Adults: 2-4 g/daily divided to 9 hours IV push over 3-5 min or IV infusion over 15-30 min.
NB: 50-100 mg/kg/daily divided to 12 hours IV push over 5 min or IV infusion over 15-30 min.
CH: 100-150 mg/kg/daily divided to 8 hours IV push over 3-5 min or IV infusion over 15-30 min, maximum dose: 6 g/daily.
Gonorrhoea: 1.5 g as a single dose (as 2 x 750 mg injections intramuscularly with different sites, e.g. each buttock).
Meningitis: Cefuroxime (as Sodium) 750 mg Powder for Injection is suitable for sole therapy of bacterial meningitis due to sensitive strains.
Adults: 3 g IV every 8 hours.
Infants and Children: 150-250 mg/kg/day IV in 3 or 4 divided doses.
Neonates: The dosage should be 100 mg/kg/day IV.
Prophylaxis: The usual dose is 1.5 g IV with induction of anaesthesia for abdominal, pelvic and orthopaedic operations. This may be supplemented with two 750 mg IM doses eight and sixteen hours later. In cardiac, pulmonary, oesophageal and vascular operations, the usual dose is 1.5 g IV with induction of anaesthesia, continuing with 750 mg IM three times daily, for a further 24 to 48 hours. In total joint replacement, 1.5 g Cefuroxime (as Sodium) Powder for Injection may be mixed dry with each pack of methyl methacrylate cement polymer before adding the liquid polymer.
Impaired Renal Function: Cefuroxime is excreted by the kidneys. Therefore, as with all such antibiotics, in patients with markedly impaired renal function, it is recommended that the dosage of Cefuroxime Sodium for Injection should be reduced to compensate for its slower excretion.
It is not necessary to reduce the standard dose (750 mg-1.5 g three times daily) until the creatinine clearance falls to 20 mL/min or below.
In adults with marked impairment (creatinine clearance 10-20 mL/min) 750 mg twice daily is recommended and with severe impairment (creatinine clearance <10 mL/min) 750 mg once daily is adequate.
For patients on haemodialysis a further 750 mg dose should be given IV or IM at the end of each dialysis. In addition to parenteral use, Cefuroxime can be incorporated into the peritoneal dialysis fluid (usually 250 mg for every 2 liters of dialysis fluid given intravenously).
For patients in renal failure on continuous arteriovenous haemodialysis or high-flux haemofiltration in intensive therapy units a suitable dosage is 750 mg twice daily. For low-flux haemofiltration follow the dosage recommended under Impaired Renal Function.