Dosing & Uses
Dosage Forms & Strengths
oral suspension (discontinued; anticipated final availability early 2018)
- 125mg/5mL
- 250mg/5mL
powder for injection
- 750mg
- 1.5g
- 7.5g
- 75g
- 225g
tablet
- 250mg
- 500mg
Pharyngitis/Tonsillitis
250 mg PO q12hr for 10 days
Acute Bacterial Maxillary Sinusitis
250 mg PO q12hr for 10 days
Acute Bacterial Exacerbations of Chronic Bronchitis
250-500 mg PO q12hr for 10 days
500-750 mg IV q8hr; switch to oral therapy as soon as clinically possible
Secondary Bacterial Infections of Acute Bronchitis
250-500 mg PO q12hr for 5-10 days
Uncomplicated Pneumonia
750 mg IV/IM q8hr
Uncomplicated Skin/Skin Structure Infections
250-500 mg PO q12hr for 10 days
750 mg IV/IM q8hr; switch to oral therapy as soon as clinically possible
Uncomplicated Urinary Tract Infections
125-250 mg PO q12hr for 7-10 days
750 mg IV/IM q8hr; switch to oral therapy as soon as clinically possible
Gonorrhea
Uncomplicated: 1 g PO once or 1.5 g IM once at 2 different sites with 1 g probenecid PO
Disseminated: 750 mg IV/IM q8hr
Early Lyme Disease
500 mg PO q12hr for 20 days
Severe or Complicated Infections
1.5 g IV/IM q8hr; may be administered q6hr in life-threatening situations
Dosage Modifications
Renal impairment
- CrCl >30 mL/min: No adjustment necessary
- CrCl 10-30 mL/min: Administer dose q24hr
- CrCl <10 mL/min: Administer dose q48hr
Dosing Considerations
Susceptible organisms
- Borrelia burgdorferi, Escherichia coli, Haemophilus influenzae, Klebsiella spp, Moraxella catarrhalis, Neisseria gonorrhoeae, Proteus mirabilis, Streptococcus pneumoniae, Streptococcus pyogenes
Dosage Forms & Strengths
oral suspension (discontinued; anticipated final availability early 2018)
- 125mg/5mL
- 250mg/5mL
powder for injection
- 750mg
- 1.5g
- 7.5g
- 75g
- 225g
tablet
- 250mg
- 500mg
Acute Bacterial Maxillary Sinusitis
<3 months: Safety and efficacy not established
3 months-12 years: 30 mg/kg/day suspension PO divided q12hr for 10 days; not to exceed 1000 mg/day; alternatively, 75-150 mg/kg/day IV/IM divided q8hr; not to exceed 6 g/day
>12 years: 250 mg tablet PO q12hr for 10 days
Acute Otitis Media
<3 months: Safety and efficacy not established
3 months-12 years: 30 mg/kg/day suspension PO divided q12hr for 10 days; not to exceed 1000 mg/day; alternatively, 75-150 mg/kg/day IV/IM divided q8hr; not to exceed 6 g/day
Alternatively: 125-250 mg PO q12hr for 10 days
>12 years: 250-500 mg tablet PO q12hr for 10 days
Impetigo
<3 months: Safety and efficacy not established
3 months-12 years: 30 mg/kg/day suspension PO divided q12hr for 10 days; not to exceed 1000 mg/day or 75-100mg/kg/day IV/IM divided q8hr; not to exceed 6 g/day
Alternatively: 125-250 mg PO q12hr for 10 days
>12 years: 250-500 mg tablet PO q12hr for 10 days
Pharyngitis/Tonsillitis
<3 months: Safety and efficacy not established
3 months-12 years: 20 mg/kg/day PO divided q12hr for 10 days; not to exceed 500 mg/day or 75-150 mg/kg/day IV/IM divided q8hr; not to exceed 6 g/day
Alternatively: 125-250 mg PO q12hr for 10 days
>12 years: 250 mg PO q12hr for 10 days
Severe or Serious Infections (Off-label)
<6 days, <2 kg: 100 mg/kg/day IV/IM divided q12hr
<6 days, >2 kg: 150 mg/kg/day IV/IM divided q8hr
>7 days: 150 mg/kg/day IV/IM divided q8hr
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (0)
Serious - Use Alternative (9)
- argatroban
cefuroxime will increase the level or effect of argatroban by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity
- BCG vaccine live
cefuroxime decreases effects of BCG vaccine live by pharmacodynamic antagonism. Contraindicated. Wait until Abx Tx complete to administer live bacterial vaccine.
