Cefadroxil is a broad-spectrum, first-generation cephalosporin antibiotic indicated for the treatment of a wide range of bacterial infections. It functions by inhibiting bacterial cell wall synthesis, leading to bacterial cell death. This oral formulation offers reliable bioavailability and a convenient once or twice-daily dosing regimen, making it a practical choice in outpatient settings for both adults and pediatric patients.

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
• Demonstrated stability against beta-lactamase enzymes from certain organisms
• Once or twice-daily dosing supported by prolonged half-life
• FDA-approved for multiple infection sites including skin, urinary tract, and pharynx

Benefits

• Provides effective eradication of susceptible bacterial pathogens
• Convenient dosing schedule enhances patient adherence to therapy
• Suitable for both adult and pediatric populations with weight-based dosing
• Lower incidence of gastrointestinal side effects compared to some alternative antibiotics
• Established safety profile with extensive clinical use history
• Cost-effective option within the cephalosporin class

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 cellulitis, impetigo, and wound infections. It is also effective for urinary tract infections including cystitis and pyelonephritis caused by Escherichia coli, Proteus mirabilis, and Klebsiella species. Additionally, cefadroxil is indicated 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 these applications should be guided by culture results and clinical judgment.

Dosage and direction

The dosage of cefadroxil should be adjusted based on the infection severity, pathogen susceptibility, and patient renal function. For adults with normal renal function, the typical dosage is 1 to 2 grams per day administered either as a single daily dose or divided into two doses. For urinary tract infections, 1 to 2 grams daily is recommended, while skin and skin structure infections typically require 1 gram daily. Pediatric dosing is based on body weight at 30 mg/kg/day divided into two doses. For streptococcal pharyngitis, treatment should continue for at least 10 days to prevent rheumatic fever. Patients with renal impairment require dosage adjustment: for creatinine clearance of 10-25 mL/min, the dosing interval should be extended to every 24 hours, while for clearance below 10 mL/min, dosing every 36 hours is recommended. Administration with food may minimize potential gastrointestinal discomfort.

Precautions

Before initiating cefadroxil therapy, careful patient assessment is essential. Use with caution in patients with history of gastrointestinal disease, particularly colitis, as antibiotic use may result in pseudomembranous colitis. Renal function should be evaluated, especially in elderly patients or those with pre-existing renal impairment, as dosage adjustments may be necessary. Prolonged use may result in overgrowth of nonsusceptible organisms, including fungi; regular monitoring for superinfection is advised. In patients with diabetes, cefadroxil may cause false-positive reactions for glucose in the urine when using copper reduction tests. Safety during pregnancy (Category B) and lactation should be carefully considered, weighing potential benefits against risks.

Contraindications

Cefadroxil is contraindicated in patients with known hypersensitivity to cephalosporin antibiotics. Cross-sensitivity between penicillins and cephalosporins may occur in up to 10% of patients with penicillin allergy; therefore, caution is advised in patients with history of severe hypersensitivity reactions to penicillins or other beta-lactam antibiotics. Additional contraindications include previous episodes of antibiotic-associated colitis or pseudomembranous colitis. The medication should not be administered to patients with demonstrated anaphylactic reactions to any cephalosporin antibiotic.

Possible side effect

The most commonly reported adverse reactions associated with cefadroxil involve the gastrointestinal system, including diarrhea (approximately 3% of patients), nausea, vomiting, and abdominal pain. Dermatological reactions may occur, such as rash, urticaria, and pruritus in approximately 1-2% of patients. Less frequent side effects include dizziness, headache, fatigue, and vaginal candidiasis. Laboratory abnormalities may include transient elevations in liver enzymes, eosinophilia, and rarely, neutropenia or thrombocytopenia. Serious but rare adverse effects include pseudomembranous colitis, Stevens-Johnson syndrome, and anaphylactic reactions. Patients should be advised to report any severe diarrhea, bloody stools, or signs of allergic reaction immediately.

Drug interaction

Several clinically significant drug interactions require consideration when prescribing cefadroxil. Probenecid may decrease renal tubular secretion of cefadroxil, resulting in increased and prolonged blood levels. Concurrent use with nephrotoxic medications such as aminoglycosides or potent diuretics may increase the risk of renal dysfunction. Cefadroxil may potentiate the effects of oral anticoagulants by suppressing vitamin K-producing gut flora, potentially requiring closer monitoring of coagulation parameters. The absorption of cefadroxil may be reduced when taken with iron supplements or antacids containing aluminum or magnesium. Laboratory test interactions include false-positive urine glucose tests with Benedict’s or Fehling’s solutions and false-positive direct Coombs’ tests.

Missed dose

If a dose of cefadroxil is missed, patients should take it as soon as they remember 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. Patients should not double the dose to make up for a missed one, as this may increase the risk of adverse effects. Maintaining consistent antibiotic levels is important for therapeutic efficacy, so patients should be counseled on the importance of adherence to the prescribed regimen. Setting reminders or associating dosing with routine daily activities can help prevent missed doses.

Overdose

In cases of cefadroxil overdose, symptoms may include nausea, vomiting, epigastric distress, diarrhea, and hematuria. Serum levels of cefadroxil can be reduced through hemodialysis, though this is rarely necessary. Management should focus on supportive care, including maintenance of hydration and electrolyte balance. Gastric lavage may be considered if ingestion occurred recently. There is no specific antidote for cefadroxil overdose. Patients should be monitored for signs of renal impairment, and symptomatic treatment should be provided for gastrointestinal distress. In severe cases, particularly in patients with renal impairment, more aggressive measures may be required under medical supervision.

Storage

Cefadroxil should be stored at controlled room temperature between 20°C to 25°C (68°F to 77°F), protected from light and moisture. Keep the medication in its original container with the lid tightly closed. The oral suspension form should be reconstituted with water according to package instructions and stored in the refrigerator between 2°C to 8°C (36°F to 46°F); discard any unused portion after 14 days. Do not freeze the suspension. Keep all medications out of reach of children and pets. Do not store in bathroom cabinets where humidity and temperature fluctuations may affect drug stability. Proper disposal of expired medication should follow local regulations or medication take-back programs.

Disclaimer

This information is provided for educational purposes only and does not constitute medical advice. The content presented here is not exhaustive and should not replace professional medical judgment. Healthcare providers should consult official prescribing information and current clinical guidelines before making treatment decisions. Individual patient response to medication may vary, and therapeutic decisions should be based on the specific clinical situation, including consideration of alternative treatments. The manufacturer’s complete prescribing information should be reviewed for comprehensive details regarding indications, dosing, contraindications, and warnings.

Reviews

Clinical studies and post-marketing surveillance have demonstrated cefadroxil’s efficacy and tolerability profile. In comparative trials, cefadroxil has shown equivalent clinical efficacy to other cephalosporins for approved indications, with cure rates typically exceeding 85-90% for susceptible infections. The once-daily dosing regimen is frequently cited as advantageous for patient compliance compared to multiple-daily-dose antibiotics. Pediatric formulations are generally well-accepted by children, with the suspension form demonstrating good palatability. Some clinicians note the value of cefadroxil as a step-down therapy following intravenous cephalosporin treatment. Long-term clinical experience supports its position as a reliable option for common bacterial infections in both community and outpatient settings.