Cefadroxil is a broad-spectrum, first-generation cephalosporin antibiotic indicated for the treatment of a variety of bacterial infections. It functions by inhibiting bacterial cell wall synthesis, leading to bacterial cell death. This oral medication is valued for its once or twice-daily dosing convenience and reliable efficacy against susceptible organisms, making it a practical choice in outpatient and community settings.

Features

• Belongs to the first-generation cephalosporin class
• Broad-spectrum activity against Gram-positive and some Gram-negative bacteria
• Oral formulation available as capsules, tablets, and oral suspension
• Stable in acidic environments, allowing for consistent absorption
• Long half-life permitting once or twice-daily dosing
• Bactericidal action through inhibition of cell wall synthesis

Benefits

• Effectively treats common bacterial infections such as skin/soft tissue infections, urinary tract infections, and pharyngitis
• Convenient dosing schedule improves patient adherence and reduces missed doses
• Well-tolerated profile with a lower incidence of severe adverse effects compared to broader-spectrum alternatives
• Suitable for both adult and pediatric populations with weight-based dosing
• Cost-effective option within the cephalosporin class
• Minimal impact on gut flora compared to some broader-spectrum antibiotics

Common use

Cefadroxil is commonly prescribed for bacterial infections caused by susceptible strains of microorganisms. Primary indications include skin and skin structure infections such as impetigo, cellulitis, and wound infections caused by Staphylococcus aureus and Streptococcus pyogenes. It is also effective for urinary tract infections caused by Escherichia coli, Proteus mirabilis, and Klebsiella species. Additionally, cefadroxil is used for pharyngitis and tonsillitis caused by Group A beta-hemolytic streptococci, serving as an alternative to penicillin in penicillin-allergic patients. Off-label uses may include prophylaxis for certain surgical procedures and treatment of mild to moderate respiratory tract infections, though its spectrum is less ideal for typical respiratory pathogens compared to later-generation cephalosporins.

Dosage and direction

The dosage of cefadroxil must be individualized based on the infection’s severity, pathogen susceptibility, and patient factors including renal function. For adults with normal renal function, the typical dosage is 1-2 grams daily, administered either as a single dose or in divided doses every 12 hours. For urinary tract infections, 1-2 grams daily in single or divided doses is standard, while for skin and skin structure infections, 1 gram daily is often sufficient. Pediatric dosing is typically 30 mg/kg/day in divided doses every 12 hours. For streptococcal pharyngitis, a duration of 10 days is recommended to prevent rheumatic fever. In patients with renal impairment, dosage adjustment is necessary: for creatinine clearance of 10-25 mL/min, administer 500 mg every 12 hours; for clearance below 10 mL/min, 500 mg every 24 hours is recommended. Cefadroxil should be administered with or without food, though food may help minimize gastrointestinal upset.

Precautions

Patients should complete the entire prescribed course of therapy even if symptoms improve to prevent development of resistance. Use with caution in patients with history of gastrointestinal disease, particularly colitis, as antibiotic use can cause pseudomembranous colitis. Renal function should be monitored during prolonged therapy, and dosage adjustments must be made for patients with impaired renal function. Prolonged use may result in overgrowth of nonsusceptible organisms; if superinfection occurs during therapy, appropriate measures should be taken. As with all antibiotics, cefadroxil should only be used to treat bacterial infections and is not effective against viral infections. Patients should be advised that diarrhea is a common problem with antibiotic use and typically ends when the antibiotic is discontinued; however, watery and bloody stools (with or without stomach cramps and fever) may indicate a more serious condition.

Contraindications

Cefadroxil is contraindicated in patients with known hypersensitivity to cephalosporin antibiotics or any component of the formulation. Cross-sensitivity between penicillins and cephalosporins has been documented; therefore, caution is advised in penicillin-allergic patients. A thorough allergy history should be obtained before prescribing, and the antibiotic should be discontinued if an allergic reaction occurs. Cefadroxil is also contraindicated in patients with a history of severe immediate hypersensitivity reactions to other beta-lactam antibiotics.

Possible side effect

The most commonly reported adverse reactions involve the gastrointestinal system, including diarrhea (4%), nausea (3%), and vomiting (1%). Dermatological reactions such as rash and urticaria occur in approximately 1-2% of patients. Hypersensitivity reactions ranging from mild skin eruptions to rare cases of anaphylaxis have been reported. Transient elevations in liver enzymes may occur but are typically asymptomatic. Other less common side effects include genital pruritus, vaginitis, dizziness, and fatigue. As with other cephalosporins, cefadroxil may cause positive direct Coombs’ tests. Pseudomembranous colitis has been reported with nearly all antibacterial agents, including cefadroxil, and may range in severity from mild to life-threatening.

Drug interaction

Probenecid may decrease renal tubular secretion of cefadroxil, resulting in increased and prolonged blood levels. Concurrent use with nephrotoxic drugs (aminoglycosides, potent diuretics) may increase the risk of nephrotoxicity. Cefadroxil may reduce the efficacy of oral contraceptives; additional contraceptive methods are recommended during therapy. False-positive reactions for glucose in the urine may occur with Benedict’s or Fehling’s solutions but not with enzyme-based tests. The absorption of cefadroxil may be reduced when taken with aluminum- or magnesium-containing antacids.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is almost time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Doubling the dose to make up for a missed dose is not recommended. Patients should be educated on the importance of adherence to the prescribed regimen to maintain effective drug concentrations and prevent development of resistance.

Overdose

Symptoms of overdose may include nausea, vomiting, epigastric distress, and diarrhea. In cases of significant overdose, hemodialysis may aid in removal of cefadroxil from the bloodstream. Serum levels of cefadroxil can be measured, and treatment should be symptomatic and supportive. Particular attention should be paid to electrolyte balance and renal function. There is no specific antidote for cefadroxil overdose.

Storage

Store at controlled room temperature (20-25°C or 68-77°F) in a tight, light-resistant container. Keep the oral suspension refrigerated after reconstitution and discard any unused portion after 14 days. Do not freeze. Keep all medications out of reach of children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for diagnosis and treatment recommendations. The prescribing physician should be consulted regarding specific indications, dosage, and duration of therapy. Not all possible uses, precautions, side effects, or interactions are listed here.

Reviews

Clinical studies have demonstrated cefadroxil’s efficacy rates of 85-95% for skin and soft tissue infections and 80-90% for urinary tract infections caused by susceptible organisms. The once-daily dosing regimen is frequently cited as a significant advantage in patient satisfaction and adherence studies. Medical professionals appreciate its predictable pharmacokinetics and generally favorable safety profile. Some reviews note that while its spectrum is narrower than newer cephalosporins, this can be advantageous in minimizing disruption to normal flora. The drug receives particular praise for its utility in pediatric populations due to the palatable suspension formulation.