Cefuroxime

Parenteral Cefuroxime (IV or IM, Zinacef)
1. Mild to Moderate Infection
  1. Give 750 mg IM or IV every 8 hours
2. Severe Infection (includes bone and joint infections)
  1. Give 1.5 g IM or IV every 8 hours
3. Sepsis
  1. Give 1.5 g IV every 6 hours OR
  2. Give 3 g IV every 8 hours
4. General Surgery Prophylaxis
  1. Give 1.5 g IV at 30 to 60 min before surgery, then 750 mg every 8 hours during procedure
5. Open Heart Surgery Prophylaxis
  1. GIve 1.5 g IV every 12 hours for 4 doses (start with first dose at Anesthesia induction)
Oral Cefuroxime Axetil (Ceftin)
1. Typical Dosing
  1. Take 250 to 500 mg orally twice daily with food
2. Streptococcal Pharyngitis
  1. Take 250 mg orally twice daily for 10 days
Renal Dosing
1. eGFR 10 to 30 ml/min: Give typical dose every 24 hours
2. eGFR <10 ml/min: Give typical dose every 48 hours
  1. Give dose after Hemodialysis

Parenteral Cefuroxime (IV or IM, Zinacef)
1. Mild to Moderate Infection (typical infections)
  1. Give 50-100 mg/kg/day IM or IV divided every 6 to 8 hours (max: 1.5 g/dose)
2. Severe Infection (includes bone and joint infections)
  1. Give 150 mg/kg/day IM or IV divided every 6 to 8 hours (max: 1.5 g/dose)
Oral Cefuroxime Axetil (Ceftin)
1. Suspension reported to have unpleasant taste (Cefprozil may be better tolerated)
2. Typical Dosing
  1. Give 20 to 30 mg/kg/day orally (up to 1 g/day) divided twice daily with food
3. Streptococcal Pharyngitis
  1. Give 20 mg/kg/day (max 500 mg/day) orally divided twice daily for 10 days
4. Otitis Media or Acute Sinusitis
  1. Give 30 mg/kg/day (max 1 g/day) orally divided twice daily

Antacids (e.g. H2 Blockers, Proton Pump Inhibitors)
1. Decrease Cefuroxime absorption
2. Avoid with Proton Pump Inhibitors or H2 Blockers
3. Take at least 1 hour before or 2 hours after other Antacids