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) | 3000 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.
- IV cefuroxime is capped at a maximum of 3 g/day in adults, regardless of a weight-based calculation exceeding that figure.
- Requires dose-interval adjustment in significant renal impairment.
Frequently asked questions
What is cefuroxime axetil tablet used for?
Cefuroxime axetil is the oral prodrug form of cefuroxime, used as a tablet or suspension for respiratory tract infections, otitis media, and urinary tract infections — it's converted to active cefuroxime after absorption. A common adult dose is cefuroxime 500 mg, typically given twice daily.
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, and IV dosing is capped at a maximum of 3 g/day. Always match the formulation selected to the intended route.
What does the BNF say about cefuroxime?
The British National Formulary lists cefuroxime axetil for oral use and cefuroxime sodium for IV/IM use, with separate dosing tables for each since they aren't interchangeable mg-for-mg — see the BNF or BNFc for the current age/weight-banded doses and maximums.
Can cefuroxime be used in penicillin allergy?
Cephalosporins carry a low (roughly 1–3%) rate of cross-reactivity with penicillins, higher in patients with a history of severe/anaphylactic penicillin reactions, where cefuroxime and other cephalosporins are generally avoided — a careful allergy history should guide this decision.
Are cefuroxime eye drops available?
Cefuroxime is not commercially available as a standard eye-drop formulation — where a cephalosporin is needed for eye infections, it's more commonly prepared as an extemporaneous/compounded ophthalmic preparation by a specialist pharmacy, not something dosed from this weight-based systemic calculator.
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.