Cefadroxil is a first-generation cephalosporin antibiotic with broad-spectrum activity against numerous gram-positive and some gram-negative bacteria. It functions by inhibiting bacterial cell wall synthesis, leading to bacterial cell death. This oral formulation offers excellent bioavailability and a prolonged half-life, allowing for convenient once- or twice-daily dosing in appropriate indications. Cefadroxil remains a clinically relevant option for treating common community-acquired infections, particularly those involving skin, soft tissue, and the urinary tract.

Features

• Chemical structure: Semisynthetic cephalosporin antibiotic
• Pharmacokinetic profile: High oral bioavailability (~90%); not significantly affected by food
• Half-life: Approximately 1.5 hours, permitting less frequent dosing than some comparable agents
• Spectrum of activity: Effective against Staphylococcus aureus (non-MRSA), Streptococcus pyogenes, E. coli, Proteus mirabilis, and Klebsiella pneumoniae
• Formulations: Available as 500 mg and 1 g tablets, and oral suspension (250 mg/5 mL and 500 mg/5 mL)
• Excretion: Primarily renal, requiring dosage adjustment in renal impairment

Benefits

• Effective first-line treatment for uncomplicated skin and skin structure infections, including impetigo and cellulitis
• Proven efficacy in treating streptococcal pharyngitis and tonsillitis, offering an alternative for penicillin-allergic patients (non-anaphylactic allergy)
• Convenient dosing regimen improves patient adherence compared to antibiotics requiring more frequent administration
• Generally well-tolerated profile with a lower incidence of severe adverse effects compared to broader-spectrum alternatives
• Cost-effective therapeutic option for common outpatient bacterial infections
• Demonstrated clinical success in treating uncomplicated urinary tract infections caused by susceptible organisms

Common use

Cefadroxil is indicated for the treatment of infections caused by susceptible strains of designated microorganisms. Primary uses include skin and skin structure infections such as cellulitis, impetigo, and wound infections. It is also prescribed for pharyngitis and tonsillitis caused by Group A beta-hemolytic streptococci. Additionally, cefadroxil demonstrates efficacy in uncomplicated urinary tract infections including cystitis caused by E. coli, P. mirabilis, and Klebsiella species. Off-label uses may include dental infections and prophylaxis in certain surgical procedures, though these applications require specific clinical justification.

Dosage and direction

Adults: For skin and skin structure infections: 1 g daily or 500 mg twice daily. For pharyngitis and urinary tract infections: 1 g daily in single or divided doses. Children: 30 mg/kg/day in divided doses every 12 hours. For streptococcal pharyngitis, treatment should continue for at least 10 days. Dosage must be adjusted in renal impairment: For creatinine clearance 10-25 mL/min: 500 mg every 12 hours; For creatinine clearance <10 mL/min: 500 mg every 24 hours. Administration with food may minimize gastrointestinal upset. Complete the full course of therapy even if symptoms improve earlier.

Precautions

Use with caution in patients with history of gastrointestinal disease, particularly colitis. May result in emergence of resistant organisms with prolonged use. Superinfections with fungi or bacterial pathogens may occur. Use with caution in breastfeeding women as cefadroxil is excreted in human milk. False-positive reactions for glucose in the urine may occur with Benedict’s or Fehling’s solutions but not with enzyme-based tests. Positive direct Coombs tests have been reported. Prolonged use may result in overgrowth of nonsusceptible organisms.

Contraindications

Known hypersensitivity to cefadroxil or other cephalosporin antibiotics. Patients with history of anaphylactic reactions to penicillins should not receive cephalosporins due to cross-reactivity risk. Not indicated for the treatment of meningitis as penetration into cerebrospinal fluid is poor. Should not be used for infections caused by methicillin-resistant Staphylococcus aureus (MRSA) or other resistant organisms.

Possible side effect

Common adverse reactions (≥1%) include diarrhea (2.5%), nausea (1.9%), dyspepsia, and abdominal pain. Hypersensitivity reactions including rash, urticaria, and pruritus occur in approximately 1.5% of patients. Transient elevations in liver enzymes may occur. Rare but serious side effects include pseudomembranous colitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, and blood dyscrasias including neutropenia and thrombocytopenia. Vaginal candidiasis may develop secondary to alteration of normal flora.

Drug interaction

Probenecid may decrease renal tubular secretion of cefadroxil, increasing and prolonging antibiotic levels. May reduce efficacy of oral contraceptives; additional contraceptive methods recommended during therapy. Concomitant use with nephrotoxic drugs (aminoglycosides, potent diuretics) may increase risk of renal dysfunction. False-positive urine glucose tests may occur with certain methods. No clinically significant interaction with warfarin documented, but monitoring is advised during concomitant therapy.

Missed dose

If a dose is missed, take it as soon as remembered unless it is almost time for the next scheduled dose. Do not double the dose to make up for a missed one. Maintaining consistent antibiotic levels is important for therapeutic efficacy, but occasional missed doses are unlikely to significantly impact treatment outcomes if the regular schedule is promptly resumed.

Overdose

Symptoms of overdose may include nausea, vomiting, epigastric distress, and diarrhea. Neurological symptoms including seizures may occur with very high doses, particularly in patients with renal impairment. Management is supportive with gastric lavage if ingestion was recent. Hemodialysis may be effective in removing cefadroxil from the bloodstream, particularly in patients with renal compromise. Maintain adequate hydration and electrolyte balance.

Storage

Store at controlled room temperature (20-25°C or 68-77°F). Protect from moisture and light. Keep container tightly closed. Reconstituted oral suspension is stable for 14 days when refrigerated; discard any unused portion after this period. Keep out of reach of children. Do not use after expiration date printed on packaging.

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. Individual patient response and susceptibility patterns may vary. Not all possible uses, interactions, or adverse effects are included here.

Reviews

Clinical studies demonstrate cefadroxil achieves clinical cure rates of 85-95% in skin and soft tissue infections caused by susceptible organisms. For streptococcal pharyngitis, bacteriologic eradication rates exceed 90% when used as directed. In urinary tract infections, success rates of 80-90% have been reported in compliant patients. The once-daily dosing regimen receives positive patient feedback regarding convenience compared to multiple-daily-dose antibiotics. Healthcare providers appreciate its predictable pharmacokinetics and generally favorable safety profile, though note the importance of assessing penicillin allergy status before prescription.