Cefuroxime: veterinary dose and monograph

At a glance

Drug class

Antibiotic

Also known as

Ceftum, Zinacef, Supacef, Cefuroxime axetil

Species with doses

Dogs and Cats

General dose range

10–20 mg/kg IV q8–12h — check the species tables for the indication

Routes

IV, SC, PO

Last reviewed

1 October 2026

Indications

• Skin / soft-tissue and wound infections
• Respiratory tract infections (susceptible)
• Urinary tract infection
• Surgical antibiotic prophylaxis (beta-lactamase-stable Gram-positive cover)

Cefuroxime dose by species

Doses are per administration unless stated. mg/kg doses scale with body weight; per-animal, per-quarter and infusion-rate doses are shown as the reference writes them.

Dogs

• Systemic infection: Plumb’s p.239 (Greene 2006): systemic infections 15 mg/kg IV q8h — extrapolated from human dosing. Not in Papich 5e.
• Surgical prophylaxis: Plumb’s p.239 (Greene 2006): 20 mg/kg IV 30 minutes before surgery and every 2 hours during surgery. Plumb’s 10e p.233 widens this to 20–50 mg/kg IV given slowly (over at least 3–5 minutes) ≈30 minutes before surgery, then every 1.5–3 hours during surgery (next row).
• Surgical prophylaxis (Plumb’s 10e): Plumb’s 10e p.233 (dogs/cats, extra-label): 20–50 mg/kg IV slowly over at least 3–5 minutes, ≈30 minutes before surgery, and every 1.5 to 3 hours during surgery.
• Susceptible infection — MIC ≤1 µg/mL (SC): Plumb’s 10e p.233 (dogs/cats, extra-label, small PK study): 20 mg/kg SC every 12 hours for bacteria with MIC ≤1 µg/mL.
• Susceptible infection — MIC ≤4 µg/mL (IM/SC): Plumb’s 10e p.233 (dogs/cats, extra-label, small PK study): 20 mg/kg IM or SC every 8 hours for bacteria with MIC ≤4 µg/mL.
• Soft-tissue infection (oral axetil): Plumb’s p.239 (Greene 2006): 10 mg/kg PO q12h for 10 days (extrapolated from human dosing).
• Bacterial meningitis: Plumb’s p.239 (Greene 2006): 30 mg/kg IV q8h (extrapolated from human dosing).

Cats

• Surgical prophylaxis: Plumb’s 10e p.233 (dogs/cats, extra-label): 20–50 mg/kg IV slowly over at least 3–5 minutes, ≈30 minutes before surgery, and every 1.5 to 3 hours during surgery. Papich 5e has no monograph.
• Susceptible infection — MIC ≤1 µg/mL (SC): Plumb’s 10e p.233 (dogs/cats, extra-label, small PK study): 20 mg/kg SC every 12 hours for bacteria with MIC ≤1 µg/mL. (Plumb’s also lists an anecdotal “oral” 10–15 mg/kg q8–12h, but prints the route as IV — the route is ambiguous in the source, so it is not offered as a dose here.)
• Susceptible infection — MIC ≤4 µg/mL (IM/SC): Plumb’s 10e p.233 (dogs/cats, extra-label, small PK study): 20 mg/kg IM or SC every 8 hours for bacteria with MIC ≤4 µg/mL.

Horses

• No reference dose for this species: Neither Papich 5e nor Plumb’s 10e (p.233 doses dogs/cats and goats only) gives a cefuroxime dose for horses or foals.

Contraindications

Beta-lactam (penicillin/cephalosporin) hypersensitivity. Reduce dose in significant renal impairment. Known hypersensitivity. Not for confirmed resistant Gram-negatives/Pseudomonas (limited cover). Give oral form with food (improves axetil absorption).

Adverse effects

• GI upset (vomiting, diarrhoea)
• Hypersensitivity reactions
• Injection-site pain/phlebitis
• Antibiotic-associated diarrhoea

Drug interactions

• Aminoglycosides: additive nephrotoxicity (and Gram-negative synergy)
• Probenecid: prolongs half-life
• Bacteriostatic agents: possible antagonism
• Antacids/H2-blockers: reduce oral axetil absorption

Pregnancy and lactation

Cephalosporins are generally considered safe in pregnancy/lactation.

Monitoring

• Culture & sensitivity and clinical response
• Renal function on prolonged/high-dose therapy
• Hypersensitivity at first dose
• Surgical-prophylaxis timing (re-dose intra-op for long procedures)

Toxicity and overdose

Wide margin — acute toxicity essentially limited to GI upset and hypersensitivity; accumulates in renal impairment. Overuse selects for resistant Gram-negatives but less so than third-generation agents.

Management: Supportive; no specific antidote. Treat hypersensitivity conventionally; fluids and dose reduction in renal impairment.

Clinical pearls

• A dependable second-generation beta-lactam and a good surgical-prophylaxis choice (beta-lactamase-stable Gram-positive cover) — give at induction and re-dose every ~90–120 min for long surgeries
• Broader Gram-negative reach than first-generation cephalosporins, while sparing third-generation agents (stewardship)
• Give the oral axetil prodrug with food for best absorption
• Not a choice for Pseudomonas/confirmed resistant Gram-negatives

Mechanism of action

Beta-lactam that binds penicillin-binding proteins to inhibit peptidoglycan cross-linking and bacterial cell-wall synthesis — bactericidal, time-dependent. Its second-generation structure is more stable against many staphylococcal and Gram-negative beta-lactamases than first-generation cephalosporins, broadening Gram-negative reach while retaining good Gram-positive activity.

Formulations and products

• Injection 750 mg / 1.5 g vial (reconstitute)
• 250 / 500 mg tablet (cefuroxime axetil, oral)
• Ceftum — 250 / 500 mg tablet, Tablet (axetil) (human-label)
• Supacef / Zinacef — 750 mg / 1.5 g vial, Injection (human-label)

Storage

Powder vial: 15–25 °C; reconstituted solution refrigerate and use within 24 h. Tablets: 15–30 °C, dry.

Before you use this dose

Reference doses for veterinary professionals. Confirm the dose against the product label, the patient’s condition, current guidance and local regulations before use; the attending veterinarian remains responsible for every clinical decision.

Other antibiotics

• Cefquinome
• Ceftazidime
• Ceftiofur
• Ceftriaxone
• Cephalexin
• Chloramphenicol
• Ciprofloxacin
• Clarithromycin

Frequently asked questions