First-lineZinacef
Cefuroxime
2nd-generation cephalosporin
Surgical prophylaxis for caesarean section (single dose pre-incision).
IVOral
First-line for
- Prophylaxis at LSCS
- UTI alternative in pregnancy
- Wound infection
Mechanism
β-lactam — inhibits PBPs; stable against many β-lactamases.
“1g pre-skin”
- 1.5 g IV within 60 min before LSCS skin incision (NICE)
- Reduces wound infection ~60%
Dosing
- LSCS prophylaxis
- 1.5 g IV once, pre-incision
- Oral
- 250–500 mg BD
Contraindications
- AbsoluteCephalosporin/penicillin anaphylaxis
- CautionEg renal impairment dose adjust
Side effects
- Diarrhoea, candidiasis
- Rash
- Rare C. difficile
Fetal & maternal notes
- • Safe in pregnancy and lactation
Key interactions
Warfarin
CautionMild ↑ INR
Probenecid
OK↑ levels
Clinical pearls
- 💡 Give before skin incision, not after cord clamp — Cochrane 2014 evidence
- 💡 Re-dose if blood loss >1.5 L or >4 h
Content last reviewed: REPLACE_ME (e.g. 2026-07)
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