Cefuroxime Dosing for Uncomplicated Urinary Tract Infections
For uncomplicated UTIs, cefuroxime should be dosed at 250 mg orally twice daily for 7-10 days, or as intravenous therapy at 750 mg every 8 hours when parenteral treatment is required.
Oral Cefuroxime (Cefuroxime Axetil) Dosing
Uncomplicated UTI:
- Recommended dose: 250 mg twice daily 1, 2
- Duration: 7-10 days (standard β-lactam duration for UTIs) 3
- Alternative dosing option: Some studies have shown efficacy with a single daily dose of 250 mg taken at night with a milk drink for 10 days 4
Clinical Efficacy:
- Clinical cure rates of 84.8-97% have been demonstrated in controlled trials 1, 2
- Bacteriological clearance rates of 72-80.3% 1, 2
- Comparable efficacy to other antibiotics like cefaclor, amoxicillin/clavulanate, and ofloxacin 1, 2
Parenteral Cefuroxime Dosing
Uncomplicated UTI:
Complicated UTI:
- Recommended dose: 1.5 grams every 8 hours 3
- Duration: Based on clinical response, typically 10-14 days
Dosage Adjustment for Renal Impairment
| Creatinine Clearance (mL/min) | Dose | Frequency |
|---|---|---|
| >20 | 750 mg-1.5 grams | q8h |
| 10-20 | 750 mg | q12h |
| <10 | 750 mg | q24h* |
*Patients on hemodialysis should receive an additional dose after dialysis 3
Antimicrobial Coverage
Cefuroxime demonstrates good activity against most common uropathogens:
- Escherichia coli (the predominant pathogen in UTIs)
- Klebsiella pneumoniae
- Proteus mirabilis
- Methicillin-sensitive Staphylococcus aureus 5
Important Considerations
β-lactam limitations: β-lactams generally have inferior efficacy compared to other UTI antimicrobials and may have more adverse effects 6. Consider this when selecting therapy.
Alternative agents: If local resistance patterns or patient factors preclude the use of cefuroxime, consider fluoroquinolones, nitrofurantoin, fosfomycin, or trimethoprim-sulfamethoxazole based on susceptibility 6.
Monitoring: Continue therapy for at least 48-72 hours after the patient becomes asymptomatic 3.
Common adverse effects: Primarily gastrointestinal disturbances including diarrhea (4%), nausea, and vomiting 5, 1.
Administration: Oral cefuroxime axetil should be taken with food to enhance absorption 5.
While cefuroxime is an effective option for UTI treatment, it's worth noting that current guidelines often recommend other agents as first-line therapy for uncomplicated UTIs, with β-lactams generally considered alternative options when preferred agents cannot be used 6.