What is the recommended duration in days and dosing frequency per day for cefuroxime 500 mg tablets in adults?

Cefuroxime 500 mg Tablet Dosing

Cefuroxime 500 mg tablets should be given twice daily (every 12 hours), with treatment duration ranging from 4-21 days depending on the specific infection being treated. 1

Dosing Frequency

• Standard dosing is 500 mg twice daily for most infections requiring this dose strength 1, 2, 3
• The twice-daily schedule is based on cefuroxime's pharmacokinetic profile, which maintains therapeutic tissue concentrations with 12-hour dosing intervals 2, 3
• Tablets should be taken with food to increase absorption 1

Duration by Infection Type

Respiratory Tract Infections

• Pneumonia and severe lower respiratory infections: 500 mg twice daily for 5-10 days 2, 3
• Most respiratory infections respond well to 5-10 day courses, with shorter 5-day courses proving as effective as 10-day regimens 3
• Acute bacterial sinusitis: 500 mg twice daily for 4-14 days 1, 4
  • A 4-day course showed 90.8% symptom resolution in acute maxillary sinusitis 4
  • Standard guideline recommendation is 14 days for chronic rhinosinusitis 1

Lyme Disease

• Early Lyme disease (erythema migrans): 500 mg twice daily for 14-21 days 1
• The full 14-21 day course is necessary due to cefuroxime's shorter half-life compared to other antibiotics 1

Skin and Soft Tissue Infections

• Animal bites: 500 mg twice daily for 14 days 1

Other Infections

• Urinary tract infections: May use lower doses (125-250 mg twice daily), but 500 mg dosing would follow the same twice-daily schedule for 5-10 days 2, 3

Important Clinical Considerations

• Maximum adult daily dose is 4000 mg/day (which would be 2000 mg twice daily, well above the 500 mg dose) 1
• The twice-daily dosing distinguishes oral cefuroxime from IV formulations, which require every 8-hour dosing for serious infections 1
• First-generation cephalosporins like cephalexin cannot be substituted for cefuroxime in infections like Lyme disease, as they lack activity against the causative organisms 1
• Adverse effects are generally mild and transient, primarily gastrointestinal disturbances 2, 3

Practical Algorithm for Duration Selection

1. Respiratory infections (pneumonia, bronchitis): Start with 5-7 days; extend to 10 days if severe or slow response 3
2. Sinusitis: 4 days for uncomplicated acute cases; 14 days for chronic or complicated cases 1, 4
3. Lyme disease: Always complete full 14-21 days 1
4. Skin/soft tissue infections: 14 days standard 1