- bivalirudin
cefuroxime will increase the level or effect of bivalirudin by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity
- cholera vaccine
cefuroxime, cholera vaccine. pharmacodynamic antagonism. Avoid or Use Alternate Drug. Avoid coadministration of cholera vaccine with systemic antibiotics since these agents may be active against the vaccine strain. Do not administer cholera vaccine to patients who have received oral or parenteral antibiotics within 14 days prior to vaccination.
- dalteparin
cefuroxime will increase the level or effect of dalteparin by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity
- enoxaparin
cefuroxime will increase the level or effect of enoxaparin by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity
- fondaparinux
cefuroxime will increase the level or effect of fondaparinux by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity
- heparin
cefuroxime will increase the level or effect of heparin by anticoagulation. Avoid or Use Alternate Drug. cephalosporins may decrease prothrombin activity
- microbiota oral
cefuroxime decreases effects of microbiota oral by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Microbiota oral contains bacterial spores. Antibacterial agents may decrease efficacy if coadministered. Complete antibiotic regimens 2-4 days before initiating microbiota oral. .
Monitor Closely (30)
- aluminum hydroxide
aluminum hydroxide will decrease the level or effect of cefuroxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- azithromycin
azithromycin decreases effects of cefuroxime by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.
- bazedoxifene/conjugated estrogens
cefuroxime will decrease the level or effect of bazedoxifene/conjugated estrogens by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.
- calcium carbonate
calcium carbonate will decrease the level or effect of cefuroxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- cimetidine
cimetidine will decrease the level or effect of cefuroxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- clarithromycin
clarithromycin decreases effects of cefuroxime by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.
- demeclocycline
demeclocycline decreases effects of cefuroxime by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.
- didanosine
didanosine will decrease the level or effect of cefuroxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Applies to didanosine chewable tablets and powder for oral solution; administer 2 hr before or several hours after didanosine oral solution or chewable tablet administration
- dienogest/estradiol valerate
cefuroxime will decrease the level or effect of dienogest/estradiol valerate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. An alternate or additional form of birth control may be advisable during concomitant use.
- doxycycline
doxycycline decreases effects of cefuroxime by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.
- erythromycin base
erythromycin base decreases effects of cefuroxime by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.
- erythromycin ethylsuccinate
erythromycin ethylsuccinate decreases effects of cefuroxime by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.
- erythromycin lactobionate
erythromycin lactobionate decreases effects of cefuroxime by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.
- erythromycin stearate
erythromycin stearate decreases effects of cefuroxime by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.
- esomeprazole
esomeprazole will decrease the level or effect of cefuroxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- ethinylestradiol
cefuroxime will decrease the level or effect of ethinylestradiol by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor.
- famotidine
famotidine will decrease the level or effect of cefuroxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- ibuprofen/famotidine
ibuprofen/famotidine will decrease the level or effect of cefuroxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- levonorgestrel oral/ethinylestradiol/ferrous bisglycinate
cefuroxime will decrease the level or effect of levonorgestrel oral/ethinylestradiol/ferrous bisglycinate by altering intestinal flora. Applies only to oral forms of hormone. Low risk of contraceptive failure. Use Caution/Monitor. Antibiotics may decrease hormonal contraceptive efficacy.
- minocycline
minocycline decreases effects of cefuroxime by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.
- nizatidine
nizatidine will decrease the level or effect of cefuroxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- omeprazole
omeprazole decreases effects of cefuroxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- probenecid
probenecid will increase the level or effect of cefuroxime by acidic (anionic) drug competition for renal tubular clearance. Use Caution/Monitor.
- rabeprazole
rabeprazole will decrease the level or effect of cefuroxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- sodium bicarbonate
sodium bicarbonate will decrease the level or effect of cefuroxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- sodium picosulfate/magnesium oxide/anhydrous citric acid
cefuroxime decreases effects of sodium picosulfate/magnesium oxide/anhydrous citric acid by altering metabolism. Use Caution/Monitor. Coadministration with antibiotics decreases efficacy by altering colonic bacterial flora needed to convert sodium picosulfate to active drug.
- sodium zirconium cyclosilicate
sodium zirconium cyclosilicate will decrease the level or effect of cefuroxime by increasing gastric pH. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Check specific recommendations for drugs that exhibit pH-dependent solubility that may affect their systemic exposure and efficacy. In general, administer drugs at least 2 hr before or after sodium zirconium cyclosilicate.
- tetracycline
tetracycline decreases effects of cefuroxime by pharmacodynamic antagonism. Use Caution/Monitor. bacteriostatic agents may inhibit the effects of bactericidal agents.
