Cefuroxime Dosing for a 13-Year-Old Weighing 142 lbs (64 kg)
Yes, 500mg BID (twice daily) of cefuroxime is an appropriate dose for a 13-year-old weighing 142 lbs (64 kg). 1
Dosing Rationale
- For children with Lyme disease, the recommended dose of cefuroxime axetil is 30 mg/kg/day in 2 divided doses, with a maximum of 500 mg per dose 1
- For a 13-year-old weighing 64 kg, this would calculate to approximately 960 mg/day total, or 480 mg twice daily, which rounds to the standard 500 mg BID dosing 1
- For children with respiratory tract infections, the British Thoracic Society guidelines recommend 250 mg BID for children 2-12 years and 500 mg BID for those over 12 years 1
- Since this patient is 13 years old and weighs more than 40 kg (88 lbs), the adult dosing of 500 mg twice daily is appropriate 1, 2
Weight-Based Considerations
- The patient weighs 142 lbs (64 kg), which exceeds the 40 kg (88 lb) threshold often used for transitioning to adult dosing 1
- For children >40 kg in weight, adult dosing parameters are typically applied 3
- The standard adult dose of cefuroxime axetil for most infections is 250-500 mg twice daily 2
Infection-Specific Dosing
- For respiratory tract infections: 500 mg BID is appropriate for more severe infections 2
- For skin and soft tissue infections: 250-500 mg BID is the standard dose 2
- For urinary tract infections: 250 mg BID is typically sufficient 4
- For Lyme disease: 500 mg BID is recommended (with maximum 500 mg per dose) 1
Safety Considerations
- Cefuroxime axetil is generally well tolerated in pediatric patients 5
- Most common adverse effects are mild gastrointestinal disturbances (diarrhea, nausea, vomiting) 2
- No dosage adjustment is needed based on age alone for patients over 12 years with normal renal function 3
- The 500 mg BID dosing has been shown to be safe and effective in adolescents 5
Important Clinical Considerations
- Cefuroxime should be administered with food to improve gastrointestinal tolerability and increase absorption 2
- The duration of therapy typically ranges from 5-10 days depending on the type and severity of infection 5
- For most common infections, a 7-day course is sufficient 2
- For Lyme disease, a longer course (14-21 days) may be necessary 1
Conclusion
Based on the patient's age (13 years) and weight (142 lbs/64 kg), the 500 mg BID dosing of cefuroxime is appropriate and aligns with established guidelines for adolescents. This dose provides adequate coverage for most common infections while maintaining a favorable safety profile 1, 2, 5.