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Antibiotic (2nd Generation Cephalosporin) Pregnancy: B — safe

Cefuroxime

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

Adult dose

Dose: 750mg–1.5g IV/IM three times daily. Oral: 250–500mg twice daily
Route: IV, IM, or Oral
Frequency: Three times daily (IV) or twice daily (oral)
Surgical prophylaxis: 1.5g IV at induction. Duration: single dose unless contamination risk. Pneumonia: 750mg–1.5g TDS IV.

Clinical pearls

  • First-line surgical prophylaxis for many clean and clean-contaminated procedures
  • Give within 60 minutes of incision — not at ward (timing is critical for prophylaxis)
  • Add metronidazole for colorectal/bowel surgery (covers anaerobes)
  • Oral cefuroxime axetil — prodrug, must be taken with food for adequate absorption

Contraindications

  • Cephalosporin allergy
  • Severe penicillin allergy (cross-reactivity ~2%)

Side effects

  • GI upset
  • Rash
  • Injection site pain
  • Clostridium difficile
  • Positive Coombs test

Interactions

  • Aminoglycosides — synergistic but additive nephrotoxicity
  • Probenecid — increases cefuroxime levels
  • Warfarin — potentiates INR

Monitoring

  • Renal function (IV prolonged use)
  • Signs of superinfection

Reference: WHO Surgical Site Infection Prevention Guidelines; BNF. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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