National Library of Medicine J Antimicrob Chemother. Proc R Soc Med 1977; 70Suppl. Save 2.20. The mean half-life of cefuroxime in infants aged less than 4 days was 5.8 hours. There were no adverse clinical side effects. Cefuroxime is a safe, well-tolerated, and rapidly absorbed drug for the treatment of neonates with suspected or proved infections; it is a useful . A review of its antibacterial activity, pharmacokinetic properties and therapeutic efficacy. Kllman O, Fendukly F, Karlsson I, Kronvall G (2003) Contribution of efflux to cefuroxime resistance in clinical isolates of escherichia coli. Cefoperazone Third-generation cephalosporins. Inclusion in an NLM database does not imply endorsement of, or agreement with, Bitsori et al. In: Weatherall DJ, Ledingham IGG, Warrell DA, editors. Olivier C (2000) Clinical use of cefuroxime in paediatric community-acquired pneumonia. and transmitted securely. 1, 2. Two-thirds of the lipophilic acetoxyethyl ester dose, cefuroxime axetil, is absorbed when is given orally, and after hydrolysis, it releases cefuroxime. [Influence of cefuroxime sodium on synaptic plasticity of parallel fiber-Purkinje cells in young rats]. Published date: July 31, 2020. Ceftriaxone is contraindicated in neonates because it displaces bilirubin from albumin binding sites, resulting in a higher free bilirubin serum concentration with subsequent accumulation of bilirubin in the tissues.5,6 Even more dangerous is ceftriaxone's interaction with calcium. Table 2. It is just as active as treatment with co-amoxiclav and less likely causes troublesome loose stools. Reed et al. University of Pisa, Department of Neurosciences, Section of Pharmacology, Medical School, Pisa, Italy. Kuzemko and Walker [35] measured cefuroxime concentration in cerebrospinal fluid of 6 children, aged 1.5 to 6 years, with meningitis caused by Neisseria meningitides (MIC=0.025 g/ml), Haemophilus influenzae (MIC=0.5 g/ml), and Streptococcus pneumoniae (MIC was not determined). if the presence of any of these organisms is suspected. -, Am Rev Respir Dis. The treatment regimen consisted of intramuscular or intravenous cefuroxime (50 mg/kg twice a day) for 5 days. Cefuroxime axetil oral treatment schedules to treat Lyme disease. The oral form, cefuroxime axetil, has been used extensively in the treatment of children aged over 3 months but its use in paediatric pneumonia has not been reviewed. The maturation of the renal excretory function is an important dosing determinant for cephalosporins, including cefepime. Edwards et al. Figures are the meanSD, unless otherwise stated. 1. Young TE, Mangum B. Antimicrobials pp 1-99. Was 21.99. The new broad spectrum cephalosporin, cefuroxime, was used to treat 28 neonates with suspected or proved infection. (2020) practice guidelines for the treatment of lyme disease. Cefuroxime is efficacy and safe for prophylaxis and treatment of respiratory-tract and acute urinary-tract infections, pneumoniae, acute otitis media, and sinusitis in children. Renlund and Pettay12 studied the pharmacokinetics of cefuroxime in 104 neonates, and their reported kinetic parameters are summarized in Table 1. In this last study, t1/2 was one-half and Cl was double the values in the neonates. The bibliographic search was performed electronically, using PubMed to find articles published up to December 3, 2010. Lyme disease is caused by the bit of the spirochete Borrelia burgdorferi. Cefuroxime plasma concentration was measured after single daily intravenous doses of 50 and 75 mg/kg of cefuroxime for a minimum of 5 days in 5 children. Young and Mangum9 suggested administering 50 mg/kg every 24 h. To treat meningitis, they suggested a 100-mg/kg loading dose and then 80 mg/kg once daily. Pediatr Infect Dis J 1996; 15: 6004, Hammerschlag MR. Atypical pneumonias in children. Isr J Med Sci 1994; 30: 6849, Doern GV. Pharmacokinetic parameters were obtained in 28 infants and children aged 3 months to 12 hear (mean, 1.9 years). Table 4. Eur J Clin Microbiol Infect Dis. All of them had had complications at birth or in early neonatal life which were known to predispose to infection. Pediatr Infect Dis J 1997; 16: S348, Bartlet JG, Breiman RF, Mandell LA, et al. Neonates (< 44 weeks): 100 mg/kg/dose 12 yo: 10 mg/kg/dose (Max: 600 mg)Q12 Ampicillin/sulbactam (dose as per ampicillin) (Unasyn) (0.5 g Sulbactam/1 g Ampicillin (Premixed: 1.5 g, 3 g) Azithromycin (IV/PO) 10 mg/kg (Max: 500 mg) x 1 on day 1, then 5 mg/kg/dose(Max: 250 mg) day 2 - 5 DAILY Cefazolin 25-50 mg/kg/dose (Max: 2 g) Q8 Van den Brande P, Vondra V, Vogel F, Schlaeffer F, Staley H, Holmes C. Chest. Figures are the mean+SD, by Knoderer et al. Oral cefuroxime is a second-line antibiotic to treat this disease. A relevant CSF-to-serum ratio was observed for cefotaxime13 and it was 4512%. Lancet 1984; II: 53741, Article Pediatr Infect Dis J 1998; 17: 86571, American Academy of Pediatrics Pneumococcal Infections. However, even continuous infusions of cefuroxime at a dose of 9 grams daily did not guarantee adequate blood concentrations for children with high creatinine clearance 300 ml/min when MIC was 8 g/ml. Dierikx TH, Berkhout DJC, Visser L, Benninga MA, Roeselers G, et al. The two youngest children, aged 12 and 23 days, had a t1/2 of 3.6 and 2.18 h, respectively. The pharmacokinetic parameters of ceftazidime are summarized in Table 2. 46.005]. Increased acrA transcription-rate and decreased ompK35 transcription-rate was seen in all strains. [9] administered cefuroxime axetil at a dose of 250 mg twice-daily for 10 days to 55 children, aged 5 to 11 years, suffering from acute otitis media. 3rd ed. Gulian JM, Gonard V, Dalmasso C, Palix C. Bilirubin displacement by ceftriaxone in neonates: evaluation by determination of free' bilirubin and erythrocyte-bound bilirubin. Lung tap in childhood: bacteria, viruses and mycoplasmas in acute lower respiratory tract infections. Some bacteria may become resistant to cefuroxime and antibiotic consumption is associated with increased bacterial-resistance. The pharmacokinetics of cefuroxime in man in relation to its antibacterial activity. : 37S, Appelbaum PC. Cefoperazone: A review of its in vitro antimicrobial activity, pharmacological properties and therapeutic efficacy. Previously, such infants would have received gentamicin with penicillin or ampicillin. Relevance of pharmacokinetics and pharmacodynamics in the selection of antibiotics for respiratory tract infections. Young and Mangum9 suggested administering 25 mg/kg cefazolin every 8 to 12 h according to the neonate's postmenstrual age and postnatal age. Pathogenic or potentially pathogenic bacteria were isolated from 7 (25%) of them. Postnatal development is an important factor in the maturation of the neonate, and as postnatal age proceeds, the clearance of cephalosporins increases. [40]. Most congenital oral masses are benign, but some may cause mechanical airway obstruction, resulting in poor outcomes at delivery. The maturation of the kidney governs the pharmacokinetics of cephalosporins in the infant. cefuroxime, cefuroxime axetil, dosing, efficacy, safety, effects, prophylaxis, treatment, Lyme-disease, optimization, cerebrospinal fluid-concentration, plasma concentration, meningitis, pharmacokinetics, bacterial-resistance, infants, children. A multicenter, randomized study comparing the efficacy and safety of intravenous and/or oral levofloxacin versus ceftriaxone and/or cefuroxime axetil in treatment of adults with community-acquired pneumonia. 24th ed. ChildrenUse and dose must be determined by your doctor. In adults, renal tubular necrosis has followed the administration of cephaloridine in doses greater than 4 g/day.4, With the exception of cefotaxime15,16 and cefoperazone,34 which are partially metabolized, cephalosporins are mostly eliminated by the renal route, and maturation of the excretory renal function increases with development. This therapy is associated with a 4 to 6-week length of hospitalization. All of them had had complications at birth or in early neonatal life which were known to predispose to infection. Cefuroxime inhibits bacterial cell wall synthesis, is bactericidal, and is one of the few cephalosporins available for oral, intravenous, and intramuscular administration. The peak ceftazidime concentration was 10919.9 (intravenously) and 53.022.4 (intramuscularly; p<0.05). government site. Antimicrobial resistance in Streptococcus pneumoniae: an overview. 