What is the recommended dose and frequency of Ceftin (Cefuroxime) for treating urinary tract infections (UTI)?

Cefuroxime (Ceftin) Dosing for Urinary Tract Infections

Recommended Dosing

For urinary tract infections (UTIs), the recommended dose of Ceftin (cefuroxime) is 750 mg every 8 hours for uncomplicated UTIs, typically for 5-10 days. 1

The dosing regimen should follow this algorithm:

• Uncomplicated UTIs: 750 mg every 8 hours for 5-10 days 1
• Complicated UTIs: 1.5 grams every 8 hours for 7-14 days 2, 1
• Severe or complicated infections: May require 1.5 grams every 6 hours 1

Dosage Adjustments for Renal Impairment

Cefuroxime requires dose adjustment in patients with impaired renal function:

• Creatinine clearance >20 mL/min: 750 mg - 1.5 grams every 8 hours
• Creatinine clearance 10-20 mL/min: 750 mg every 12 hours
• Creatinine clearance <10 mL/min: 750 mg every 24 hours 1

For patients on hemodialysis, an additional dose should be administered after dialysis sessions 1.

Treatment Duration Considerations

The duration of treatment should be tailored based on the type of UTI:

• Uncomplicated cystitis in women: 3 days may be sufficient
• Complicated UTIs: 7-14 days is recommended
• Male UTIs (considered complicated): 7-14 days (14 days if prostatitis cannot be excluded) 2

Clinical Monitoring

• Obtain urine culture before starting therapy, especially in complicated cases 2
• Assess clinical response within 48-72 hours of initiating treatment 2
• Consider repeat urine culture 1-2 weeks after completion of therapy for complicated UTIs 2

Important Considerations

• The FDA label specifically indicates that cefuroxime should be continued for a minimum of 48 to 72 hours after the patient becomes asymptomatic or after evidence of bacterial eradication has been obtained 1
• For chronic UTIs, frequent bacteriologic and clinical appraisal may be required for several months after therapy completion 1
• Persistent infections may require treatment for several weeks 1

Potential Adverse Effects

• Approximately 8-14% of patients report adverse events with antibiotic treatment for UTIs 2
• Common side effects include gastrointestinal disturbances (diarrhea, nausea, vomiting) and neurological effects 2, 3
• These adverse reactions are generally mild and transient in nature 3

Pitfalls to Avoid

• Do not use doses smaller than those indicated above as they may be ineffective 1
• In staphylococcal and other infections involving a collection of pus, surgical drainage should be carried out where indicated 1
• Always consider local resistance patterns when selecting empiric therapy for UTIs 2