Cefuroxime

Name of Drug

Generic Name: Cefuroxime
Brand Name: Ceftin, Zinacef

Classification

Therapeutic: Anti - Infectives
Pharmacologic: Second Generation Cephalosporins
Pregnancy Category B

Mode of Action

Bind to bacterial cell wall membrane, causing cell death.
Therapeutic Effects: Bactericidal action against susceptible bacteria.
Spectrum: Similar to that of first-generation cephalosporins but have increase activity against several other gram-negative pathogens including: Haemophilus influenzae, Escherichia coli, Klebsiella pneumoniae, Morganella morganii, Neisseria gonorrhoeae (including penicillinase-producing strains), Proteus, Providencia, Serratia marcescens, Moraxella catarrhalis. Not active against methicillin-resistant staphylococci or enterococci. Cefuroxime: Active against Borrelia burgdorferi. Cefotetan and cefoxitin: Active against Bacteroides fragilis.

Indication

Treatment of the following infections caused by susceptible organisms: Respiratory tract infections, Skin and skin structure infections, Bone and joint infections (not cefaclor or cefprozil), Urinary tract infections (not cefprozil). Meningitis, gynecologic infections, and Lyme dis
Unlabeled Uses: In combination with other agents in the management of Mycobacterium avium complex infections.

Contraindications

Contraindicated in: Hypersensitivity to cephalosporins; Serious hypersensitivity to penicillins.
Use Cautiously in: Renal impairment (dose adjustments necessary); History of GI disease, especially colitis; Geri: Dosage adjustment due to age-related decrease in renal function may be necessary; may also be at increase risk for bleeding with cefotetan or cefoxitin; OB: Pregnancy and lactation (have been used safely).

Side / Adverse Effects

CNS: seizures (high doses). GI: Pseudomembranous colitis, diarrhea, cramps, nausea, vomiting. Derm: rashes, urticaria. Hemat agranulocytosis, bleeding (increase with cefotetan and cefoxitin), eosinophilia, hemolytic anemia, neutropenia, hrombocytopenia. Local: pain at IM site, phlebitis at IV site. Misc: allergic reactions including anaphylaxis and serum sickness, superinfection.

Nursing Responsibilities

  • Assess patient for signs and symptoms of infection prior to and throughout therapy.
  • Before initiating therapy, obtain a history to determine previous use of and reactions to penicillins or cephalosporins. Persons with a negative history of penicillin sensitivity may still have an allergic response.
  • Observe patient for signs and symptoms of anaphylaxis (rash, pruritus, laryngeal edema, wheezing). Discontinue the drug and notify physician or other health care professional immediately if these symptoms occur. Keep thromepinephrine, an antihistamine, and resuscitation equipment close by in the event of an anaphylactic reaction.
  • Instruct patient to report signs of hypersensitivity.
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