Cefuroxime 1.5g IV

How it works

It is a beta-lactam that binds penicillin-binding proteins to inhibit bacterial cell-wall peptidoglycan cross-linking, causing cell lysis, with useful activity against meticillin-sensitive staphylococci and many streptococci.

Prescribing in practice

• Do not give to patients with a history of immediate or severe (anaphylactic) reaction to penicillins or cephalosporins; check allergy status before induction and document a suitable alternative.
• Timing is critical — administer within the window before knife-to-skin so adequate tissue levels are present, and consider an intra-operative redose for prolonged surgery or major blood loss per local protocol.
• Reduce frequency in significant renal impairment and review against the SPC and local microbiology guidance.

Monitoring

Routine prophylactic courses need little laboratory monitoring, but observe for hypersensitivity, and review renal function and for antibiotic-associated diarrhoea if therapy is extended.

Counselling the patient

• Tell the team and patient about any previous penicillin or cephalosporin reaction before surgery.
• Report rash, swelling or breathing difficulty immediately.
• Report persistent diarrhoea after antibiotics, as this needs assessment.

Evidence & guidelines

Cephalosporin surgical prophylaxis is supported by NICE and SIGN guidance, which emphasise correct dose timing relative to incision to reduce surgical site infection.