, and absorption is unreliable due to hemodynamic instability that is relatively common in this population.
Neonates 0 to 7 days†
50 mg/kg/dose IM every 12 hours is the general dosing recommended by the American Academy of Pediatrics (AAP). In general, IM administration of drugs in very low birth weight premature neonates is not practical due to small muscle mass, and absorption is unreliable due to hemodynamic instability that is relatively common in this population.
Oral dosage†
Adults
500 mg PO twice daily. Clinical practice guidelines suggest cefuroxime as an alternative to amoxicillin or amoxicillin; clavulanate in combination with a macrolide or doxycycline for use in outpatients with comorbidities, who have used antibiotics in the preceding 3 months, or who have other risks for drug-resistant S. pneumoniae. Treat for at least 5 days; before discontinuing therapy, be afebrile for 48 to 72 hours with no more than 1 community acquired pneumonia (CAP)-associated sign of clinical instability. A longer duration of treatment may be necessary if the initial therapy is not active against identified pathogens or if there are complications.
Infants, Children, and Adolescents
20 to 30 mg/kg/day PO divided twice daily (Max: 1000 mg/day) is the general pediatric dosing recommended by the American Academy of Pediatrics (AAP). Cefuroxime is recommended as an alternative oral step-down therapy for infants and children 3 months of age and older with community-acquired pneumonia (CAP) due to S. pneumoniae and penicillin allergy.
For the treatment of intraabdominal infections†.
Intravenous dosage
Adults
1.5 g IV every 8 hours for 4 to 7 days. Clinical practice guidelines suggest cefuroxime in combination with metronidazole as a preferred therapy for community-acquired, mild-to-moderate infections; for acute cholecystitis, cefuroxime monotherapy is recommended.
Infants, Children, and Adolescents
150 mg/kg/day IV divided every 6 to 8 hours (Max: 4.5 g/day) is recommended by the Infectious Diseases Society of America (IDSA). 75 to 100 mg/kg/day IV divided every 8 hours (Max: 4.5 g/day) for mild-to-moderate infections and 100 to 200 mg/kg/day IV divided every 6 to 8 hours (Max: 6 g/day) for severe infections is the general pediatric dosing recommended by the American Academy of Pediatrics (AAP).
Neonates 8 days and older weighing more than 2000 g
50 mg/kg/dose IV every 8 hours is the general dosing recommended by the American Academy of Pediatrics (AAP).
Neonates 8 days and older weighing 2000 g or less
50 mg/kg/dose IV every 8 to 12 hours is the general dosing recommended by the American Academy of Pediatrics (AAP).
Neonates 0 to 7 days
50 mg/kg/dose IV every 12 hours is the general dosing recommended by the American Academy of Pediatrics (AAP).
†Indicates off-label use
MAXIMUM DOSAGE
Adults
9 g/day IM/IV; 1000 mg/day PO.
Elderly
9 g/day IM/IV; 1000 mg/day PO.
Adolescents
9 g/day IM/IV; 1000 mg/day PO.
Children
240 mg/kg/day IM/IV not to exceed 9 g/day IM/IV; 30 mg/kg/day PO not to exceed 1000 mg/day PO.
Infants
>= 3 months: 240 mg/kg/day IM/IV; 30 mg/kg/day PO.
< 3 months: Safety and efficacy have not been established.
DOSING CONSIDERATIONS
Hepatic Impairment
Specific guidelines for dosage adjustments in hepatic impairment are not available; however, it appears no dosage adjustment is necessary.
Renal Impairment
For oral formulations:
CrCl >= 30 mL/min: No dosage adjustmen |
