What is the recommended dose of cefuroxime (Cefuroxime) for treating sinusitis in adults?

Cefuroxime Dosage for Sinusitis in Adults

The recommended dose of cefuroxime for treating sinusitis in adults is 250-500 mg twice daily for 10-14 days. 1, 2

Dosage Guidelines

• Cefuroxime should be administered at 250-500 mg twice daily (BID) for adults with sinusitis 1
• The typical duration of treatment is 10-14 days for most cases of acute bacterial sinusitis 1, 2
• For severe or complicated infections, the higher dose of 500 mg twice daily is preferred 2
• Some studies suggest that a shorter 5-day course may be effective in certain cases, though the standard recommendation remains 10-14 days 2

Efficacy and Comparison with Other Antibiotics

• Cefuroxime has demonstrated similar efficacy to amoxicillin-clavulanate in the treatment of acute and chronic sinusitis 1, 2
• In comparative studies, cefuroxime 250 mg twice daily showed comparable clinical cure rates to amoxicillin 250 mg three times daily for acute sinusitis 3
• Cefuroxime has good activity against common sinusitis pathogens including β-lactamase-producing H. influenzae, M. catarrhalis, and S. aureus 1
• When compared with ciprofloxacin, cefuroxime showed similar bacteriologic eradication rates but potentially lower clinical resolution rates in some studies 4

Clinical Considerations

• Cefuroxime is a second-generation cephalosporin with enhanced activity against β-lactamase-producing bacteria commonly found in sinusitis 1
• First-generation cephalosporins (like cephalexin) have poor coverage for H. influenzae and are therefore inappropriate for sinusitis treatment 1
• Cefuroxime has the advantage of twice-daily administration, improving compliance compared to medications requiring more frequent dosing 1
• For patients who do not respond to initial treatment with amoxicillin after 3-5 days, cefuroxime is an appropriate alternative 2

Special Populations and Contraindications

• For patients with renal impairment, dosage adjustment is necessary: 5
  • Creatinine clearance >20 mL/min: Standard dosing
  • Creatinine clearance 10-20 mL/min: 750 mg every 12 hours
  • Creatinine clearance <10 mL/min: 750 mg every 24 hours
• Common adverse effects include gastrointestinal symptoms, particularly diarrhea 3, 4
• Cefuroxime should be completed for the full prescribed course even after symptom resolution to prevent relapse and development of resistance 2

Monitoring and Follow-up

• Evaluate response to treatment after 3-5 days and consider changing antibiotics if there is no improvement 2
• If symptoms worsen or complications develop (such as meningeal syndrome, exophthalmos, palpebral edema), immediate referral to hospital may be necessary 2