Oral Dose of Cefuroxime for Urinary Tract Infections
The recommended oral dose of cefuroxime axetil for urinary tract infections is 250 mg twice daily for 7-14 days. 1, 2, 3
Dosing Guidelines for UTIs
Adult Dosing
- Standard dose: 250 mg twice daily for 7-14 days 1, 3
- For more severe or complicated UTIs: 500 mg twice daily may be appropriate 2, 4
- For uncomplicated UTIs in some cases: 125 mg twice daily has been shown to be effective 5
Pediatric Dosing
For children with UTIs:
- Children >3 months: 50-100 mg/kg/day divided every 8 hours 2
- Higher dosage (100 mg/kg/day, not exceeding maximum adult dose) should be used for more severe infections 2
Treatment Duration
- Total course of therapy should be 7-14 days 1
- Evidence shows that shorter courses (1-3 days) are inferior for febrile UTIs 1
- Treatment should be continued for a minimum of 48-72 hours after the patient becomes asymptomatic 2
Clinical Considerations
Efficacy
- Clinical trials have demonstrated 97% success rates with cefuroxime axetil 250 mg twice daily for UTIs 3
- Bacteriological clearance rates of 72% have been reported 3
- Single daily dosing (250 mg) has also shown 93% clearance of original infecting organisms, though this regimen is less common 6
Advantages
- Twice-daily dosing provides convenient administration 4
- Effective against most common UTI pathogens, including E. coli (which accounts for approximately 61% of UTI isolates) 3
- Can be used as empiric therapy for uncomplicated UTIs prior to sensitivity testing 7
Cautions
- For complicated UTIs, sensitivity testing should be performed before initiating treatment 7
- Dosage adjustment is required in patients with renal impairment 2:
- CrCl >20 mL/min: Standard dose
- CrCl 10-20 mL/min: 750 mg q12h
- CrCl <10 mL/min: 750 mg q24h
Adverse Effects
- Most common adverse effects are gastrointestinal disturbances (10% of patients), including diarrhea (4%) 3
- Candida vaginitis has been reported in some female patients 6
- Adverse effects are generally mild to moderate and reversible upon discontinuation 4
Special Populations
- For pregnant patients, cefuroxime is generally considered safe, but alternative agents may be preferred based on specific patient factors 8
- In elderly patients, dosage adjustment may be needed based on renal function 2
Cefuroxime axetil represents an effective oral option for UTI treatment with a favorable safety profile and convenient dosing schedule. The standard 250 mg twice daily regimen provides adequate coverage for most uncomplicated UTIs, while more severe infections may require higher dosing.