From the Guidelines
Taking 500 mg of Cefuroxime TID instead of BID is not recommended as it may increase the risk of adverse effects without providing additional benefits.
Key Points
- The recommended dosage for Cefuroxime axetil is 500 mg twice per day for adults, as stated in the guidelines by the Infectious Diseases Society of America 1.
- Increasing the frequency to three times a day may lead to a higher risk of drug-induced rashes and other adverse effects, although the evidence does not specifically address the safety of TID dosing.
- The guidelines emphasize that cefuroxime axetil is effective for the treatment of early Lyme disease, but first-generation cephalosporins are ineffective and should not be used 1.
- It is essential to follow the recommended dosage to minimize the risk of adverse effects and ensure the effectiveness of the treatment.
Rationale
The guidelines provide clear recommendations for the treatment of Lyme disease, including the dosage and frequency of Cefuroxime axetil. While the evidence does not specifically address the safety of TID dosing, it is essential to follow the recommended guidelines to minimize the risk of adverse effects and ensure the effectiveness of the treatment.
Important Considerations
- Pregnant or lactating patients may be treated with Cefuroxime axetil, but doxycycline should be avoided due to its potential risks 1.
- Children under 8 years of age should not be treated with doxycycline, and alternative antibiotics such as amoxicillin or cefuroxime axetil may be used 1.
From the Research
Dosage Comparison
- The study 2 compared the efficacy, safety, and tolerability of cefuroxime 750 mg iv administered either twice daily (bd) or three times daily (tds) for 48-72 h, followed by oral cefuroxime axetil 500 mg bd for 5-7 days in a sequential therapy regimen for the treatment of acute exacerbations of chronic bronchitis.
- The results showed that both treatment regimens were well tolerated, with a similar incidence of drug-related adverse events (7% in the cefuroxime tds group and 6% in the cefuroxime bd group).
- Another study 3 found that oral cefuroxime axetil 250 or 500 mg twice daily was an effective treatment in patients with upper and lower respiratory tract infections, and that shorter courses (5 to 10 days') of cefuroxime axetil were at least as effective as a 10 day course.
Safety and Efficacy
- The study 4 compared the clinical and bacteriologic efficacies and the safety of 5- or 10-day treatment with cefuroxime axetil with those of 10-day treatment with amoxicillin-clavulanate in the treatment of secondary bacterial infections of acute bronchitis.
- The results showed that treatment with cefuroxime axetil for either 5 or 10 days was associated with significantly fewer gastrointestinal adverse events, particularly diarrhea and nausea, than was 10-day treatment with amoxicillin-clavulanate.
- Another study 5 found that a 5-day regimen of 800 mg telithromycin once daily was similar in efficacy and equally well tolerated as a 10-day regimen of 500 mg cefuroxime axetil twice daily in adults with acute exacerbations of chronic bronchitis.
Adverse Events
- The study 6 compared the clinical and bacteriologic efficacy and safety of cefuroxime axetil and amoxicillin/clavulanate in the treatment of patients with secondary bacterial infections of acute bronchitis.
- The results showed that treatment with amoxicillin/clavulanate was associated with a significantly higher incidence of drug-related adverse events than was treatment with cefuroxime axetil, primarily reflecting a higher incidence of drug-related gastrointestinal adverse events.
- However, none of the studies directly compared the safety and efficacy of taking 500 mg of Cefuroxime TID instead of BID, but they suggest that cefuroxime axetil is well tolerated and effective in various dosing regimens 2, 3, 4, 5, 6.