Cefuroxime Injection Dosage
For most bacterial infections in adults, administer cefuroxime 750 mg to 1.5 grams intravenously every 8 hours for 5-10 days, with the specific dose determined by infection severity and site. 1
Adult Dosing by Infection Type
Standard Infections
- Uncomplicated infections (urinary tract, skin/soft tissue, uncomplicated pneumonia): 750 mg IV every 8 hours 1
- Severe or complicated infections: 1.5 grams IV every 8 hours 1
- Bone and joint infections: 1.5 grams IV every 8 hours 1
Life-Threatening Infections
- Critical infections or less susceptible organisms: 1.5 grams IV every 6 hours 1
- Bacterial meningitis: Up to 3 grams IV every 8 hours (maximum dose) 1
Specific Indications
- Uncomplicated gonorrhea: 1.5 grams IM as single dose at 2 different sites with 1 gram oral probenecid 1
Surgical Prophylaxis Dosing
General Surgery
- Clean-contaminated procedures: 1.5 grams IV 30-60 minutes before incision, then 750 mg IV/IM every 8 hours if procedure is prolonged 1
Cardiac Surgery
- Open heart surgery: 1.5 grams IV at anesthesia induction, then every 12 hours for total of 6 grams 1
- Alternative cardiac prophylaxis: 1.5 grams IV + 0.75 grams in priming solution, with 0.75 gram reinjection every 2 hours intraoperatively 2
Vascular Surgery
- Arterial procedures (carotid with patch, endoprosthesis): 1.5 grams IV slow, single dose; if duration exceeds 2 hours, reinject 0.75 grams 2
Ophthalmologic Surgery
- Cataract surgery: 1 mg intracameral injection in 0.1 mL at end of procedure 2
Neurosurgery
- Spine surgery with prosthetic material: 1.5 grams IV as single dose; if duration exceeds 2 hours, reinject 0.75 grams 3
Pediatric Dosing (>3 Months)
- Standard infections: 50-100 mg/kg/day IV divided every 6-8 hours 1
- Severe infections: 100 mg/kg/day IV (not exceeding maximum adult dose) 1
- Bone and joint infections: 150 mg/kg/day IV divided every 8 hours (not exceeding maximum adult dose) 1
Renal Impairment Adjustments
Dosing must be reduced when creatinine clearance is impaired: 1
- CrCl >20 mL/min: 750 mg to 1.5 grams every 8 hours (standard dosing)
- CrCl 10-20 mL/min: 750 mg every 12 hours
- CrCl <10 mL/min: 750 mg every 24 hours
- Hemodialysis patients: Give additional dose at end of dialysis 1
Pharmacokinetic Considerations
Peak serum concentrations after 750 mg IM reach 16-25 mcg/mL at 1 hour, declining to <4 mcg/mL by 8 hours in patients with normal renal function. 4 IV bolus of 750 mg produces slightly higher peaks around 40 mcg/mL. 4 The serum half-life is approximately 1.1 hours with nearly complete urinary excretion in 24 hours. 5
For optimal bactericidal activity, maintain serum concentrations above the MIC for at least 40-50% of the dosing interval. 2 Recent pharmacodynamic modeling demonstrates that 750 mg every 12 hours achieves >99% probability of target attainment for Streptococcus pneumoniae, while Staphylococcus aureus requires 1500 mg every 8 hours for >97% probability. 6
Duration of Therapy
- Most infections: 5-10 days minimum 1
- Continue 48-72 hours after symptom resolution or bacterial eradication 1
- Streptococcal infections: Minimum 10 days to prevent rheumatic fever or glomerulonephritis 1
- Chronic urinary tract infections: May require several weeks with frequent monitoring 1
Critical Caveats
Never use doses smaller than those indicated above. 1 For staphylococcal infections with purulent collections, surgical drainage is mandatory as adjunct to antibiotic therapy. 1 In surgical prophylaxis, the injection must end at latest at the beginning of intervention, ideally 30 minutes before incision. 2