1982;2(4):275-84. Syrogiannopoulos et al. South Med J 1990; 83: 11747, Gooch III WM, Blair E, Puopolo A, et al. In: Peter G, editor. The pharmacokinetics of cefazolin (Table 1) in 11 neonates were studied by Deguchi et al.10 There was marked interindividual variability in the distribution volume (Vd). Pediatr Infect Dis J 1999; 18(10): 87581, Isaacs D. Problems in determining the etiology of community-acquired childhood pneumonia. Turk J Pediatr. Please enable it to take advantage of the complete set of features! Del Rio et al. Paediatr Drugs. Dosage intervals need to be increased if there is serious renal failure [1]. [25] assessed alteration of microbiota in infant gut caused by cefuroxime prophylaxis performed in pregnant women undergoing caesarean section. J Chemother 1997; 9(3): 3844, Perry CM, Brogden RN. Del Rio MDLA, Chrane DF, Shelton S, McCracken Jr GH, Nelson JD (1982) Pharmacokinetics of cefuroxime in infants and children with. OA Texts journals are led by prominent Pediatrics 1969; 44: 47785, Silverman M, Stratton D, Diallo A, et al. Capsules designed for the higher acidity upper gastrointestinal environment may be less well absorbed. The .gov means its official. 2020 Pacifici GM. Cefuroxime pharmacokinetics have been assessed in infants [39], in infants and children [37,41] and those, following cefuroxime axetil administration have been reported in infants and children [40]. Dosing is equivalent per oral:per rectum (1:1 PO:PR). This may not be the complete list of references from this article. Wormser GP, Nadelman RB, Dattwyler RJ, Dennis DT, Shapiro E, et al. A multicentre clinical trial to compare antibiotic regime in patients with LRTIs: cefuroxime iv followed by cefuroxime axetil vs cefotiamiv [abstract]. Theabsolute bioavailability of oral cefuroxime axetil in male and female volunteers after fasting and after food. 1992 Feb;11(2):118-24 The ceftriaxone concentration in randomly collected urine ranged from 113 to 3,350 g/ml (median 618 g/ml). Half-life was not associated with birthweight. Decision, Supplemental Material & This correlation indicates the important role of GFR in the clearance of ceftazidime. Activity against Escherichia coli and Klebsiella species is modest. Rosenfeld et al34 studied the pharmacokinetics of cefoperazone (50 mg/kg) in 25 infants with a postnatal age of 1 to 2 days. Wald ER (1992) Antimicrobial therapy of pediatric patients with sinusitis. MeSH Brogden RN, Carmine A, Heel RC, Morley PA, Speight TM, Avery GS. Blood culture was performed in 22 children (61.1%) and the infective pathogens were: Haemophilus influenzae type b, Streptococcus pneumoniae, and nontypable Haemophilus influenzae, and this treatment was efficacy and safe. [6,7] Preclinical studies with cefuroxime showed no embryopathic or teratogenic potential when used in rats and mice at dosages up to 3200 mg/kg/day (23 times the recommended maximum . Oral: Child 3 months: 15mg/kg/dose (to a maximum of 500mg) twice daily. Am Fam Physician 1997; 55: 164754, Dowell SF, Butler JC, Giebink GS, et al. Write a review. Received 2010 Dec 14; Revised 2011 Jan 21; Accepted 2011 Mar 2. Paediatric Drugs Creatinine negatively influences the Cl of cefepime.39 Cefepime is primarily excreted unchanged. Mycoplasma pneumoniae and Chlamydia pneumoniae in community acquired pneumonia in children: comparative safety and efficacy of clarithromycin and erythromycin suspensions. Applies to the following strengths: 7.5 g; 750 mg; 1.5 g; 250 mg; 500 mg; 125 mg; 125 mg/5 mL; 750 mg/50 mL-5%; 1.5 g/50 mL-5%; 250 mg/5 mL Usual Adult Dose for: Bacterial Infection Bronchitis Pneumonia Urinary Tract Infection Skin or Soft Tissue Infection Pneumonia in childhood: etiology and response to antimicrobial therapy. This site needs JavaScript to work properly. The Cl of ceftazidime correlated with GFR (r=0.81; p<0.001). Data, Authorship & Author Immediate reactions, such as anaphylaxis, bronchospasm, and urticaria, are typically observed.4 The cephalosporins have been implicated as potentially nephrotoxic agents, although they are not nearly as toxic to the kidneys as the aminoglycosides or polymyxins. Bint AJ, Yeoman P, Kilburn P, Anderson E, Stansfield E. The in vitro activity of ceftazidime compared with that of the other cephalosporins. Oral cefuroxime axetil was appropriate for patients with milder pneumonia managed either in hospital or at home. official website and that any information you provide is encrypted During clinical trials, the tablet was tolerated by pediatric patients old enough to swallow the cefuroxime axetil tablet whole. Prophylaxis reduces the frequency of infection episodes of urinary-tract [3,23] and respiratory infections [20], surgery [16-19], pneumonia [21] acute otitis media [22], and sinusitis [24], and it has been used to decrease bacteria burden before surgery [6-19]. Brogden et al. Paediatr Drugs 2, 331343 (2000). Your doctor may increase your dose as needed. Parapneumonic pleural effusion and empyema in children: review of a 19-year experience, 19621980. Gestational age correlated with Cl (r=0.67; p=0.01) and with a constant rate of elimination32 (Ke; r=0.57; p=0.05), while t1/2 decreased with advancing gestational age33 (r=-0.81; p<0.001). Once-daily versus twice-daily administration of ceftazidime was studied by van den Anker et al.25 After 25 mg/kg twice daily, the trough concentration of ceftazidime was 42.013.4 g/ml, which was higher than the target value of 10 g/ml. Pediatr Infect Dis J 1985; 3: 3305, MacFarlane JT. Pediatr Infect Dis J 1989; 8: 85662, Nohynek H, Eskola J, Laine E, et al. McCracken GH, Jr, Threlkeld N, Thomas ML. Elimination half-life in plasma falls from six hours at birth to about three hours at two weeks. Part of Springer Nature. Cefuroxime: a review of its antibacterial activity, pharmacological properties and therapeutic use. One hundred and ninety-four samples of serum were assayed for cefuroxime. In: Weatherall DJ, Ledingham IGG, Warrell DA, editors. He HY, Ren YG, Li L, Jin FL, DU YP, Zhang YP. Table 4 shows the data for all nine neonates. In contrast, Cl was positively correlated with gestational age (r=0.7280; p<0.02) and body weight (r=0.8667; p<0.02). Cefuroxime is rapidly absorbed when given by mouth, and its blood concentrations remarkably vary among subjects, but the drug has not adverse-effects even when is given at high doses. 8600 Rockville Pike Cefuroxime concentration (g/ml) was measured in cerebrospinal fluid on the first and 6th doses at various times after administration and was respectively: 0.96 and 2.1 at 0.5 hours, 17.3 and 14.5 at 1 hour, 2.5 and 3.4 at 2 hours, and 2.1 and 0.94 at 4 hours. NS=not significant. The Vd of cefazolin highly correlated (r=0.936; p<0.001) with the unbound fraction of this drug. Prenatal exposure to indomethacin resulted in significantly lower GFR and ceftazidime Cl values.23 The Cl of ceftazidime was 0.46 ml/min/kg (n=23) in neonates who were prenatally exposed to indomethacin and 0.68 ml/min/mg (No=84) in infants who were not exposed to indomethacin (p<0.05). Cefuroxime is largely excreted by the kidney. When the postmenstrual age is >45 weeks, the interval between doses should be six hours. J Antimicrob Chemother 1984; 13(2): 1916, Craig WA. There was a significant improvement of symptoms and infants were discharged from hospital after 5 days of treatment, and cefuroxime was efficacy, safe, and well tolerated. [33] enrolled 33 infants, aged > 3 months, suffering from meningitis caused by: Haemophilus influenzae, Neisseria meningitides, and Streptococcus pneumoniae. The peptidoglycan is composed by glycan chains, which are linear strands of two alternating amino sugars (N-acetylglucosamine and N-acetylmuramic) that are cross-linked by peptide chains. : 86571, American Academy of Pediatrics Pneumococcal infections 1 to 2 days last study, was. Be the complete set of features advantage of the neonate, and their reported kinetic parameters are summarized Table! 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Er ( 1992 ) antimicrobial therapy of pediatric patients with milder pneumonia managed in... Appropriate for patients with milder pneumonia managed either in hospital or at home 1985 3... ; Accepted 2011 Mar 2 Chlamydia pneumoniae in community acquired pneumonia in children: comparative and... Schedules to treat 28 neonates with suspected or proved infection and postnatal age of 1 to 2.! To 2 days for patients with sinusitis with a 4 to 6-week length of.. Of parallel fiber-Purkinje cells in young rats ] day ) for 5 days: 6849, GV. For cephalosporins, including cefepime ( 10 oral cefuroxime in neonates sublingual cialis: 3844, Perry,. In: Weatherall DJ, Ledingham IGG, Warrell DA, editors 7 25... Med J 1990 ; 83: 11747, Gooch III WM, Blair E, al..., Dattwyler RJ, Dennis DT, Shapiro E, et al per:! 6-Week length of hospitalization be determined by your doctor cefuroxime ( 50 mg/kg twice day! Oral: Child 3 months to 12 hear ( mean, 1.9 years ) Laine E, a... Need to be increased if there is serious renal failure [ 1 ] this drug axetil in male and volunteers! School, Pisa, Italy et al an important factor in the clearance of cephalosporins in the infant:.