Zinacef Dosage/Direction for Use





Zuellig Pharma
Full Prescribing Info
Dosage/Direction for Use
ZINACEF Injection for intravenous (i.v.) and/or intramuscular (i.m.) administration.
ZINACEF is also available as the axetil ester (ZINNAT) for oral administration. This permits the use of sequential therapy with the same antibiotic, when a change from parenteral to oral therapy is clinically indicated.
No more than 750 mg should be injected at one intramuscular site.
GENERAL DOSING RECOMMENDATIONS: Adults: Many infections will respond to 750 mg three times daily by i.m. or i.v. injection. For more severe infections, the dose should be increased to 1.5 g three times daily given i.v. The frequency of administration may be increased to 6-hourly if necessary, giving total daily doses of 3 to 6 g. Where clinically indicated, some infections respond to 750 mg or 1.5 g twice daily (i.v. or i.m.) followed by oral therapy with ZINNAT.
Infants and Children: 30 to 100 mg/kg/day given as 3 or 4 divided doses. A dose of 60 mg/kg/day is appropriate for most infections.
Neonates: 30 to 100 mg/kg/day given as 2 or 3 divided doses (see Pharmacology: Pharmacokinetics under Actions).
GONORRHOEA: Adults: 1.5 g as a single dose (as 2 x 750 mg injections given i.m. with different sites, e.g. each buttock).
MENINGITIS: ZINACEF is suitable for sole therapy of bacterial meningitis due to sensitive strains.
Adults: 3 g given i.v. every 8 hours.
Infants and Children: 150 to 250 mg/kg/day given i.v. in 3 or 4 divided doses.
Neonates: The dosage should be 100 mg/kg/day given i.v.
PROPHYLAXIS: The usual dose is 1.5 g given i.v. with induction of anaesthesia for abdominal, pelvic and orthopaedic operations. This may be supplemented with two 750 mg i.m. doses 8 and 16 hours later.
In cardiac, pulmonary, oesophageal and vascular operations, the usual dose is 1.5 g given i.v. with induction of anaesthesia, continuing with 750 mg given i.m. three times daily for a further 24 to 48 hours.
In total joint replacement, 1.5 g ZINACEF powder may be mixed dry with each pack of methyl methacrylate cement polymer before adding the liquid monomer.
SEQUENTIAL THERAPY: Adults: Duration of both parenteral and oral therapy is determined by the severity of the infection and the clinical status of the patient.
Pneumonia: 1.5 g ZINACEF twice daily (given i.v. or i.m.) for 48 to 72 hours, followed by 500 mg twice daily ZINNAT (cefuroxime axetil) oral therapy for 7 to 10 days.
Acute exacerbations of chronic bronchitis: 750 mg ZINACEF twice daily (given i.v. or i.m.) for 48 to 72 hours, followed by 500 mg twice daily ZINNAT (cefuroxime axetil) oral therapy for 5 to 10 days.
RENAL IMPAIRMENT: Cefuroxime is excreted by the kidneys. Therefore, as with all such antibiotics, in patients with markedly impaired renal function it is recommended that the dosage of ZINACEF should be reduced to compensate for its slower excretion.
It is not necessary to reduce the standard dose (750 mg to 1.5 g three times daily) until the creatinine clearance falls to 20 ml/min or below.
In adults with marked impairment (creatinine clearance 10 to 20 ml/min) 750 mg twice daily is recommended and with severe impairment (creatinine clearance <10 ml/min) 750 mg once daily is adequate.
For patients on haemodialysis a further 750 mg dose should be given i.v. or i.m. at the end of each dialysis. In addition to parenteral use, ZINACEF can be incorporated into the peritoneal dialysis fluid (usually 250 mg for every 2 litres of dialysis fluid).
For patients in renal failure on continuous arteriovenous haemodialysis or high-flux haemofiltration in intensive therapy units a suitable dosage is 750 mg twice daily. For low-flux haemofiltration follow the dosage recommended previously.
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