Adult: 1-2 g daily in 2-4 divided doses. Max: 4 g daily. Child: 25-50 mg/kg daily in 2-4 divided doses. For otitis media: 75-100 mg/kg daily in divided doses 6-12 hrly. Max: 4 g daily.
Parenteral Susceptible infections
Adult: 2-4 g daily in 4 divided doses by deep IM or slow IV inj over 3-5 min or by IV infusion. Max: 8 g daily. Child: 50-100 mg/kg daily in 4 divided doses. May increase to 200-300 mg/kg daily in severe infections.
Parenteral Prophylaxis of surgical infections
Adult: 1-2 g given prior to surgery by IM or IV inj. Subsequent doses may be given as needed.
Renal Impairment
Patient on chronic, intermittent haemodialysis: 250 mg before the procedure, repeated after 6-12 hr, then again 36-48 hr after the initial dose, and again at the start of the next haemodialysis if >30 hr have elapsed since the previous dose.
CrCl (mL/min)
Dosage
<5
250 mg 12 hrly.
5-20
250 mg 6 hrly.
>20
500 mg 6 hrly.
Administration
May be taken with or without food. May be taken w/ meals to reduce GI discomfort.
Reconstitution
IM: Add 2 mL or 4 mL of sterile water for inj or NaCl 0.9% inj to 500 mg or 1 g vial, respectively. IV: Add 5 mL of sterile water for inj, dextrose 5% inj, NaCl 0.9% inj or other suitable soln to 500 mg vial. Shake well the entire soln.
Contraindications
Hypersensitivity to cefradine or to other cephalosporins.
Special Precautions
Hypersensitivity to penicillins. Renal impairment. Pregnancy and lactation.
Food may delay the rate but does not affect the extent of absorption.
Lab Interference
False-positive urinary glucose test using Benedict's or Fehling's soln or Clinitest tablets.
Action
Description: Mechanism of Action: Cefradine is a 1st-generation cephalosporin which inhibits the final transpeptidation step of the peptidoglycan synthesis in bacterial cell wall by binding to 1 or more of the penicillin-binding proteins (PBPs), thus arresting cell wall synthesis leading to bacterial cell death. Pharmacokinetics: Absorption: Rapidly and almost completely absorbed from the GI tract. Food may delay the rate but does not affect the extent of absorption. Time to peak plasma concentration: 1 hr (oral); w/in 1-2 hr (IM). Distribution: Widely distributed to body tissues and fluids; CSF (insignificant amount). Crosses the placenta and enters breast milk (small amount). Plasma protein binding: Approx 8-12%. Excretion: Via urine (oral: >90%; IM: 60-80%) as unchanged drug. Plasma half-life: Approx 1 hr.
Chemical Structure
Cefradine Source: National Center for Biotechnology Information. PubChem Database. Cephradine, CID=38103, https://pubchem.ncbi.nlm.nih.gov/compound/Cephradine (accessed on Jan. 21, 2020)
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