Oral Skin and skin structure infections, Urinary tract infections
Adult: Usual dose: 1 or 2 g daily as a single or in 2 divided doses. Individualise dosage based on the susceptibility of pathogens, severity of infection, and clinical status of the patient. Consideration must be given to local treatment guidelines on the appropriate use of antibacterials. Child: ≥6 years Recommended dose: <40 kg: 30-50 mg/kg daily as a single or in 2 divided doses. Max: 100 mg/kg daily. >40 kg: Same as adult dose. Consideration must be given to local treatment guidelines on the appropriate use of antibacterials.
Oral Streptococcal pharyngitis, Tonsillitis
Adult: For cases caused by susceptible strains of Streptococcus pyogenes (group A β-haemolytic streptococci): 1 g once daily or 500 mg bid for at least 10 days. Consideration must be given to local treatment guidelines on the appropriate use of antibacterials. Child: Recommended dose: <40 kg: 30 mg/kg daily as a single or in 2 divided doses for at least 10 days. Max: 100 mg/kg daily. >40 kg: Same as adult dose.
Renal Impairment
Patient on haemodialysis: Give an additional 0.5-1 g dose at the end of each dialysis session. CrCl ≤10 mL/min/1.73 m2: Initially, 1 g as a single dose, then 0.5-1 g every 36 hours. CrCl 11-25 mL/min/1.73 m2: Initially, 1 g as a single dose, then 0.5-1 g every 24 hours. CrCl 26-50 mL/min/1.73 m2: Initially, 1 g as a single dose, then 0.5-1 g every 12 hours.
Administration
May be taken with or without food. May be taken w/ meals to reduce GI discomfort.
Reconstitution
Powder for oral susp: Tap the bottle to lightly loosen the powder, then add the appropriate amount of water as specified on the packaging. Shake the bottle well after each addition until suspended.
Contraindications
Hypersensitivity to cefadroxil or other cephalosporins.
Special Precautions
Patient with history of hypersensitivity to penicillins or any other β-lactam drugs, severe allergy or asthma; history of gastrointestinal disease, especially colitis. Renal impairment. Pregnancy and lactation.
Adverse Reactions
Significant: Hypersensitivity reactions, including anaphylaxis; Clostridium difficile-associated diarrhoea. Blood and lymphatic system disorders: Rarely, eosinophilia, neutropenia, thrombocytopenia, agranulocytosis. Gastrointestinal disorders: Diarrhoea, nausea, vomiting, dyspepsia, abdominal pain, glossitis. General disorders and administration site conditions: Rarely, fever. Immune system disorders: Rarely, serum sickness-like reaction, angioneurotic oedema. Investigations: Rarely, slightly elevated AST and ALT. Musculoskeletal and connective tissue disorders: Rarely, arthralgia. Skin and subcutaneous tissue disorders: Rash, pruritus, allergic exanthema, urticaria. Potentially Fatal: Pseudomembranous colitis.
Perform culture and susceptibility tests; consult local institutional recommendations before treatment initiation due to antibiotic resistance risks. Monitor renal function test, LFTs and blood count frequently on long-term use; signs and symptoms of anaphylaxis during 1st dose.
Overdosage
Symptoms: Nausea, hyperreflexia, extrapyramidal symptoms, hallucinations, clouded consciousness or even coma, and renal function impairment. Management: Immediately induce vomiting or perform gastric lavage. Consider haemodialysis if needed. Monitor renal function, and correct water and electrolyte balance if necessary.
Drug Interactions
May cause an antagonistic effect with bacteriostatic antibiotics (e.g. tetracycline, erythromycin, sulfonamides, chloramphenicol). May potentiate nephrotoxic effects of aminoglycoside antibiotics, polymyxin B, colistin or high-dose loop diuretics. May cause haemorrhagic complications with prolonged use of anticoagulant or thrombocyte inhibitors. May increase plasma concentration with probenecid. May decrease bioavailability with colestyramine.
Lab Interference
Positive direct Coombs’ test. May result in false-positive reaction for urine glucose using cupric sulfate (Benedict’s solution, Fehling’s solution); false-positive serum or urine creatinine with Jaffé reaction.
Action
Description: Mechanism of Action: Cefadroxil is a 1st generation oral cephalosporin. It binds to 1 or more of the penicillin-binding proteins (PBPs) which in turn blocks the final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thereby inhibiting cell wall biosynthesis and arresting cell wall assembly resulting in bacterial lysis. Pharmacokinetics: Absorption: Rapidly and almost completely absorbed from the gastrointestinal tract. Time to peak plasma concentration: Approx 1-2 hours. Distribution: Widely distributed into body tissues and fluids. Crosses the placenta and enters breast milk. Volume of distribution: 0.31 L/kg. Plasma protein binding: Approx 20%. Excretion: Via urine (>90% as unchanged drug within 24 hours). Elimination half-life: 1-2 hours; 20-24 hours (patient with renal failure).
Chemical Structure
Cefadroxil Source: National Center for Biotechnology Information. PubChem Database. Cefadroxil, CID=47965, https://pubchem.ncbi.nlm.nih.gov/compound/Cefadroxil (accessed on Jan. 21, 2020)
Storage
Store between 20-25°C. Reconstituted powder for susp: Store between 2-8°C. Discard unused portion after 14 days.
J01DB05 - cefadroxil ; Belongs to the class of first-generation cephalosporins. Used in the systemic treatment of infections.
References
Anon. Cefadroxil. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 03/03/2021.Anon. Cefadroxil. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 03/03/2021.Buckingham R (ed). Cefadroxil. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/03/2021.Cefadroxil 500 mg Capsules (Sandoz Ltd). MHRA. https://products.mhra.gov.uk. Accessed 03/03/2021.Cefadroxil Capsule (Lupin Pharmaceuticals, Inc). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 03/03/2021.Cefadroxil Film-Coated Tablet (Hikma Pharmaceuticals USA Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 03/03/2021.Cefadroxil Powder for Suspension (Hikma Pharmaceuticals USA Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 03/03/2021.Joint Formulary Committee. Cefadroxil. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/03/2021.Wincocef-500 Capsule (Checktrade Pharma, Inc.). MIMS Philippines. http://www.mims.com/philippines. Accessed 03/03/2021.
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