Recommended Dosage of Cefuroxime (Cefuroxime Axetil) for Adults and Children
The recommended oral dose of cefuroxime axetil for adults is 250-500 mg twice daily, while for children the dosage is 20-50 mg/kg/day divided into two doses, with specific dosing based on infection type and severity. 1, 2
Adult Dosing
- For most infections in adults, 250 mg twice daily is appropriate 3
- For more severe infections like pneumonia, 500 mg twice daily is recommended 1, 3
- For uncomplicated urinary tract infections, 125 mg twice daily may be sufficient 3
- For uncomplicated gonorrhea, a single 1 g dose has been shown to be effective 3
- Maximum adult daily dose is 4000 mg/day 1
Pediatric Dosing
- For children, cefuroxime axetil is dosed at 20-50 mg/kg/day divided into two doses (every 12 hours) 1
- The maximum pediatric dose is 500 mg per dose 1
- For more severe infections in children, the higher end of the dosing range (50 mg/kg/day) is recommended 1
- Cefuroxime is available as tablets and as an oral suspension for pediatric use 3
Intravenous Cefuroxime Dosing
- For adults requiring IV therapy: 750 mg to 1.5 g every 8 hours 2
- For severe infections: 1.5 g every 6 hours may be required 2
- For pediatric patients above 3 months: 50-100 mg/kg/day IV divided every 6-8 hours 2
- For bone and joint infections in children: 150 mg/kg/day (not exceeding maximum adult dose) 2
- For bacterial meningitis in children: 200-240 mg/kg/day IV divided every 6-8 hours 2
Dosage Adjustments
- For patients with renal impairment, dosage adjustment is necessary 2:
- Creatinine clearance >20 mL/min: Standard dose
- Creatinine clearance 10-20 mL/min: 750 mg every 12 hours
- Creatinine clearance <10 mL/min: 750 mg every 24 hours
- Patients on hemodialysis should receive an additional dose after dialysis 2
Clinical Applications
- Cefuroxime axetil is effective for respiratory tract infections (both upper and lower), including bronchitis and pneumonia 3, 4
- It is also indicated for genitourinary tract infections, skin and soft tissue infections 3
- For early Lyme disease, 500 mg twice daily for 14-21 days is recommended 1
- In cataract surgery, a single intracameral injection of 1 mg in 0.1 mL is used 1
- For cardiac surgery, 1.5 g IV with 0.75 g reinjection every 2 hours intraoperatively may be used 1
Important Considerations
- Cefuroxime axetil should be taken with food to increase absorption 1
- The drug is well-tolerated with primarily mild to moderate gastrointestinal side effects 3, 4
- Cefuroxime has shown efficacy against common respiratory pathogens including H. influenzae, S. pneumoniae, and M. catarrhalis 3, 5
- Sequential therapy (IV to oral) has proven effective in community-acquired pneumonia 4
- Cefuroxime axetil has been shown to cause fewer gastrointestinal adverse events compared to some other cephalosporins 5
Remember that dosing should always consider the specific infection being treated, the severity of illness, and patient factors such as age and renal function.