Indication and Dosage of Cefuroxime plus Clavulanic acid

Cefuroxime is a 2nd generation cephalosporin group of broad-spectrum β-lactam antibiotic.

Clavulanic acid is a beta lactamase inhibitor used to enhance the effectiveness of beta lactam antibiotics.

Cefuroxime and Clavulanic Acid: A combination of cefuroxime and ß -lactamase inhibitor (Clavulanic acid) for the treatment of various bacterial infections.

EXECUTIVE SUMMARY
Drug Name	Cefuroxime+ Clavulanic Acid
Mechanism of Action	CEFUROXIME: Bactericidal action due to inhibition of cell-wall synthesis. Clavulanic Acid: Enzyme inhibitor that enhances the antibacterial activity
Indication	CEFUROXIME-CLAVULANATE is indicated for the treatment of patients with mild to moderate infections caused by susceptible strains of the designated microorganisms in the conditions listed below: Pharyngitis/tonsillitis Acute bacterial otitis media Acute bacterial maxillary sinusitis Acute bacterial exacerbations of chronic bronchitis and secondary bacterial infections of acute bronchitis Uncomplicated skin and skin-structure infections Uncomplicated urinary tract infections Uncomplicated gonorrhea (urethral and endocervical) Early lyme disease (erythema migrans)
Form	Tablets (Cefuroxime/Clavulanic Acid) : 500/125mg 250/62.5mg, 125/31.25mg Dry Syrup(Cefuroxime/Clavulanic Acid) : 125/31.25mg

TABLE 1: Indications & dosage for CEFUROXIME-CLAV tablets (May be administered without regard to meals.)

Population/Infection	Dosage	Duration (days)
Adolescents and Adults (13 years and older)
Pharyngitis/tonsillitis	250 mg b.i.d.	10
Acute bacterial maxillary sinusitis	250 mg b.i.d.	10
Acute bacterial exacerbations of chronic bronchitis	250 or 500 mg b.i.d.	10
Secondary bacterial infections of acute bronchitis	250 or 500 mg b.i.d.	05-10
Uncomplicated skin and skin-structure infections	250 or 500 mg b.i.d.	10
Uncomplicated urinary tract infections	250 mg b.i.d.	07-10
Uncomplicated gonorrhea	1,000 mg once	single dose
Early Lyme disease	500 mg b.i.d.	20
Pediatric Patients (who can swallow tablets whole)
Acute otitis media	250 mg b.i.d.	10
Acute bacterial maxillary sinusitis	250 mg b.i.d.	10

Available Brand

CEFUROXIME-CLAV Suspension: Suspension may be administered to pediatric patients ranging in age from 3 months to 12 years, according to dosages in Table 2.

TABLE 2: Indications & dosage for CEFUROXIME-CLAVULANATE Oral Suspension (Must be administered with food. Shake well each time before using.)

Population/Infection	Dosage	Daily Maximum Dose	Duration (days)
Pediatric Patients (3 months to 12 years)
Pharyngitis/tonsillitis	20 mg/kg/day divided b.i.d.	500 mg	10
Acute otitis media	30 mg/kg/day divided b.i.d.	1,000 mg	10
Acute bacterial maxillary sinusitis	30 mg/kg/day divided b.i.d.	1,000 mg	10
Impetigo	30 mg/kg/day divided b.i.d.	1,000 mg	10

Key Points:

Cefuroxime is generally well tolerated and side effects are usually transient.

Unlike other second generation cephalosporins cefuroxime can cross the blood-brain-barrier.

Cefuroxime "follow-on" therapy produces clinical and bacteriological efficacy equivalent to that of amoxicillin/clavulanic acid, with the advantage of twice daily oral administration.

Most active cephalosporin for beta-lactamase-producing Haemophilus influenzae, organism that causes respiratory tract infections such as otitis media, bronchitis and sinusitis

Cefuroxime serum levels may be increased if taken with food or dairy products (from 37% to 52%)