What is the maximum dose (MD) in adults for oral cefuroxime (Cefuroxime axetil) 250 mg/5 ml?

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Maximum Dose of Oral Cefuroxime Axetil in Adults

The maximum adult daily dose of oral cefuroxime axetil is 4000 mg/day, though standard dosing for most infections ranges from 250-500 mg twice daily (500-1000 mg/day total). 1

Standard Adult Dosing by Indication

For the 250 mg/5 mL oral suspension formulation, adult dosing follows these parameters:

Mild to Moderate Infections

  • 250 mg (5 mL) twice daily is appropriate for most upper respiratory tract infections, uncomplicated urinary tract infections, and mild skin/soft tissue infections 1, 2
  • This represents a total daily dose of 500 mg 2

More Severe Infections

  • 500 mg (10 mL) twice daily should be used for pneumonia, severe lower respiratory tract infections, and more serious bacterial infections 1, 2, 3
  • This represents a total daily dose of 1000 mg 2, 4

Specific Clinical Scenarios

  • Early Lyme disease (erythema migrans): 500 mg twice daily for 14-21 days 1, 5
  • Uncomplicated gonorrhea: Single 1-g dose (20 mL of the 250 mg/5 mL suspension) 2
  • Chronic rhinosinusitis: 500 mg twice daily for 14 days 1
  • Animal bites: 500 mg twice daily for 14 days 1

Important Administration Considerations

Cefuroxime axetil must be taken with food to increase absorption 1. This is a critical point that directly impacts bioavailability—the absolute bioavailability of tablets is 68% when taken after a meal 2.

Maximum Dose Context

While the absolute maximum is 4000 mg/day 1, this ceiling is rarely approached in standard outpatient practice. The typical maximum used in clinical practice is 1000 mg/day (500 mg twice daily) for severe community-acquired infections 1, 4, 3. The 4000 mg/day maximum likely represents a safety threshold rather than a commonly prescribed dose.

Treatment Duration

Standard treatment courses range from 5-10 days for most respiratory infections 4, with 14-21 days for Lyme disease 1, 5 and 10 days for most other bacterial infections 2.

References

Guideline

Cefuroxime Axetil Dosage Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

Cefuroxime axetil.

International journal of antimicrobial agents, 1994

Guideline

Cefuroxime Dosing Guidelines

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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