-flow hemodialysis in a care setting, the appropriate dose is 750 mg twice daily [4-6].

Table 1 Dose adjustment in patients with kidney injury

When using this product, care should be taken to monitor renal function, especially for severely ill patients receiving high doses. In patients with severe renal impairment, the interval between medications should be extended [7-11].

child

▌Domestic usage:

This product should not be broken and taken. Care should be taken to ensure that the whole tablet is swallowed in children under 12 years of age, so patients with young children may take cefuroxime esters in other appropriate dosage forms, such as granules or suspensions.

There is no experience with children under 3 months of age using this product.

The usual dose is 125 mg 2 times a day or 2 times a day, 10 mg / kg body weight, with a maximum dose of 250 mg per day.

For acute tonsillitis and pharyngitis, acute bacterial sinusitis, 125 mg twice daily, with a maximum daily dose of 250 mg.

For uncomplicated skin and soft tissue infections, the recommended dose is 250 mg/kg body weight 2 times a day or 2 times a day, with a maximum daily dose of 500 mg.

For acute bacterial otitis media, children over 2 years of age are usually taken at a dose of 250 mg or 2 times a day for 15 mg/kg body weight, with a maximum daily dose of 500 mg.

Children with unconstructed urinary tract infections are given 2 times a day at a dose of 250 mg each time is usually sufficient, and the recommended dose for patients with pyelonephritis is 2 times a day of 250 mg for 10 to 14 days.

Treatment of Lyme disease in children aged 3 months to 12 years: the recommended dose is 250 mg (or 15 mg/kg body weight) 2 times a day for 14 days (range 10-21 days). There is no experience with the use of this product in infants under 3 months of age [1-4].

▌FDA Usage:

Cefuroxime ester oral suspensions are indicated in children aged 3 months to 12 years and can be used to treat mild to moderate infection caused by susceptible strains of the specified microorganism in the following cases.

Pharyngitis/tonsillitis caused by Streptococcus purulence. Penicillin is the commonly used and preferred drug for the treatment of streptococcal infections and the prevention of rheumatic fever. Oral suspensions of cefuroxime esters are also effective in eradicating streptococcus in the nasopharynx.

Acute bacterial otitis media caused by Streptococcus pneumoniae, Haemophilus influenzae (including β-lactamase strains), Moraxella catarrhalis (including β-lactamase strains), or Streptococcus purulentis.

Pustular disease caused by Staphylococcus aureus (including β-lactamase strains) or Streptococcus purulentis.

Cefuroxime ester oral suspensions are available in patients aged 3 months to 12 years, and the dosages administered are shown in the table below.

Table 2 Ceffuroxime ester oral suspension (must be taken with food. Shake well before each use. ）

old age

In elderly patients, no special precautions are required when the maximum daily dose does not exceed 1 g [1-3].

In older patients with renal insufficiency, dose adjustment is required [4].

Patients over 65 years of age may be given a dose of 1/2 to 2/3 of the normal amount, with a daily dose not exceeding 3 g [5].

See Dosage for adults [6-9].

Of the total number of subjects receiving cefuroxime ester in 20 clinical trials, 375 were aged ≥ 65 years and 151 were ≥ 75 years. No overall difference in safety or efficacy was observed between these subjects and younger adult subjects. The reported clinical experience has not yet established differences in response between elderly and young adult patients, but it cannot be ruled out that some elderly individuals are more sensitive.

Cefuroxime is excreted mainly through the kidneys, and patients with impaired renal function may be at greater risk of adverse reactions. Because older patients are more likely to experience decreased renal function, caution should be exercised in dose selection, and monitoring renal function may be useful [10-11].

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