cefadroxil

Action

Interferes with bacterial cell-wall synthesis, causing cell to rupture and die

Availability

Capsules: 500 mg

Oral suspension: 250 mg/5 ml, 500 mg/5 ml

Tablets: 1 g

Indications and dosages

➣ Pharyngitis and tonsillitis caused by beta-hemolytic streptococci

Adults: 1 g/day P.O. or 500 mg P.O. b.i.d. for 10 days

Children: 30 mg/kg/day P.O. in divided doses q 12 hours for 10 days

➣ Skin infections caused by staphylococci and streptococci

Adults: 1 g/day P.O. or 500 mg P.O. q 12 hours

Children: 30 mg/kg/day P.O. in divided doses q 12 hours

➣ Urinary tract infections caused by Proteus mirabilis, Escherichia coli, and Klebsiella species

Adults: 1 to 2 g/day P.O. in divided doses q 12 hours

Children: 30 mg/kg/day P.O. in divided doses q 12 hours

Dosage adjustment

• Renal insufficiency

• Elderly patients

Off-label uses

• Bone and joint infections

• Unspecified respiratory infections

Contraindications

• Hypersensitivity to cephalosporins or penicillins

Precautions

Use cautiously in:

• renal impairment, phenylketonuria

• history of GI disease (especially colitis)

• elderly patients

• pregnant or breastfeeding patients

• children.

Administration

• Obtain specimens for culture and sensitivity testing as necessary before starting therapy.

• Give with or without food.

Adverse reactions

CNS: headache, lethargy, paresthesia, syncope, seizures

CV: hypotension, palpitations, chest pain, vasodilation

EENT: hearing loss

GI: nausea, vomiting, diarrhea, cramps, oral candidiasis, pseudomembranous colitis

GU: vaginal candidiasis, nephrotoxicity

Hematologic: lymphocytosis, eosinophilia, bleeding tendency, hemolytic anemia, hypoprothrombinemia, neutropenia, thrombocytopenia, agranulocytosis, bone marrow depression

Hepatic: hepatic failure, hepatomegaly

Musculoskeletal: arthralgia

Respiratory: dyspnea

Skin: urticaria, maculopapular or erythematous rash

Other: chills, fever, superinfection, anaphylaxis

Interactions

Drug-drug. Aminoglycosides, loop diuretics: increased risk of nephrotoxicity

Probenecid: decreased excretion and increased blood level of cefadroxil

Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase, bilirubin, blood urea nitrogen, creatinine, eosinophils, gamma-glutamyltransferase, lactate dehydrogenase: increased levels
Coombs' test, urinary 17-ketosteroids, nonenzyme-based urine glucose tests (such as Clinitest): false-positive results

Hemoglobin, platelets, white blood cells: decreased values

Patient monitoring

• Assess baseline CBC and kidney and liver function test results.

• Monitor for signs and symptoms of superinfection and other serious adverse reactions.

• Be aware that cross-sensitivity to penicillins may occur.

• With long-term therapy, obtain monthly Coombs' test.

Patient teaching

• Advise patient to take drug with food or milk if GI upset occurs.

• Instruct patient to complete entire course of therapy even if he feels better.

• Tell patient to report signs and symptoms of allergic response and other adverse reactions, such as rash, easy bruising, bleeding, severe GI problems, wheezing, or difficulty breathing.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and tests mentioned above.