What is the dosage and treatment protocol for Ceftin (cefuroxime) in adults?

Cefuroxime (Ceftin) Dosage and Treatment Protocol for Adults

The standard adult oral dosage for Ceftin (cefuroxime axetil) is 250-500 mg taken twice daily for 5-10 days, with specific dosing based on infection type and severity. 1

Oral Dosage Recommendations by Infection Type

Respiratory Tract Infections

• Standard infections: 250 mg twice daily 1, 2
• More severe infections/pneumonia: 500 mg twice daily 1, 2
• Duration: 5-10 days (shorter 5-day courses have shown similar efficacy to 10-day courses for some infections) 3

Urinary Tract Infections

• Uncomplicated UTIs: 125 mg twice daily 2
• Pyelonephritis: 250 mg twice daily 2

Skin and Soft Tissue Infections

• Standard dose: 250 mg twice daily 2
• More severe infections: 500 mg twice daily 2

Sexually Transmitted Infections

• Uncomplicated gonorrhea: Single 1 g dose (often administered with 1 g oral probenecid) 1, 2

Lyme Disease

• Early stage: 500 mg twice daily for 14-21 days 4

Parenteral to Oral Sequential Therapy

For hospitalized patients requiring initial IV therapy before transitioning to oral medication:

• Initial IV dose: 750 mg to 1.5 g every 8 hours 1
• Transition to oral: 500 mg twice daily when clinically appropriate 3
• Total treatment duration: 7-14 days (depending on infection) 1

Dosage Adjustments for Renal Impairment

• Creatinine clearance >20 mL/min: No adjustment needed
• Creatinine clearance 10-20 mL/min: 750 mg every 12 hours
• Creatinine clearance <10 mL/min: 750 mg every 24 hours
• Hemodialysis patients: Additional dose after dialysis 1

Administration Guidelines

• Take with food to enhance absorption and bioavailability (increases from 37% to 52% when taken after meals) 2, 3
• Maintain consistent dosing intervals (approximately 12 hours apart) for optimal therapeutic effect
• Complete the full course of treatment even if symptoms improve before completion

Clinical Considerations

Advantages

• Broad-spectrum activity against common respiratory pathogens including H. influenzae, S. pneumoniae, and M. catarrhalis 2, 3
• Beta-lactamase stability provides effectiveness against many resistant strains 2
• Convenient twice-daily dosing improves adherence 3

Common Side Effects

• Gastrointestinal disturbances (diarrhea, nausea, vomiting) - generally mild and transient 2
• Hypersensitivity reactions (rash, urticaria)
• Transient elevation in liver enzymes

Contraindications

• Known hypersensitivity to cephalosporins
• Caution in patients with penicillin allergy due to potential cross-reactivity

Treatment Efficacy

Cefuroxime axetil has demonstrated clinical efficacy comparable to other antibiotics including:

• Amoxicillin/clavulanic acid in respiratory infections 3, 5
• Macrolides and fluoroquinolones in community-acquired pneumonia 4, 3
• Other cephalosporins in various infections 3, 5

Important Clinical Pitfalls to Avoid

• Inadequate duration: Ensure full course completion to prevent relapse and antimicrobial resistance
• Improper administration: Taking without food significantly reduces bioavailability
• Inappropriate use: Not recommended for viral infections or as prophylaxis for endocarditis during genitourinary procedures 4
• Overlooking renal function: Failure to adjust dosage in patients with renal impairment may lead to toxicity
• Drug interactions: Antacids and H2-blockers may reduce absorption if taken simultaneously

Cefuroxime axetil remains an effective option for empiric treatment of various community-acquired infections, particularly when beta-lactamase-producing pathogens are suspected.