Zinacef Special Precautions

Special care is indicated in patients who have experienced an allergic reaction to penicillins or other beta-lactams.
As with other antibiotics, use of Cefuroxime axetil (Zinacef) may result in the overgrowth of Candida. Prolonged use may also result in the overgrowth of other non-susceptible organisms (e.g. enterococci and Clostridium difficile), which may require interruption of treatment.
Pseudomembranous colitis has been reported with the use of antibiotics and may range in severity from mild to life-threatening. Therefore, it is important to consider its diagnosis in patients who develop diarrhoea during or after antibiotic use. If prolonged or significant diarrhoea occurs or the patient experiences abdominal cramps, treatment should be discontinued immediately and the patient investigated further.
With a sequential therapy regimen the timing of change to oral therapy is determined by severity of the infection, clinical status of the patient and susceptibility of the pathogens involved. If there is no clinical improvement within 72 hours, then the parenteral course of treatment must be continued.
Refer to the relevant prescribing information for cefuroxime before initiating sequential therapy.
Tablet: The Jarisch-Herxheimer reaction has been seen following Cefuroxime axetil (Zinacef) treatment of Lyme disease. It results directly from the bactericidal activity of Cefuroxime axetil (Zinacef) on the causative organism of Lyme disease, the spirochaete Borrelia burgdorferi. Patients should be reassured that this is a common and usually self-limiting consequence of antibiotic treatment of Lyme disease.
Injection: Cephalosporin antibiotics at high dosage should be given with caution to patients receiving concurrent treatment with potent diuretics such as furosemide or aminoglycosides, as renal impairment has been reported with these combinations. Renal function should be monitored in these patients, the elderly, and those with pre-existing renal impairment (see Dosage & Administration).
As with other therapeutic regimens used in the treatment of meningitis, mild-to-moderate hearing loss has been reported in a few paediatric patients treated with Cefuroxime (as sodium) (Zinacef). Persistence of positive cerebral spinal fluid (CSF) cultures of Haemophilus influenzae at 18-36 hours has also been noted with Cefuroxime (as sodium) (Zinacef) injection, as well as with other antibiotic therapies; however, the clinical relevance of this is unknown.
Ability to perform tasks that require judgement, motor or cognitive skills: Tablet: As this medicine may cause dizziness, patients should be warned to be cautious when driving or operating machinery.
Effects on ability to drive and use machines: Injection: None reported.