How the dose is calculated
Cefuroxime is dosed in mg/kg/day. The oral (axetil) formulation is used for standard mild-moderate infections divided every 12 hours; the injectable (sodium) formulation is used for more severe infections at a higher total daily dose divided every 8 hours.
Typical dosing by indication
| Indication | Dose | Frequency | Max |
|---|---|---|---|
| Standard oral | 25 mg/kg/day | every 12h (2×/day) | 1000 mg/day |
| Severe (IV) | 100 mg/kg/day | every 8h (3×/day) | 4500 mg/day |
Clinical use
- Cefuroxime is a second-generation cephalosporin with broader Gram-negative activity than first-generation agents like cephalexin, while retaining good Gram-positive coverage.
- The oral (axetil) and injectable (sodium) formulations are not interchangeable mg-for-mg in bioavailability terms — always select the formulation matching the route being used.
- Commonly used for respiratory tract infections, otitis media, and as a surgical prophylaxis or step-down agent from broader IV therapy.
- Requires dose-interval adjustment in significant renal impairment.
Frequently asked questions
What is cefuroxime used for?
Cefuroxime is a second-generation cephalosporin used for respiratory tract infections, otitis media, urinary tract infections, and surgical prophylaxis, available in both oral and injectable forms.
Is the oral and IV cefuroxime dose the same?
No — the oral (axetil) and IV (sodium) formulations have different bioavailability, so the mg/kg/day dosing differs substantially between them. Always match the formulation selected to the intended route.
How is cefuroxime different from cephalexin?
Cefuroxime is a second-generation cephalosporin with broader Gram-negative coverage than cephalexin (a first-generation agent), while still covering many of the same Gram-positive organisms.
Does cefuroxime need adjusting for kidney function?
Yes — cefuroxime is renally cleared, so the dose or dosing interval needs adjustment in significant renal impairment.
References
- British National Formulary for Children (BNFc) — Cefuroxime.
- American Academy of Pediatrics Red Book — Cefuroxime.
- Bradley JS, et al. PIDS/IDSA Community-Acquired Pneumonia Guideline. Clin Infect Dis. 2011.