2nd Generation Cephalosporin Pregnancy: Limited data in pregnant women; animal studies show no reproductive toxicity. Should be prescribed to pregnant women only if the benefit outweighs the risk. Excreted in human milk in small quantities; adverse reactions at therapeutic doses not expected, though a risk of diarrhoea and fungal mucosal infection cannot be excluded.

Cefuroxime

Brand names: Zinnat (oral), Zinacef (IV)

Cefuroxime is a second-generation cephalosporin used in children for respiratory, urinary and other infections, and for surgical prophylaxis, available in oral and parenteral forms.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: 750 mg - 1.5 g

Route: Intravenous or intramuscular

Frequency: Every 8 hours

Structured per-kg paediatric dose not extracted because the SPC states weight-based ranges rather than a single clean per-kg dose. Paediatric dosing from the SPC (parenteral cefuroxime sodium, children <40 kg): infants and toddlers 3 weeks to children <40 kg 30 to 100 mg/kg/day (intravenously) given as 3 or 4 divided doses, with 60 mg/kg/day appropriate for most infections; infants birth to 3 weeks 30 to 100 mg/kg/day (intravenously) given as 2 or 3 divided doses. These paediatric figures cover community acquired pneumonia, complicated UTI including pyelonephritis, soft-tissue infections (cellulitis, erysipelas, wound infections) and intra-abdominal infections. Children >=40 kg receive the adult dosage (750 mg to 1.5 g every 8 hours). Method: give IV over 3-5 minutes directly into a vein or via drip tube, or by deep IM injection (no more than 750 mg per IM site). In paediatric renal insufficiency modify dosing frequency consistent with adult recommendations. Verify all paediatric dosing against a children's formulary before administration.

Dose adjustments

Renal

Cefuroxime is primarily excreted by the kidneys; reduce dosage in markedly impaired renal function. SPC (adults): creatinine clearance >20 mL/min/1.73m2 no reduction of standard dose; 10-20 mL/min/1.73m2 750 mg twice daily; <10 mL/min/1.73m2 750 mg once daily; haemodialysis a further 750 mg at the end of each dialysis. In paediatric patients with renal insufficiency modify the dosing frequency consistent with the adult recommendations.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to cefuroxime or to any of the cephalosporins
Previous immediate and/or severe hypersensitivity (e.g. anaphylactic reaction) to any other type of beta-lactam antibacterial agent (penicillins, monobactams and carbapenems)

Side effects

Neutropenia, eosinophilia, decreased haemoglobin concentration
Gastrointestinal disturbance
Transient rise in liver enzymes or bilirubin
Skin rash, urticaria and pruritus
Injection site reactions including pain and thrombophlebitis

Clinical monograph

How it works

It inhibits bacterial cell-wall synthesis by binding penicillin-binding proteins, with useful activity against many Gram-positive and Gram-negative organisms and stability against some beta-lactamases.

Prescribing in practice

Check for penicillin or cephalosporin hypersensitivity before prescribing, as cross-reactivity can cause serious allergic reactions.
Dose by weight using a children's formulary, with adjustment in renal impairment, and take the oral form with food to improve absorption.
As with other broad-spectrum antibiotics, there is a risk of antibiotic-associated diarrhoea including Clostridioides difficile.

Monitoring

Monitor clinical response and watch for allergic reactions or persistent diarrhoea during treatment.

Counselling the patient

Give the oral medicine with food and complete the full course.
Report any rash, facial swelling or difficulty breathing straight away.
Mention any previous reaction to penicillins or cephalosporins.

Evidence & guidelines

Cefuroxime is an established cephalosporin used across a range of paediatric infections and surgical prophylaxis in UK practice.

Reference: NICE NG143; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways