What is the recommended dosage and treatment guidelines for Cefuroxime (Cefuroxime) in adults with bacterial infections?

Cefuroxime Dosage and Treatment Guidelines for Adults with Bacterial Infections

For adults with bacterial infections, cefuroxime is typically administered at 750 mg to 1.5 grams every 8 hours intravenously or 250-500 mg twice daily orally (as cefuroxime axetil), with treatment duration usually 5-10 days depending on infection type and severity. 1

Dosage Recommendations by Route of Administration

Oral Cefuroxime (Cefuroxime Axetil)

• Standard adult dosage: 250 mg twice daily for most infections 2
• For more severe infections or pneumonia: 500 mg twice daily 2
• For uncomplicated urinary tract infections: 125 mg twice daily may be effective 2
• For uncomplicated gonorrhea: Single 1 g dose 2
• Treatment duration: Generally 5-10 days for most infections 3

Parenteral Cefuroxime (IV/IM)

• Standard adult dosage range: 750 mg to 1.5 grams every 8 hours 1
• For uncomplicated infections (UTIs, skin infections, uncomplicated pneumonia): 750 mg every 8 hours 1
• For severe or complicated infections: 1.5 grams every 8 hours 1
• For bone and joint infections: 1.5 grams every 8 hours 1
• For life-threatening infections: 1.5 grams every 6 hours may be required 1
• For bacterial meningitis: Maximum 3 grams every 8 hours 1

Dosage Adjustment for Renal Impairment

• Creatinine clearance >20 mL/min: Standard dose (750 mg-1.5 g) every 8 hours 1
• Creatinine clearance 10-20 mL/min: 750 mg every 12 hours 1
• Creatinine clearance <10 mL/min: 750 mg every 24 hours 1
• Patients on hemodialysis should receive an additional dose after dialysis 1

Specific Infection Types and Recommended Regimens

Respiratory Tract Infections

• For community-acquired pneumonia:
  • Oral: 500 mg twice daily 4
  • IV: 750 mg-1.5 g every 8 hours 1
  • Sequential therapy: IV cefuroxime (750 mg 2-3 times daily for 2-5 days) followed by oral cefuroxime axetil (500 mg twice daily for 3-8 days) 3
• For acute exacerbations of chronic bronchitis:
  • Oral: 250-500 mg twice daily 4
  • IV: 750 mg every 8 hours 5

Sinusitis

• For acute bacterial rhinosinusitis:
  • Adults with mild disease: 250-500 mg twice daily for 5-10 days 4
  • Cefuroxime axetil has been shown to be effective in 5 days for sinusitis 4

Skin and Soft Tissue Infections

• Standard dosage: 250-500 mg twice daily orally or 750 mg-1.5 g every 8 hours IV 1, 2
• For more severe infections: 1.5 g every 8 hours IV 1
• Clinical success rate of 90% has been reported in soft tissue infections 6

Urinary Tract Infections

• Uncomplicated UTIs: 125-250 mg twice daily orally 2
• Complicated UTIs: 250 mg twice daily orally or 750 mg every 8 hours IV 1

Comparative Efficacy

• Cefuroxime axetil has similar activity to cefpodoxime and cefdinir against S. pneumoniae 4
• Cefuroxime axetil is less active than cefpodoxime against H. influenzae 4
• Clinical efficacy of cefuroxime axetil (83-88%) is comparable to other second-generation cephalosporins but lower than respiratory fluoroquinolones (90-92%) 4

Important Clinical Considerations

• Cefuroxime should be administered for a minimum of 48-72 hours after the patient becomes asymptomatic 1
• For Streptococcus pyogenes infections, a minimum of 10 days treatment is recommended to prevent rheumatic fever or glomerulonephritis 1
• Absorption of oral cefuroxime axetil is enhanced when taken with food 2
• Common adverse effects are generally mild and include gastrointestinal disturbances (diarrhea, nausea, vomiting) 2

Treatment Duration

• Standard duration: 5-10 days for most infections 1, 3
• Shorter courses (5 days) may be effective for certain respiratory infections 4, 3
• Longer treatment may be required for bone and joint infections or chronic urinary tract infections 1

Cefuroxime has a long-established history in treating moderate-to-severe respiratory infections and demonstrates good potency, efficacy, and side effect profiles across various bacterial infections 4.