Drugs List

Therapeutic Indications

Uses

Prophylaxis of infection following cataract surgery

Prophylaxis of postoperative endophthalmitis after cataract surgery.

Administration

Intra-ocular injection in the anterior chamber of the eye (intra-cameral) at the end of the cataract surgery.

Contraindications

Children under 18 years

Precautions and Warnings

Consult national/regional policy on the use of anti-infectives
Discard any unused portion
Do not use if solution is discoloured or particulates are apparent

In patients at risk of infections with resistant strains, alternative prophylactic antibiotic should be considered.

Corneal endothelial toxicity has not been reported at the recommended concentration of cefuroxime, however, the risk cannot be excluded and in the post-surgical surveillance, physicians should have in mind this potential risk.

Pregnancy and Lactation

Pregnancy

Cefuroxime used via the intra-cameral route is considered safe for use during pregnancy.

The manufacturer advises that no effects during pregnancy are expected since systemic exposure through intra-cameral use is negligible. Cefuroxime does reach the embryo/foetus via the placenta. At the time of writing, there are limited data from the use of cefuroxime sodium in pregnant women. Animal studies have not shown harmful effects on embryonal and fetal development.

Briggs (2015), suggests there is no teratogenic risk with the use of cefuroxime in pregnancy. Schaefer (2015), suggests that well established cephalosporins such as cefuroxime are the antibiotics of choice in pregnancy.

Lactation

Cefuroxime used via the intra-cameral route is considered safe for use during breastfeeding.

The manufacturer advises that cefuroxime can be used during breastfeeding. Adverse effects at therapeutic doses are not expected after intra-cameral use. Cefuroxime is expected to be excreted in human milk in very small amounts. Schaefer (2015), suggests that well established cephalosporins such as cefuroxime are the antibiotics of choice in breastfeeding.

Side Effects

Anaphylactic reaction
Macular oedema

Presentation

Intra-ocular injections of cefuroxime as cefuroxime sodium.

Drugs List

Therapeutic Indications

Uses

Prophylaxis of infection following cataract surgery

Prophylaxis of postoperative endophthalmitis after cataract surgery.

Dosage

Adults

Administration

Intra-ocular injection in the anterior chamber of the eye (intra-cameral) at the end of the cataract surgery.

Contraindications

Children under 18 years

Precautions and Warnings

Consult national/regional policy on the use of anti-infectives
Discard any unused portion
Do not use if solution is discoloured or particulates are apparent

In patients at risk of infections with resistant strains, alternative prophylactic antibiotic should be considered.

Corneal endothelial toxicity has not been reported at the recommended concentration of cefuroxime, however, the risk cannot be excluded and in the post-surgical surveillance, physicians should have in mind this potential risk.

Pregnancy and Lactation

Pregnancy

Cefuroxime used via the intra-cameral route is considered safe for use during pregnancy.

The manufacturer advises that no effects during pregnancy are expected since systemic exposure through intra-cameral use is negligible. Cefuroxime does reach the embryo/foetus via the placenta. At the time of writing, there are limited data from the use of cefuroxime sodium in pregnant women. Animal studies have not shown harmful effects on embryonal and fetal development.

Briggs (2015), suggests there is no teratogenic risk with the use of cefuroxime in pregnancy. Schaefer (2015), suggests that well established cephalosporins such as cefuroxime are the antibiotics of choice in pregnancy.

Lactation

Cefuroxime used via the intra-cameral route is considered safe for use during breastfeeding.

The manufacturer advises that cefuroxime can be used during breastfeeding. Adverse effects at therapeutic doses are not expected after intra-cameral use. Cefuroxime is expected to be excreted in human milk in very small amounts. Schaefer (2015), suggests that well established cephalosporins such as cefuroxime are the antibiotics of choice in breastfeeding.

Side Effects

Anaphylactic reaction
Macular oedema

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: May 2017

Reference Sources

Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 10th edition (2015) ed. Briggs, G., Freeman, R. Wolters Kluwer Health, Philadelphia.

Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 3rd edition (2015) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.

Summary of Product Characteristics: Aprokam 50 mg powder for solution for injection. Spectrum Thea Pharmaceuticals Ltd. Revised September 2016.

Summary of Product Characteristics: Ximaract 50 mg powder for solution for injection. Bausch and Lomb UK Ltd. Revised September 2021.

NICE Evidence Services Available at: www.nice.org.uk Last accessed: 03 August 2022