ZINNAT Special Precautions
ZINNAT 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 may result in the overgrowth of Candida. Prolonged use may also result in the overgrowth of non-susceptible organisms (e.g. Enterococci and Clostridium difficile), which may require interruption of treatment.
Pseudomembranous colitis has been reported with the use of broad-spectrum antibiotics, therefore, it is important to consider its diagnosis in patients who develop serious diarrhoea during or after antibiotic use.
The Jarisch-Herxheimer reaction has been seen following Zinnat treatment of Lyme disease. It results from the bactericidal activity of Zinnat on the causative organism of Lyme disease, the spirochaete Borrelia burgdorferi. Patients should be reassured that this is common and usually self-limited consequence of antibiotic treatment of Lyme disease.
With a sequential therapy regime 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. The change to oral therapy should only be made once there is a clear clinical improvement. If there has been no clinical improvement after 72 hours of parenteral treatment, then the patient's treatment should be reviewed. Please refer to the relevant prescribing information for cefuroxime sodium before initiating sequential therapy.
ZINNAT Adverse Reactions
Adverse drug reactions to cefuroxime axetil are generally mild and transient in nature.
The following convention has been used for the classification of frequency:
very common (1/10), common (1/100, <1/10), uncommon (1/1000, <1/100), rare (1/10,000 and <1/1000), very rare (<1/10,000).
Infections and infestations
Common: Candida overgrowth
Blood and lymphatic system disorders
Uncommon: Positive Coombs' test, thrombocytopenia, leukopenia (sometimes profound)
Very rare: Haemolytic anaemia
Cephalosporins as a class tend to be absorbed onto the surface of red cells membranes and react with antibodies directed against the drug to produce a positive Coombs' test (which can interfere with cross-matching of blood) and very rarely haemolytic anaemia.
Immune system disorders
Hypersensitivity reactions including
Uncommon: Skin rashes
Rare: Urticaria, pruritus
Very rare: Drug fever, serum sickness, anaphylaxis
Nervous system disorders
Common: Headache, dizziness
Common: Gastrointestinal disturbances including diarrhoea, nausea, abdominal pain
Rare: Pseudomembranous colitis
Common: Transient increases of hepatic enzyme levels, [ALT (SGPT), AST (SGOT), LDH]
Very rare: Jaundice (predominantly cholestatic), hepatitis
Skin and subcutaneous tissue disorders
Very rare: Erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis (exanthematic necrolysis)