Oral Cefuroxime Axetil Dosing for an 8.9 kg Infant
For an 8.9 kg infant, administer cefuroxime axetil 125 mg (approximately 5 mL of the 125 mg/5 mL suspension) twice daily for most common bacterial infections. 1, 2
Standard Pediatric Dosing Algorithm
The FDA-approved pediatric dosing for cefuroxime axetil is 20–30 mg/kg/day divided into two doses for most infections, including respiratory tract infections, otitis media, and skin infections. 1, 2
For an 8.9 kg infant, this translates to:
The practical dose is 125 mg twice daily (approximately 28 mg/kg/day), which falls within the recommended range and corresponds to 5 mL of the 125 mg/5 mL oral suspension. 1, 2
Indication-Specific Considerations
For upper respiratory tract infections (otitis media, sinusitis, pharyngitis), the 125 mg twice-daily dose provides adequate coverage against common pathogens including Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. 2, 3
For lower respiratory tract infections (pneumonia, bronchitis), consider the higher end of dosing (250 mg twice daily if the child were larger), but for an 8.9 kg infant, 125 mg twice daily remains appropriate as it achieves therapeutic serum levels. 2, 4
For skin and soft tissue infections, the standard 125 mg twice-daily dose is effective. 2, 4
Administration Guidelines
Administer with food to enhance absorption; bioavailability increases from approximately 37% (fasting) to 52% (with food). 3, 4
The oral suspension should be constituted according to package instructions and shaken well before each dose. 1, 2
Treatment duration is typically 5–10 days depending on infection severity and clinical response, with 5-day courses shown to be as effective as 10-day courses for acute otitis media and acute bronchitis. 3, 4
Clinical Monitoring
Clinical improvement should be evident within 48–72 hours; if no improvement occurs, reassess the diagnosis and consider alternative pathogens or treatment failure. 4
Continue therapy for a minimum of 48–72 hours after the patient becomes asymptomatic or after bacterial eradication is documented. 1
Important Caveats
Do not use cefuroxime axetil for meningitis; parenteral cefuroxime at higher doses (200–240 mg/kg/day IV) is required for CNS infections. 1
Cefuroxime has no activity against Pseudomonas aeruginosa or anaerobes such as Bacteroides fragilis; if these pathogens are suspected, choose an alternative agent. 5
For penicillin-allergic patients, exercise caution as cross-reactivity with cephalosporins occurs in approximately 1–10% of patients with documented penicillin allergy; avoid in patients with immediate hypersensitivity reactions to penicillins. 3, 4
Gastrointestinal disturbances (diarrhea, nausea, vomiting) are the most common adverse effects but are generally mild and transient. 2, 3