Cefadroxil: Effective First-Line Oral Cephalosporin Antibiotic Therapy
Cefadroxil is a broad-spectrum, first-generation cephalosporin antibiotic designed for the treatment of a wide range of bacterial infections. Its bactericidal action inhibits cell wall synthesis, making it a reliable choice for both gram-positive and some gram-negative pathogens. With excellent oral bioavailability and a convenient once- or twice-daily dosing regimen, cefadroxil offers clinicians a practical option for outpatient management. It is particularly valued for its sustained serum concentrations, which support consistent therapeutic coverage throughout the dosing interval.
Features
- Chemical structure: Semi-synthetic cephalosporin antibiotic
- Spectrum: Broad-spectrum activity against gram-positive bacteria including Staphylococcus aureus and Streptococcus pyogenes, and select gram-negative organisms
- Administration: Oral formulation available as capsules, tablets, and suspension
- Pharmacokinetics: High oral bioavailability (>90%), prolonged half-life (~1.5 hours), primarily renal excretion
- Stability: Resistant to degradation by gastric acid, allowing effective oral absorption
Benefits
- Provides reliable bactericidal coverage for common skin, soft tissue, and urinary tract infections
- Convenient once- or twice-daily dosing supports patient adherence and reduces dosing errors
- Demonstrates high tissue penetration, particularly in skin, tonsillar, and urinary tissues
- Lower incidence of gastrointestinal side effects compared to some other oral antibiotics
- Suitable for use in both adult and pediatric populations (with appropriate weight-based dosing)
- Cost-effective generic availability increases accessibility for long-term treatment courses when necessary
Common use
Cefadroxil is indicated for the treatment of bacterial infections caused by susceptible strains of designated microorganisms. Common clinical applications include pharyngitis and tonsillitis caused by Streptococcus pyogenes, skin and skin structure infections caused by staphylococci and streptococci, and uncomplicated urinary tract infections caused by Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae. Off-label uses may include dental infections and as prophylactic treatment in certain surgical procedures, though these applications require specific clinical justification.
Dosage and direction
The recommended dosage varies based on infection severity, pathogen susceptibility, and patient factors including renal function. For most infections in adults with normal renal function, the typical dose is 1-2 grams daily, administered either as a single dose or in divided doses every 12 hours. Pediatric dosing is typically 30 mg/kg/day in divided doses every 12 hours. For streptococcal pharyngitis, a duration of 10 days is standard. Dosage adjustment is necessary in patients with impaired renal function (creatinine clearance <50 mL/min). Administration with food may minimize potential gastrointestinal discomfort.
Precautions
Use with caution in patients with history of gastrointestinal disease, particularly colitis. Renal function should be assessed before initiation and monitored during prolonged therapy. As with all antibiotics, cefadroxil may cause overgrowth of nonsusceptible organisms, including fungi; monitor for superinfection. Use during pregnancy only if clearly needed (Category B). Cefadroxil is excreted in human milk; caution should be exercised when administering to nursing women. False positive reactions for glucose in the urine may occur with Benedict’s or Fehling’s solutions but not with enzyme-based tests.
Contraindications
Cefadroxil is contraindicated in patients with known hypersensitivity to cephalosporin antibiotics. Cross-sensitivity may occur in patients allergic to penicillins; the incidence is approximately 5-10%. Contraindicated in patients with previous history of severe hypersensitivity reaction (anaphylaxis) to any beta-lactam antibiotic. Not recommended for the treatment of meningitis due to inadequate cerebrospinal fluid penetration.
Possible side effect
Common adverse reactions (≥1%) include diarrhea (2.5%), nausea (1.9%), dyspepsia, abdominal pain, and vaginitis. Hypersensitivity reactions may manifest as rash, urticaria, pruritus, or fever. Rare but serious adverse effects include pseudomembranous colitis, Stevens-Johnson syndrome, toxic epidermal necrolysis, and hematologic effects such as neutropenia, thrombocytopenia, and eosinophilia. Transient elevations in hepatic transaminases, alkaline phosphatase, and BUN have been reported. As with many antibiotics, Clostridium difficile-associated diarrhea may occur.
Drug interaction
Probenecid may decrease renal tubular secretion of cefadroxil, increasing and prolonging serum concentrations. Concurrent use with nephrotoxic drugs (aminoglycosides, potent diuretics) may increase renal toxicity potential. Anticoagulant effects of warfarin may be potentiated; monitor prothrombin time. False positive Coombs test results may occur. Oral typhoid vaccine efficacy may be reduced; avoid concurrent administration.
Missed dose
If a dose is missed, it should be taken as soon as possible. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed administration. Maintaining consistent serum levels is important for therapeutic efficacy, but single missed doses are unlikely to significantly impact overall treatment outcomes in most cases.
Overdose
Symptoms of overdose may include nausea, vomiting, epigastric distress, diarrhea, and hematuria. Serum concentrations may be reduced by hemodialysis or peritoneal dialysis. Treatment should be supportive and symptomatic. In cases of significant overdose, particularly in patients with renal impairment, monitor renal function and provide appropriate hydration. 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 suspension form refrigerated after reconstitution; discard unused portion after 14 days. Keep out of reach of children. Do not freeze. Protect from excessive moisture and light. Do not use beyond the expiration date printed on the packaging.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. The prescribing physician should be consulted for diagnosis and treatment of medical conditions. Dosage and administration should be determined by a qualified healthcare professional based on individual patient characteristics. Not all possible uses, precautions, side effects, or interactions are listed here.
Reviews
Clinical studies demonstrate cefadroxil’s efficacy rates of 85-95% for indicated infections, with favorable tolerability profiles compared to some alternative antibiotics. Physician surveys indicate preference for cefadroxil in specific clinical scenarios due to its dosing convenience and predictable pharmacokinetics. Patient-reported outcomes generally reflect good tolerance, with particularly positive feedback regarding the once-daily dosing regimen improving compliance. The drug maintains its position in treatment guidelines as a recommended option for uncomplicated skin and urinary tract infections in appropriate patient populations.