Cefuroxime ============ **PD Dialyzability**: Likely Pharmacokinetic Parameters [1]_ [2]_ -------------------------------------- ======= ====== ======= /////// |pk| |pk8| ======= ====== ======= |pk1| |v1| |v8| |pk2| |v2| |v9| |pk3| |v3| |v10| |pk4| |v4| |v11| |pk5| |v5| |v12| |pk6| |v6| |v13| |pk7| |v7| |v14| ======= ====== ======= CAPD Dosing: [3]_ [4]_ [5]_ ---------------------------- * PO Dosing: Cefuroxime axetil 250-500mg PO Q12H * IV/IM Dosing: Cefuroxime sodium 0.75-1.5g IV/IM Q8H CCPD Dosing: --------------------- * No literature identified. Extrapolate dosing from CAPD dosing recommendations. Indication Specific PD Dosing: -------------------------------- * Peritonitis [6]_ * Intermittent Dosing: Cefuroxime 400mg PO/IV daily * Continuous Dosing: Cefuroxime 200mg/L exchange IP (LD), then 100-200mg/L exchange IP * Surgical Prophylaxis: Cefuroxime 1.5g IV (2) +/- 250mg IP (7,8) 30 minutes – 1 hours preoperatively * Exit-site/Tunnel Infection: Cefuroxime 2.25g PO initially, then 750mg PO Q12H x 4 weeks (Exit-site) or 6 weeks (Exit site + tunnel infection) Literature Summary: ---------------------- +--------+----------+--------------+------------+-------------------+ | Title | Patient | Intervention | Outcome | Note | +========+==========+==============+============+===================+ | |L1| | - |L2| | |L3| | - |L4| | - |L5| | | [9]_ | - |L6| | | - |L7| | | | | | | - |L8| | | +--------+----------+--------------+------------+-------------------+ | |L9| | - |L10| | - |L11| | - |L12| | - |L13| | | [10]_ | - |L14| | - |L18| | - |L15| | | | | - |L16| | | | | | | - |L17| | | | | +--------+----------+--------------+------------+-------------------+ References ------------ .. [1] Wishart DS, Knox C, Guo AC, Shrivastava S, Hassanali M, Stothard P, et al. DrugBank: a comprehensive resource for in silico drug discovery and exploration. Nucleic Acids Res. 2006 Jan 1;34(suppl_1):D668–72. .. [2] American Pharmacist Association. Drug information handbook: a comprehensive resource for all clinicians and healthcare professionals [Internet]. Hudson, Ohio: American Pharmacist association; 2012 [cited 2018 Jan 24]. Available from: http://online.lexi.com.login.ezproxy.library.ualberta.ca/lco/action/home?siteid=1 .. [3] Gilbert B, Robbins P, Livornese LL. Use of Antibacterial Agents in Renal Failure. Med Clin North Am. 2011;95:677–702. .. [4] Aronoff GR. Drug prescribing in renal failure: dosing guidelines for adults and children. 5th ed. Philadelphia, PA: American College of Physicians; 2007. .. [5] Adjusting oral antibiotics to estimated creatinine clearance [Internet]. [cited 2018 Jan 24]. Available from: http://www.vhpharmsci.com/VHFormulary/Tools/ADJUSTING%20ORAL%20ANTIBIOTICS.pdf .. [6] Keane WF, Bailie GR, Boeschoten E, Gokal R, Golper T a, Holmes CJ, et al. ISPD Guidelines/Recommendations: Adult peritoneal dialysis-related peritonitis treatment recommendations: 2000 Update. Perit Dial Int. 2000;20(May):396–411. .. [7] Gokal R, Alexander S, Ash S, Chen TW, Danielson A, Holmes C, et al. Peritoneal catheters and exit-site practices toward optimum peritoneal access: 1998 Update. Perit Dial Int. 1998;18:11–33. .. [8] Wikdahl AM, Engman U, Stegmayr BG, Sörenssen JG. One-dose cefuroxime i.v. and i.p. reduces microbial growth in PD patients after catheter insertion. Nephrol Dial Transpl. 1997;12(1):157–160. .. [9] Schiffl H, Mücke C, Lang SM. Exit-site infections by non-diphtheria corynebacteria in CAPD. Perit Dial Int J Int Soc Perit Dial. 2004;24(5):454–9. .. [10] Velioglu A, Asicioglu E, Ari E, Arikan H, Tuglular S, Ozener C. Prevention of peritonitis in newly-placed peritoneal dialysis catheters: efficacy of oral prophylaxis with cefuroxime axetil - a preliminary study. Minerva Urol E Nefrol Ital J Urol Nephrol. 2016 Feb;68(1):27–31. .. |pk| replace:: Cefuroxime axetil .. |pk1| replace:: Molecular Weight (Da) .. |pk2| replace:: Plasma Protein Binding (%) .. |pk3| replace:: Volume of Distribution (L/Kg) .. |pk4| replace:: Hepatic Metabolism .. |pk5| replace:: Excreted Unchanged (%) .. |pk6| replace:: Half-Life; Normal Renal Function (hours) .. |pk7| replace:: Half-Life; ESRD (hours) .. |v1| replace:: 510.48 .. |v2| replace:: 30-50 .. |v3| replace:: 0.13-1.8 .. |v4| replace:: Partial metabolism in the liver. Axetil moiety is metabolized to acetic acid and acetaldehyde .. |v5| replace:: 90 .. |v6| replace:: 1.2 .. |v7| replace:: 17 .. |L1| replace:: Exit-site infections by non-diphtheria corynebacteria in CAPD. .. |L2| replace:: CAPD .. |L3| replace:: Cefuroxime 2.25g initially, then 0.75g Q12H PO .. |L4| replace:: Exit site appearance .. |L5| replace:: No ADR noted .. |L6| replace:: 3 Patients with exit-site/tunnel *Corynebacteria* infection .. |L7| replace:: Ultrasound examination .. |L8| replace:: Follow up exit-site culture. .. |L9| replace:: Prevention of peritonitis in newly placed peritoneal dialysis catheters: efficacy of oral prophylaxis with cefuroxime axetil- a preliminary study. .. |L10| replace:: CAPD .. |L11| replace:: Cefuroxime axetil 750mg IV 30 minutes before catheter placement. .. |L12| replace:: Emergence of peritonitis within 14 days of catheter placement. .. |L13| replace:: Abstract only .. |L14| replace:: 67 patients (32 female) .. |L15| replace:: 3 patients from IV group and 3 patients from PO group experienced peritonitis infection. .. |L16| replace:: Mean age 46 years old .. |L17| replace:: Undergoing percutaneous PD placement procedure .. |L18| replace:: Cefuroxime 500mg PO 1 hour before catheter placement, then 500mg PO BID x 3 days .. |pk8| replace:: Cefuroxime sodium .. |v8| replace:: 446.37 .. |v9| replace:: 33 .. |v10| replace:: 0.13-1.8 .. |v11| replace:: Partial metabolism in the liver .. |v12| replace:: 90 .. |v13| replace:: 1.2 .. |v14| replace:: 17