Cefuroxime Dosage for Bacterial Infections
The standard dosage of cefuroxime for bacterial infections in adults is 500 mg twice daily for 7-14 days, with dosage adjustments based on infection severity and site. 1
Adult Dosing Recommendations
- For most common bacterial infections, oral cefuroxime is administered at 250-500 mg twice daily 1, 2
- For more severe infections including pneumonia, the recommended dose is 500 mg twice daily 2, 3
- For respiratory tract infections, 250 mg twice daily is typically sufficient, though more severe lower respiratory tract infections may require 500 mg twice daily 2, 4
- For chronic rhinosinusitis, 500 mg twice daily for 14 days has shown clinical efficacy comparable to amoxicillin-clavulanate 5
- For skin and soft tissue infections, 250 mg twice daily is generally appropriate 2, 3
Parenteral (Injectable) Dosing
- For severe infections requiring parenteral therapy, the standard dosage is 750 mg to 1.5 grams every 8 hours 1
- In life-threatening infections, dosing may be increased to 1.5 grams every 6 hours 1
- For bacterial meningitis, the dosage should not exceed 3 grams every 8 hours 1
Pediatric Dosing
- For children above 3 months of age, the recommended dosage is 50-100 mg/kg/day divided every 6-8 hours 1
- Higher dosage (100 mg/kg/day, not exceeding maximum adult dosage) should be used for more severe infections 1
- For bone and joint infections in children, 150 mg/kg/day (not exceeding maximum adult dosage) is recommended in equally divided doses every 8 hours 1
Duration of Therapy
- Standard duration for most infections is 7-10 days 1, 3
- For respiratory tract infections, 5-10 days of treatment is typically sufficient 3, 4
- For chronic rhinosinusitis, a 14-day course is recommended 5
- Treatment should continue for a minimum of 48-72 hours after the patient becomes asymptomatic 1
Dosage Adjustments for Renal Impairment
- For patients with creatinine clearance >20 mL/min: standard dosing (750 mg-1.5 grams every 8 hours) 1
- For patients with creatinine clearance 10-20 mL/min: 750 mg every 12 hours 1
- For patients with creatinine clearance <10 mL/min: 750 mg every 24 hours 1
- Hemodialysis patients should receive an additional dose after dialysis 1
Clinical Considerations
- Cefuroxime is effective against common respiratory pathogens including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis 2, 6
- In studies comparing cefuroxime with amoxicillin-clavulanate for chronic rhinosinusitis, both showed similar clinical cure rates and bacteriologic eradication 5
- Cefuroxime has shown comparable efficacy to other cephalosporins, quinolones, macrolides, and amoxicillin/clavulanic acid in respiratory infections 3
Potential Pitfalls and Caveats
- Amoxicillin-clavulanate may provide faster symptom improvement in the first 3-5 days of treatment compared to cefuroxime in chronic rhinosinusitis 5
- Clinical relapse at 2-4 weeks may be higher with cefuroxime compared to amoxicillin-clavulanate in chronic rhinosinusitis (8% vs 0%) 5
- The most common adverse effect is diarrhea, which occurs at rates comparable to other antibiotics 5, 2
- Cefuroxime should be taken with food to enhance absorption and bioavailability 2
- For patients with penicillin allergy, be aware of potential cross-reactivity with cephalosporins 7