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

Cefuroxime (Ceftin) Dosage and Frequency Recommendations

The recommended dose of oral cefuroxime (Ceftin) for most bacterial infections in adults is 250-500 mg twice daily, with specific dosing based on infection type and severity. 1

Adult Dosing Guidelines

Oral Cefuroxime (Ceftin) Dosing:

• Standard adult dose: 250-500 mg twice daily 1, 2
• Duration: Typically 7-10 days, depending on infection type 3

Specific Infection Types:

• Respiratory tract infections:
  • Mild to moderate: 250 mg twice daily 3
  • More severe or pneumonia: 500 mg twice daily 3
• Urinary tract infections:
  • Uncomplicated: 125-250 mg twice daily 2, 4
• Skin and soft tissue infections:
  • 250-500 mg twice daily 2
• Gonorrhea:
  • Single 1 g dose 2

Pediatric Dosing Guidelines

Oral Cefuroxime Axetil:

• Children ≥3 months: 20-50 mg/kg/day divided twice daily 5
• Maximum daily dose: 500 mg per dose 5

Parenteral Cefuroxime:

• Children: 100-200 mg/kg/day IV divided every 6-8 hours 5
• Maximum dose: 1500 mg per dose 5

Special Populations

Renal Impairment:

Dosage adjustment is necessary based on creatinine clearance 1:

• CrCl >20 mL/min: Standard dosing
• CrCl 10-20 mL/min: 750 mg every 12 hours
• CrCl <10 mL/min: 750 mg every 24 hours

Administration Guidelines

• Take oral cefuroxime with food to enhance absorption 2
• For better absorption, tablets should be swallowed whole rather than crushed 3
• When switching from IV to oral therapy, cefuroxime axetil 500 mg twice daily is appropriate for continuation therapy 3

Comparative Efficacy and Tolerability

• Cefuroxime axetil has shown similar efficacy to other antibiotics including amoxicillin/clavulanate, macrolides, and quinolones for respiratory tract infections 3, 6
• Short-course therapy (5 days) with cefuroxime axetil has demonstrated similar efficacy to 10-day regimens for acute bronchitis 7
• Cefuroxime axetil generally has fewer gastrointestinal side effects compared to amoxicillin/clavulanate and cefixime 6, 7

Common Adverse Effects

• Gastrointestinal disturbances (diarrhea, nausea, vomiting) are most common but generally mild 2
• Lower incidence of diarrhea compared to cefixime (5% vs 15%) 6

Important Considerations

• Cefuroxime has good activity against common respiratory pathogens including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis 2
• For animal bites, cefuroxime is an appropriate option at 500 mg twice daily orally or 1 g every day intravenously 5
• For severe infections requiring parenteral therapy, consider starting with IV cefuroxime before transitioning to oral therapy 3

Pitfalls and Caveats

• Avoid using cefuroxime as monotherapy for suspected atypical pneumonia in school-aged children; consider adding a macrolide 5
• Cefuroxime may be less effective against certain resistant strains of S. pneumoniae with high MICs for penicillin (≥4.0 μg/mL) 5
• Do not use in patients with known hypersensitivity to cephalosporin antibiotics
• Like other antibiotics, cefuroxime should be continued for at least 48-72 hours after the patient becomes asymptomatic 1