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ANTIINFECTIVES FOR SYSTEMIC USE › ANTIBACTERIALS FOR SYSTEMIC USE › COMBINATIONS OF ANTIBACTERIALS › Combinations of antibacterials
cefuroxime and metronidazole
J01RA03
Forms & Strengths
- Tablets: 250mg/500mg cefuroxime and 125mg metronidazole
- Injectable: 750mg/375mg cefuroxime and 500mg metronidazole per vial
- Capsules: 125mg/250mg cefuroxime and 62.5mg metronidazole
Adult Dosing
- 500mg to 1000mg of cefuroxime with 250mg to 500mg of metronidazole every 8 to 12 hours orally
- 1.5g of cefuroxime with 750mg of metronidazole IV every 8 hours
- Dosage adjustments for renal impairment may be necessary
Pediatric Dosing
- 50mg/kg/day of cefuroxime divided every 8 hours for children > 3 months
- 20-30mg/kg/day of metronidazole divided every 8 hours for children > 3 months
- Dosage adjustments for pediatric patients based on weight and renal function
Indications
- Treatment of complicated skin and skin structure infections
- Intra-abdominal infections
- Gynecologic infections
- Lower respiratory tract infections
Mechanism of Action
- Cefuroxime is a second-generation cephalosporin antibiotic that inhibits cell wall synthesis
- Metronidazole is a nitroimidazole antibiotic that disrupts DNA synthesis in bacteria
- Synergistic effect of combination against aerobic and anaerobic bacteria
Contraindications
- Hypersensitivity to cefuroxime or other cephalosporins
- Hypersensitivity to metronidazole or other nitroimidazoles
- First trimester of pregnancy
Adverse Reactions
- Gastrointestinal upset
- Diarrhea
- Rash
- Pruritus
- Hematologic effects
- Seizures and other CNS effects with high doses of metronidazole
Drug Interactions
- Concurrent use with oral anticoagulants may increase INR
- Metronidazole may potentiate lithium toxicity
- Cefuroxime may interact with certain antibiotics and decrease efficacy
- Interaction with alcohol may cause disulfiram-like reaction with metronidazole
Curated Content: Needs Vetting Before Put to Clinical Use