What is the recommended pediatric dose of Zocef CV (Cefuroxime Axetil)?

Zocef CV (Cefuroxime Axetil) Pediatric Dosing

The recommended pediatric dose of cefuroxime axetil (Zocef CV) is 20-50 mg/kg/day divided into two doses every 12 hours, with a maximum of 500 mg per dose. 1

Standard Dosing Guidelines

Oral Cefuroxime Axetil Dosing

• 20-50 mg/kg/day divided every 12 hours is the established pediatric dose 1
• Maximum single dose: 500 mg 1
• The dose should not exceed adult dosing limits 1

Parenteral Cefuroxime (IV/IM) Dosing for Reference

• 100-200 mg/kg/day divided every 6-8 hours for severe infections 1
• Maximum single dose: 1500 mg 1
• For pediatric patients above 3 months: 50-100 mg/kg/day in divided doses every 6-8 hours for most infections 2
• Higher dosage of 100 mg/kg/day should be used for more severe infections 2

Clinical Context and Indications

When Cefuroxime Axetil is Appropriate

• Community-acquired pneumonia caused by Streptococcus pneumoniae with penicillin MIC <2.0 μg/mL 1
• Alternative therapy to amoxicillin or amoxicillin/clavulanate for respiratory tract infections 1
• Beta-lactamase producing organisms including Haemophilus influenzae 1
• Upper and lower respiratory tract infections, otitis media, sinusitis 3, 4

Important Prescribing Considerations

• Cefuroxime axetil should be given with food to enhance absorption - bioavailability is 68% when taken after meals 3
• The drug is particularly useful when beta-lactamase-producing strains are suspected 4
• Amoxicillin remains first-line for most pediatric community-acquired pneumonia; cefuroxime axetil is an alternative 1

Age-Specific Cautions

Neonates and Young Infants

• Infants under 3 months: Use parenteral cefuroxime with caution; dose is 50 mg/kg twice daily 5
• Half-life is prolonged in neonates <4 days old (5.8 hours vs 1.6-3.8 hours in older infants) 5
• All infants <6 months with pneumonia should be hospitalized regardless of antibiotic choice 1

Renal Impairment

• Dosage adjustment required in children with renal insufficiency, following adult guidelines proportionally 2
• Cefuroxime is dialyzable; additional dose needed after hemodialysis 2

Common Pitfalls to Avoid

• Do not underdose: The 20 mg/kg/day dose may be insufficient for serious infections; use 40-50 mg/kg/day for pneumonia 1
• Do not confuse oral and IV formulations: Oral cefuroxime axetil dosing (20-50 mg/kg/day) differs significantly from IV cefuroxime (100-200 mg/kg/day) 1, 2
• Ensure adequate food intake: Administration without food significantly reduces absorption 3
• Consider atypical pathogens: In school-aged children (≥5 years), if Mycoplasma pneumoniae is suspected, a macrolide is preferred over cefuroxime 1