- voclosporin
voclosporin, cefuroxime. Either increases toxicity of the other by nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Coadministration with drugs associated with nephrotoxicity may increase the risk for acute and/or chronic nephrotoxicity.
- warfarin
cefuroxime increases effects of warfarin by unspecified interaction mechanism. Use Caution/Monitor.
Minor (4)
- chloramphenicol
chloramphenicol decreases effects of cefuroxime by pharmacodynamic antagonism. Minor/Significance Unknown. bacteriostatic agents may inhibit the effects of bactericidal agents.
- choline magnesium trisalicylate
cefuroxime will increase the level or effect of choline magnesium trisalicylate by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
- furosemide
cefuroxime increases toxicity of furosemide by pharmacodynamic synergism. Minor/Significance Unknown. Increased risk of nephrotoxicity.
- rose hips
rose hips will increase the level or effect of cefuroxime by acidic (anionic) drug competition for renal tubular clearance. Minor/Significance Unknown.
Adverse Effects
>10%
Diarrhea (4-11%; depends on duration)
1-10%
Decreased hemoglobin or hematocrit (10%)
Eosinophilia (7%)
Nausea or vomiting (3-7%)
Vaginitis (<5%)
Transient rise in hepatic transaminases (2-4%)
Diaper rash (3%)
Increase in alkaline phosphatase (2%)
Thrombophlebitis (2%)
Increase in lactate dehydrogenase (1%)
<1%
Anemia
Cholestasis
Colitis
Dyspnea
Epidermal necrolysis
Increase in blood urea nitrogen (BUN) and creatinine
Jaundice
Nephritis
Prolonged prothrombin time (PT)/international normalized ratio (INR)
Rash
Stevens-Johnson syndrome
Stomach cramps
Transient neutropenia and leukopenia
Urticaria
Postmarketing Reports
Immune system disorders: Angioedema, acute myocardial ischemia with or without myocardial infarction
Neurologic system disorders: Seizure
Cutaneous vasculitis
Warnings
Contraindications
Documented hypersensitivity
Cautions
Do not crush tablet
Prolonged INR in nutritionally deficient patients, prolonged treatment, and hepatic and renal disease reported
Film-coated tablet and oral solution are not bioequivalent; tablets should not be crushed
Use caution in patients with history of colitis, renal impairment, or with a history of seizure disorders
Use with caution in patients with history of penicillin allergy
Reduce dosage by 50% if CrCl is 10-30 mL/min and by 75% if CrCl <10 mL/min (high doses may cause CNS toxicity)
Some products may contain phenylalanine
Bacterial or fungal overgrowth of nonsusceptible organisms may occur with prolonged or repeated therapy
Pregnancy & Lactation
Pregnancy
Available data from published epidemiologic studies, case series, and case reports over several decades in pregnant women have not established drug-associated risks of major birth defects, miscarriage, or adverse maternal or fetal outcomes
Animal data
- In studies in pregnant mice and rats administered orally during organogenesis at 14 and 9 times maximum recommended human dose (MRHD) based on body surface area, respectively, there were no adverse developmental outcomes
Lactation
Based on several published case reports describing multiple lactating women receiving therapy via intravenous, intramuscular, and oral routes, drug is present in human milk; the highest maternal milk concentration described occurred in lactating women 8 hours after an intramuscular administration of 750 mg; allowing for an infant milk consumption of 150 mL/kg/day, the estimated breastfed infant dose would be less than 1% of adult dose
No data are available on effects of drug on breastfed infant or on milk production; developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for therapy and any potential adverse effects on breastfed infant from drug or from underlying maternal condition
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Binds to penicillin-binding proteins and inhibits final transpeptidation step of peptidoglycan synthesis, resulting in cell-wall death; resists degradation by beta-lactamase; proper dosing and appropriate route of administration are determined by condition of patient, severity of infection, and susceptibility of microorganism
Absorption
Bioavailability: Fasting, 37%; postprandial, 52%
Peak serum time: 2-3 hr (PO); 15-60 min (IM); 2-3 min (IV)
Distribution
Widely distributed to body tissues and fluids, including cerebrospinal fluid (CSF)
Protein bound: 33-50%
Metabolism
Partially metabolized in liver
Elimination
Half-life: 1-2 hr (prolonged with renal impairment)
Excretion: Urine (66-100% as unchanged drug)
Administration
IV Incompatibilities
Additive: Aminoglycosides, ciprofloxacin, ranitidine, sodium bicarbonate
Syringe: Doxapram
Y-site: Azithromycin, cisatracurium (potentially; compatible at low concentration [0.1 mg/mL]), clarithromycin, filgrastim, fluconazole, midazolam, vancomycin, vinorelbine
IV Compatibilities
