Cefuroxime (TIL) is indicated in the treatment of-
Upper Respiratory Tract Infections: Such as otitis media, sinusitis, tonsillitis and pharyngitis caused by M. catarrhalis, S. pyogenes, S. pneumoniae or S. influenzae.
Lower Respiratory Tract Infections: Such as acute bronchitis, acute exacerbations of chronic bronchitis and pneumonia caused by Streptococcus pneumoniae, Haemophilus influenzae.
Skin and Soft Tissue Infections: Such as furunculosis, pyoderma, and impetigo caused by Staphylococcus aureus (penicillinase and non-penicillinase-producing strains), Streptococcus pyogenes.
Urinary Tract Infections: Such as pyelonephritis, urethritis and cystitis caused by Escherichia coli and Klebsiella spp. Uncomplicated gonorrhoea, urethral & endocervical caused by Neisseria gonorrhoeae.
Early Lyme disease and subsequent prevention of late Lyme disease caused by Borrelia burgdorferi.
Dosage and administration:
Adults and Adolescents (above 12 years)
Infection Dosage Duration
Pharyngitis/tonsillitis/sinusitis 250 mg twice daily 10 days
Acute exacerbations of chronic bronchitis 250 or 500 mg twice daily 10 days
Uncomplicated skin and soft tissue infections 250 or 500 mg twice daily 10 days
Uncomplicated urinary tract infections 125 or 250 mg twice daily 7-10 days
Uncomplicated gonorrhoea 1000 mg single dose
Early Lyme disease ( Adult & children) 500 mg twice daily 20 days
Children: Over 3 months of age: 125 mg twice daily or 10 mg/kg twice daily to a maximum of 250 mg daily. Over 2 years of age: 250 mg twice daily or 15 mg/kg twice daily to a maximum of 500 mg daily.
Adult: 750 mg three times daily by IM or IV injection. In severe infections, dose can be increased upto 1.5 gm three times daily by IV injection. The frequency may be increased to four times daily, if necessary, giving total daily doses of 3 to 6 gm.
Children (above 3 months of age): 30 - 100 mg/kg/day given in 3 or 4 equally divided doses. A dose of 60mg/kg/day is appropriate for most infections.
Neonate: 30 - 100 mg/kg/day given in 2 or 3 equally divided doses.
Surgical prophylaxis: 1.5 gm by IV injection at induction of anaesthesia; up to 3 further doses of 750 mg may be given by IV/IM injection every 8 hours for high risk procedures
Sequential therapy in adults:
Pneumonia: 1.5 gm IV injection twice daily for 2-3 days, followed by 500 mg twice daily (oral) for 7-10 days.
Acute exacerbations of chronic bronchitis: 750 mg twice daily (IM or IV injection) for 2-3 days, followed by 500 mg twice daily (oral) for 5-10 days. (Duration of both parenteral and oral therapy is determined by the severity of the infection and the clinical status of the patient.)
Gonorrhoea: Adult: 1.5g as a single dose (as 2 x 750mg injections intramuscularly with different sites, e.g. each buttock).
Meningitis: Adults: 3gm IV injection three times daily. Children (above 3 months of age): 200-240 mg/kg/day by IV injection in 3 or 4 divided doses reduced to 100 mg/kg/day after 3 days or on clinical improvement. Neonate: 100 mg/kg/day by IV injection reduced to 50 mg /kg/day.
Bone and joint infections: Adult: 1.5 gm IV injection four times daily. Children (above 3 months of age): 150 mg/kg/day (not to exceed the maximum adult dose) in equally divided doses every 8 hours.
In renal impairment: As Cefuroxime's half-life is prolonged in renal impairment, doses of Cefuroxime should be adjusted.