Posology : מינונים

4.2       Posology and method of administration
Posology

Table 1. Adults and children  40 kg

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

Sinusitis, septic arthritis                       750 mg every 8 hours (intravenously or intramuscularly). For more severe infections, this dose should be increased to 1.5g 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 3g to 6g 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,             1.5 g every 8 hours (intravenously including pyelonephritis                          or intramuscularly) 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 gynaecological surgery (including caesarean       may be supplemented with two 750 mg section) and orthopaedic operations               doses (intramuscularly) after 8 hours and 16 hours
Surgical prophylaxis for cardiovascular and       1.5 g with induction of anaesthesia followed oesophageal operations                            by 750 mg (intramuscularly) every 8 hours for a further 24 hours


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

Sinusitis, septic arthritis             Doses of 30 to 100             Doses of 30 to 100 mg/kg/day given as three or    mg/kg/day given as two four divided doses. A dose     or three divided doses.
of 60 mg/kg/day is 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 Medo 750 mg should be reduced to compensate for its slower excretion.

Table 3. Recommended doses for Cefuroxime Medo 750 mg 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 continuous arteriovenous         (CAVH)            haemofiltration follow the dosage haemodialysis (CAVH) or high-    1.6 (HF)          recommended under impaired renal flux haemofiltration (HF) in                       function.
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 Medo 750 mg 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.