Antibiotic (2nd Generation Cephalosporin) Pregnancy: Limited data in pregnant women; animal studies show no reproductive toxicity. Should be prescribed to pregnant women only if benefit outweighs risk. Crosses the placenta. Excreted in breast milk in small quantities.

Cefuroxime

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

Cefuroxime is a second-generation cephalosporin available in intravenous and oral forms, used for respiratory, urinary, skin, and soft-tissue infections and widely as surgical antibiotic prophylaxis.

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 to 1.5 g

Route: intravenous or intramuscular injection

Frequency: every 8 hours

Dose depends on indication (parenteral cefuroxime sodium, adults/children >=40 kg): community-acquired pneumonia and acute exacerbations of chronic bronchitis 750 mg every 8 h; soft-tissue infections (cellulitis, erysipelas, wound infections), intra-abdominal infections, complicated UTI including pyelonephritis 1.5 g every 8 h; severe infections 750 mg every 6 h IV or 1.5 g every 8 h IV. Surgical prophylaxis (GI, gynaecological incl. caesarean, orthopaedic): 1.5 g at induction of anaesthesia, optionally supplemented by two 750 mg IM doses after 8 h and 16 h; cardiovascular/oesophageal operations: 1.5 g at induction then 750 mg IM every 8 h for a further 24 h. Method: IV over 3-5 min or deep IM (max 750 mg per IM site); doses >1.5 g must be given IV. PAEDIATRIC (children <40 kg, per source): 30-100 mg/kg/day IV in 3-4 divided doses (60 mg/kg/day appropriate for most infections); infants birth to 3 weeks 30-100 mg/kg/day IV in 2-3 divided doses. Verify paediatric dosing against a children's formulary.

Dose adjustments

Renal

Reduce dose in markedly impaired renal function. CrCl >20 mL/min/1.73m2: no reduction of standard dose (750 mg-1.5 g three times daily). CrCl 10-20 mL/min/1.73m2: 750 mg twice daily. CrCl <10 mL/min/1.73m2: 750 mg once daily. Haemodialysis: a further 750 mg IV/IM at the end of each dialysis (peritoneal dialysis: 250 mg per 2 L dialysis fluid). CAVH/high-flux haemofiltration: 750 mg twice daily.

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 (penicillins, monobactams and carbapenems)

Side effects

Neutropenia, eosinophilia
Transient rise in liver enzymes or bilirubin
Injection site reactions (pain, thrombophlebitis)
Skin rash, urticaria and pruritus
Gastrointestinal disturbance; Candida overgrowth; pseudomembranous colitis (uncommon)

Interactions

Potent diuretics (e.g. furosemide) — cephalosporins at high dosage should be given with caution; renal impairment reported
Aminoglycosides — caution with concurrent use; renal impairment reported; do not mix in the same solution

Clinical monograph

How it works

It inhibits bacterial cell wall synthesis by binding penicillin-binding proteins and has useful stability against some beta-lactamases.

Prescribing in practice

Avoid in patients with a history of severe or anaphylactic reaction to penicillins or cephalosporins because of cross-reactivity risk.
When used for surgical prophylaxis it should be given so that adequate tissue concentrations are present at the time of incision, with re-dosing for prolonged procedures or major blood loss.
Adjust dosing in renal impairment, and be alert to antibiotic-associated diarrhoea and Clostridioides difficile infection.

Monitoring

Monitor for hypersensitivity, clinical response, renal function where relevant, and signs of antibiotic-associated diarrhoea.

Counselling the patient

Take the oral tablets with food to improve absorption and complete the prescribed course.
Report any rash, swelling, or breathing difficulty straight away.
Tell your doctor if you develop severe or persistent diarrhoea.

Evidence & guidelines

Cefuroxime is an established cephalosporin with well-documented efficacy in common infections and as surgical prophylaxis in NICE and stewardship guidance.

Reference: WHO Surgical Site Infection Prevention Guidelines; 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