Zicef Special Precautions

Before cefuroxime sodium for injection therapy is started, careful inquiry should be made concerning previous hypersensitivity reactions to cephalosporins, penicillins or other medicines. Cefuroxime should be given cautiously to penicillin-sensitive patients. Care should be taken with patients who have experienced an anaphylactic reaction to penicillin.
Cefuroxime does not interfere with enzyme-based tests for glucosuria. Slight interference with copper reduction methods (Benedict's, Fehling's, Clinitest) have been observed. However this should not lead to false-positive results. It is recommended that either the glucose oxidase or hexokinase methods be used to determine blood/plasma glucose levels in patients treated with cefuroxime. In the ferricyanide test, cefuroxime may cause false-negative reactions. Some cephalosporins can cause a falsely high reading in the alkaline picrate assay for creatinine, although the degree of elevation is unlikely to be of clinical importance. It is possible that cefuroxime may also interfere with this determination. Prolonged use may result in the growth of non-susceptible organisms. Patients developing frequent loose stools should be carefully monitored for the possible development of pseudomembranous colitis.
When possible, concomitant use of furosemide and cefuroxime should be avoided. If used together renal function should be monitored closely, since furosemide may enhance the nephrotoxic potential of the cephalosporins.
The combined use of cephalosporins and aminoglycosides seems to increase the risk of nephrotoxicity, and should be undertaken with caution and with close monitoring of renal function.