What is the oral equivalent of cefuroxime (Cefuroxime) 750mg intravenous (IV) for post-operative medications?

Oral Equivalent of Cefuroxime 750mg IV for Post-Operative Medications

The oral equivalent of cefuroxime 750mg IV for post-operative medications is cefuroxime axetil 500mg taken orally twice daily. 1, 2

Rationale for Conversion

When converting from intravenous to oral cefuroxime, several factors need to be considered:

1. Bioavailability: Cefuroxime axetil (the oral form) has approximately 68% bioavailability 1
2. Pharmacokinetics: After oral administration of 500mg cefuroxime axetil, peak plasma concentrations reach approximately 7.9 mg/L 1
3. Dosing frequency: IV cefuroxime is typically given every 8 hours (three times daily), while oral cefuroxime axetil is given twice daily 2

Recommended Dosing Algorithm

• For most post-operative infections: Cefuroxime axetil 500mg twice daily 2, 3
• For less severe infections (e.g., simple urinary tract infections): Cefuroxime axetil 250mg twice daily may be sufficient 1
• For more severe infections (e.g., pneumonia or severe lower respiratory tract infections): Maintain the 500mg twice daily dosing 1

Clinical Considerations

• Oral cefuroxime axetil should be taken with food to enhance absorption 1
• The typical duration for post-operative antibiotic therapy should be limited to the operative period, sometimes 24 hours, exceptionally 48 hours, and never beyond 4
• Sequential therapy (switching from IV to oral) has been shown to be effective in multiple studies 2, 3

Common Pitfalls to Avoid

1. Prolonged duration: Extending antibiotic therapy beyond 48 hours post-operatively is not recommended and may contribute to antimicrobial resistance 4

2. Failure to adjust for renal impairment: Dosage adjustments may be necessary in patients with significant renal dysfunction

3. Inappropriate continuation: The presence of drainage at the surgical site is not a justification for extending antibiotic prophylaxis 4

4. Overlooking allergies: In patients with beta-lactam allergies, alternative antibiotics should be considered according to the surgical site and likely pathogens 4

Cefuroxime axetil is generally well tolerated with primarily mild gastrointestinal side effects including diarrhea, nausea, and vomiting 1, 3. This oral equivalent provides a convenient twice-daily dosing schedule that maintains effective antimicrobial coverage for post-operative patients.