Cefuroxime

Cefuroxime

Cefuroxime is an antibiotic used to treat many different types of bacterial infections in children. You might see a brand name such as Ceftin on the label. It belongs to the cephalosporin family of antibiotics (“cousins” to the penicillins). This antibiotic comes as tutti-frutti flavored liquid or as tablets. According to the manufacturer, only 5 percent of children complain about the taste of the liquid. Those who can swallow the tablets generally have no taste complaints; crushed tablets, though, taste very bitter.

If a child switches from liquid to tablets or vice versa, the milligram doses may be different: the two forms are not equivalent to each other.

Cefuroxime tablets may be taken with or without food. However, cefuroxime liquid should be taken with food. Liquid cefuroxime should be shaken before giving each dose. To get the correct dose, skip the silverware spoon and use a measuring spoon or dose-measuring device (ask your pharmacist for one if you don’t have one). It must be stored in a refrigerator. Discard any unused cefuroxime 10 days after it was first prepared by the pharmacist.

Cefuroxime is a recommended first antibiotic for some children with ear infections who are allergic to amoxicillin. It is given twice a day. If you happen to miss a dose, you can go ahead and give it late, but try not to give doses within about four hours of each other. If you happen to give too much at once (more than two doses), seek medical advice.

If your child is taking cefuroxime for an ear infection, you should expect improvement within 48 to 72 hours. If not, contact your doctor to discuss switching to another antibiotic, such ceftriaxone or clindamycin.

Do Not use cefuroxime if your child is known to be allergic to this or to any of the cephalosporin antibiotics, such as cephalexin, cefdinir, cefpodixime, or ceftriaxone. Other antibiotic options might include azithromycin, clarithromycin, or clindamycin. Be sure the prescribing doctor knows if your child has any other medication allergies (especially to penicillins), or has kidney disease, liver disease, intestinal problems, or diabetes. Be sure to report any other medicines your child might be taking.

Diarrhea is a common side effect of antibiotics. Whenever antibiotics are given, consider also giving your child probiotics (beneficial bacteria). Out of ten well-designed studies, nine showed significantly less diarrhea in the children receiving probiotics (the studies used between 5 and 40 billion cfu per day). Probiotics are available as supplements or in some foods and beverages (yogurt, kefir, juice). Whatever you choose, look for at least 5 billion colonies.

Get emergency care if your child is showing signs of a serious allergic reaction, such as difficulty breathing, spreading hives, or swelling of the lips, tongue, or throat.

Other side effects are possible with this or any medication. Be sure to report unexpected new symptoms to your healthcare provider. Whether they are caused by the antibiotic or by the illness getting worse, unexpected symptoms are important to report.

AAP Clinical Practice Guideline. Diagnosis and management of acute otitis media. Pediatrics, May 2004, 113(5):1451-1465.

Johnston BC, Supina AL, Ospina M, Vohra S. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database of Systematic Reviews 2007, Issue 2. Art. No.: CD004827. DOI: 10.1002/14651858.CD004827.pub2.

Dr. Greene is a practicing physician, author, national and international TEDx speaker, and global health advocate. He is a graduate of Princeton University and University of California San Francisco.

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