Solution: D5W, NS
Additive: Clindamycin, floxacillin, furosemide, gentamicin (incompatible in total parenteral nutrition [TPN]), metronidazole, midazolam, netilmicin
Y-site (partial list): Acyclovir, allopurinol, amiodarone, diltiazem, linezolid, milrinone, morphine sulfate, ondansetron, propofol, tacrolimus
IV Preparation
Direct injection: reconstitute in 8 mL (for 750-mg vial) or 16 mL (for 1.5-g vial) to obtain ~90 mg/mL solution
Infusion: Reconstitute in 100 mL SWI, D5W or NS to obtain 7.5 mg/mL (750-mg vial) or 15 mg/mL (1.5-g vial) solution
7.5 g bulk package not to be used for direct injection
IM Preparation
Reconstitute 750 mg in 3 mL SWI to obtain ~220 mg/mL solution
IV Administration
Direct injection: Inject directly into vein over 3-5 minutes or slowly into tubing of free-flowing compatible IV solution
Infusion: Infuse intermittently over 15-60 minutes
Images
BRAND | FORM. | UNIT PRICE | PILL IMAGE |
---|---|---|---|
cefuroxime axetil oral - | 500 mg tablet | ![]() | |
cefuroxime axetil oral - | 500 mg tablet | ![]() | |
cefuroxime axetil oral - | 250 mg tablet | ![]() | |
cefuroxime axetil oral - | 250 mg tablet | ![]() | |
cefuroxime axetil oral - | 500 mg tablet | ![]() | |
cefuroxime axetil oral - | 250 mg tablet | ![]() | |
cefuroxime axetil oral - | 250 mg tablet | ![]() | |
cefuroxime axetil oral - | 500 mg tablet | ![]() |
Copyright © 2010 First DataBank, Inc.
Patient Handout
cefuroxime axetil oral
CEFUROXIME - ORAL
(seff-you-ROX-eem)
COMMON BRAND NAME(S): Ceftin
USES: Cefuroxime is used to treat a wide variety of bacterial infections. This medication is known as a cephalosporin antibiotic. It works by stopping the growth of bacteria.This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections.
HOW TO USE: Take this medication by mouth as directed by your doctor, usually twice daily (every 12 hours). Take cefuroxime with food to increase absorption and reduce stomach upset. The dosage is based on your medical condition and response to treatment.Swallow the tablets whole. Do not crush or chew because the tablets have a strong bitter taste. Use the liquid suspension form of this medication if it is difficult to swallow the tablets.For the best effect, take this antibiotic at evenly spaced times. To help you remember, take this medication at the same time(s) every day.Continue to take this medication until the full prescribed amount is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.Tell your doctor if your condition lasts or gets worse.
SIDE EFFECTS: Nausea, vomiting, diarrhea, or stomach pain may occur. Dizziness and drowsiness may occur less often, especially with higher doses. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: unusual tiredness/weakness, signs of liver problems (such as nausea/vomiting that doesn't stop, stomach/abdominal pain, yellowing eyes/skin, dark urine), signs of kidney problems (such as change in the amount of urine), signs of new infection (such as sore throat that doesn't go away, fever), easy bruising/bleeding, jerky movements, mental/mood changes (such as confusion).This medication may rarely cause a severe intestinal condition due to a bacteria called C. difficile. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn't stop, abdominal or stomach pain/cramping, blood/mucus in your stool.If you have these symptoms, do not use anti-diarrhea or opioid products because they may make symptoms worse.Use of this medication for prolonged or repeated periods may result in oral thrush or a new vaginal yeast infection (oral or vaginal fungal infection). Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge or other new symptoms.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking cefuroxime, tell your doctor or pharmacist if you are allergic to it; or to penicillins or other cephalosporin antibiotics (such as cephalexin); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease, intestinal disease (colitis), liver disease, poor nutrition.This drug may make you dizzy or drowsy. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Cefuroxime may cause live bacterial vaccines (such as typhoid vaccine) to not work well. Tell your health care professional that you are using cefuroxime before having any immunizations/vaccinations.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.This medication may interfere with certain lab tests (such as certain diabetic urine tests, blood glucose tests), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include seizures.
NOTES: Do not share this medication with others.This medication has been prescribed for your current condition only. Do not use it later for another infection unless your doctor tells you to.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised September 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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