Cefadroxil

General

• Type: First generation cephalosporin
• Dosage Forms: 500, 1000; 250, 500/5ml susp
• Common Trade Names: Duricef

Adult Dosing

Infections, bacteria

• 1-2g/day PO divided q12-24h

Pharyngitis/tonsillitis, streptococcal

• 1g PO divided q12-24h x 10days

Pediatric Dosing

• infections, bacterial
  • 30mg/kg/day PO divided q12-24h max 2g/day

• paryngitis/tonsillitis, streptococcal
  • 30mg/kg/day PO divided q12-24h x 10days, max 1g/day

Special Populations

• Pregnancy Rating: B (no evidence of harm)
• Lactation: safe (no risk/minimal risk)
• Renal Dosing
  • Adult
    • GFR 25-50: 1g x1, then 500mg q12h
    • GFR 10-25: 1g x1 then 500mg q24h
    • GFR < 10: 1g x1, then 500mg q36h
    • HD: give 0.5-1g supplement
    • PD: 500mg q24h
  • Pediatric
    • GFR 10-25: give q24h
    • GFR < 10: give q36h
    • HD: give supplement
    • PD: no supplement
• Hepatic Dosing
  • Adult: not defined
  • Pediatric: not defined

Contraindications

• Allergy to class/drug

Adverse Reactions

Serious

• anaphylaxis
• Stevens-Johnson syndrome
• toxic epidermal necrolysis
• angioedema
• neutropenia
• thrombocytopenia
• pancytopenia
• anemia, hemolytic
• aplastic anemia
• hemorrhage
• seizures
• superinfection
• C.difficile-associated diarrhea

Common

• diarrhea
• nausea
• dyspepsia
• urticaria
• pruritus
• rash
• vomiting
• ALT, AST elevation

Pharmacology

• Half-life:
  • 78-96 min, 20-25hr (ESRD)
• Metabolism:
  • minimal, site unknown
• Excretion:
  • urine primarily (>90% unchanged)
• Mechanism of Action:
  • bacteriacidal; inhibits cell wall mucopeptide synthesis

Antibiotic Sensitivities

Group	Organism	Sensitivity
Gram Positive	Strep. Group A, B, C, G	S
	Strep. Pneumoniae	S
	Viridans strep	S
	Strep. anginosus gp	X1
	Enterococcus faecalis	R
	Enterococcus faecium	X1
	MSSA	S
	MRSA	R
	CA-MRSA	R
	Staph. Epidermidis	I
	C. jeikeium	R
	L. monocytogenes	R
Gram Negatives	N. gonorrhoeae	R
	N. meningitidis	R
	Moraxella catarrhalis	R
	H. influenzae	X1
	E. coli	S
	Klebsiella sp	S
	E. coli/Klebsiella ESBL+	R
	E coli/Klebsiella KPC+	R
	Enterobacter sp, AmpC neg	R
	Enterobacter sp, AmpC pos	R
	Serratia sp	R
	Serratia marcescens	X1
	Salmonella sp	R
	Shigella sp	R
	Proteus mirabilis	S
	Proteus vulgaris	R
	Providencia sp.	R
	Morganella sp.	R
	Citrobacter freundii	R
	Citrobacter diversus	R
	Citrobacter sp.	X1
	Aeromonas sp	X1
	Acinetobacter sp.	R
	Pseudomonas aeruginosa	R
	Burkholderia cepacia	R
	Stenotrophomonas maltophilia	R
	Yersinia enterocolitica	X1
	Francisella tularensis	X1
	Brucella sp.	X1
	Legionella sp.	R
	Pasteurella multocida	X1
	Haemophilus ducreyi	X1
	Vibrio vulnificus	X1
Misc	Chlamydophila sp	X1
	Mycoplasm pneumoniae	X1
	Rickettsia sp	X1
	Mycobacterium avium	X1
Anaerobes	Actinomyces	X1
	Bacteroides fragilis	X1
	Prevotella melaninogenica	X1
	Clostridium difficile	X1
	Clostridium (not difficile)	X1
	Fusobacterium necrophorum	X1
	Peptostreptococcus sp.	X1

Key

• S susceptible/sensitive (usually)
• I intermediate (variably susceptible/resistant)
• R resistant (or not effective clinically)
• S+ synergistic with cell wall antibiotics
• U sensitive for UTI only (non systemic infection)
• X1 no data
• X2 active in vitro, but not used clinically
• X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
• X4 active in vitro, but not clinically effective for strep pneumonia

See Also

• Antibiotics (Main)

References

Authors

Ross Donaldson, Ann Huang, Daniel Ostermayer, Neil Young