Posology : מינונים

4.2    Posology and method of administration
Posology
Table 1. Adults and children ≥ 40 kg

Indication                                                Dosage
Community acquired pneumonia and acute                    750 mg every 8 hours exacerbations of chronic bronchitis                       (intravenously or intramuscularly) Soft-tissue infections: cellulitis, erysipelas and wound infections.
Intra-abdominal infections

Sinusitis, septic arthritis                          750 mg every 8 hours (intravenously or intramuscularly). For more severe infections, this dose should be increased to 1.5 g every 8 hours i.v. The frequency of i.m. or i.v. injections can be increased to six-hourly if necessary, giving total doses of
3 g to 6 g daily. Where clinically indicated, some infections respond to 750 mg or 1.5 g twice daily (i.v. or i.m.)
Complicated urinary tract infections, including      1.5 g every 8 hours (intravenously or intramuscularly) pyelonephritis
Severe infections                                    750 mg every 6 hours (intravenously) 1.5 g every 8 hours (intravenously)
Surgical prophylaxis for gastrointestinal,           1.5 g with the induction of anaesthesia. This may be gynaecological surgery (including caesarean          supplemented with two 750 mg doses (intramuscularly) section) and orthopaedic operations                  after 8 hours and 16 hours Surgical prophylaxis for cardiovascular and          1.5 g with induction of anaesthesia followed by 750 mg oesophageal operations                               (intramuscularly) every 8 hours for a further 24 hours 
Table 2. Children < 40 kg

Infants and toddlers > 3 weeks          Infants (birth to 3 weeks) and children < 40 kg
Community acquired pneumonia            30 to 100 mg/kg/day                     30 to 100 mg/kg/day Complicated urinary tract infections,   (intravenously) given as 3 or 4         (intravenously) given as 2 or 3 including pyelonephritis                divided doses; a dose of 60             divided doses (see section 5.2) Soft-tissue infections: cellulitis,     mg/kg/day is appropriate for most erysipelas and wound infections         infections
Intra-abdominal infections
Sinusitis, septic arthritis             Doses of 30 to 100 mg/kg/day            Doses of 30 to 100 mg/kg/day given as three or four divided          given as two or three divided doses. A dose of 60mg/kg/day is         doses.
appropriate for most infections.

Renal impairment
Cefuroxime is primarily excreted by the kidneys. Therefore, as with all such antibiotics, in patients with markedly impaired renal function it is recommended that the dosage of Cefuroxime - Vit should be reduced to compensate for its slower excretion.

Table 3. Recommended doses for Cefuroxime - Vit in renal impairment

Creatinine clearance              T1/2 (hrs)                             Dose (mg) > 20 mL/min/1.73 m2                  1.7–2.6            It is not necessary to reduce the standard dose (750 mg to 1.5 g three times daily).


10-20 mL/min/1.73 m2                 4.3–6.5            750 mg twice daily 
< 10 mL/min/1.73 m2                  14.8–22.3          750 mg once daily 


Patients on haemodialysis         3.75                  A further 750 mg dose should be given intravenously or intramuscularly at the end of each dialysis; in addition to parenteral use, cefuroxime sodium can be incorporated into the peritoneal dialysis fluid
(usually 250 mg for every 2 litres of dialysis fluid).


Patients in renal failure on      7.9–12.6              750 mg twice daily; for low-flux haemofiltration continuous arteriovenous          (CAVH)                follow the dosage recommended under impaired renal haemodialysis (CAVH) or high-     1.6 (HF)              function.
flux haemofiltration (HF) in intensive therapy units

Hepatic impairment
Cefuroxime is primarily eliminated by the kidney. In patients with hepatic dysfunction this is not expected to affect the pharmacokinetics of cefuroxime.

Method of administration
Cefuroxime – Vit should be administered by intravenous injection over a period of 3 to 5 minutes directly into a vein or via a drip tube or infusion over 30 to 60 minutes, or by deep intramuscular injection.

Intramuscular injections should be injected well within the bulk of a relatively large muscle and not more than 750 mg should be injected at one site. For doses greater than 1.5 g intravenous administration should be used.

For instructions on reconstitution of the medicinal product before administration, see section 6.6.