Cefadroxil (cephalosporin generasi I)

Pronunciation
U.S. Brand Names
Generic Available
Synonyms
Pharmacological Index
Use
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse Reactions
Overdosage/Toxicology
Drug Interactions
Stability
Mechanism of Action

Pharmacodynamics/Kinetics
Usual Dosage
Dietary Considerations
Monitoring Parameters
Test Interactions
Mental Health: Effects on Mental
Status
Mental Health: Effects on
Psychiatric Treatment
Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions
Dental Health: Effects on Dental
Treatment
Patient Information
Nursing Implications
Dosage Forms
References

Pronunciation
(sef a DROKS il)
U.S. Brand Names
Duricef
Generic Available
No
Synonyms
Cefadroxil Monohydrate
Pharmacological Index
Antibiotic, Cephalosporin (First Generation)
Use
Dental: Alternative antibiotic for prevention of bacterial endocarditis. Individuals
allergic to amoxicillin (penicillins) may receive cefadroxil provided they have not
had an immediate, local, or systemic IgE-mediated anaphylactic allergic reaction
to penicillin.
Medical: Treatment of susceptible bacterial infections, including those caused by
group A beta-hemolytic Streptococcus; prophylaxis against bacterial endocarditis
in patients who are allergic to penicillin and undergoing surgical or dermal
procedures

Pregnancy Risk Factor

B
Contraindications
Hypersensitivity to cefadroxil or other cephalosporins
Warnings/Precautions
Modify dosage in patients with severe renal impairment; prolonged use may result
in superinfection; use with caution in patients with a history of penicillin allergy
especially IgE-mediated reactions (eg, anaphylaxis, urticaria); may cause
antibiotic-associated colitis or colitis secondary to C. difficile
Adverse Reactions
1% to 10%: Gastrointestinal: Diarrhea
<1%: Anaphylaxis, rash (maculopapular and erythematous), erythema multiforme,
Stevens-Johnson syndrome, serum sickness, arthralgia, urticaria, pruritus,
angioedema, pseudomembranous colitis, abdominal pain, dyspepsia, nausea,
vomiting, elevated transaminases, cholestasis, vaginitis, neutropenia,
agranulocytosis, thrombocytopenia, fever
Reactions reported with other cephalosporins include toxic epidermal necrolysis,
abdominal pain, superinfection. renal dysfunction, toxic nephropathy, aplastic
anemia, hemolytic anemia, hemorrhage, prolonged prothrombin time, increased
BUN, increased creatinine, eosinophilia, pancytopenia, seizures
Overdosage/Toxicology
After acute overdose, most agents cause only nausea, vomiting, and diarrhea,
although neuromuscular hypersensitivity and seizures are possible, especially in
patients with renal insufficiency; many beta-lactam antibiotics have the potential
to cause neuromuscular hyperirritability or seizures
Hemodialysis may be helpful to aid in the removal of the drug from the blood but
not usually indicated, otherwise most treatment is supportive or symptom directed
following GI decontamination
Drug Interactions
Increased effect: Probenecid may decrease cephalosporin elimination
Increased toxicity: Furosemide, aminoglycosides may be a possible additive to
nephrotoxicity
Stability
Refrigerate suspension after reconstitution; discard after 14 days

Mechanism of Action
Inhibits bacterial cell wall synthesis by binding to one or more of the penicillinbinding proteins (PBPs) which in turn inhibits the final transpeptidation step of
peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall
biosynthesis. Bacteria eventually lyse due to ongoing activity of cell wall autolytic
enzymes (autolysins and murein hydrolases) while cell wall assembly is arrested.
Pharmacodynamics/Kinetics
Absorption: Oral: Rapid and well absorbed from GI tract
Distribution: Widely distributed throughout the body and reaches therapeutic
concentrations in most tissues and body fluids, including synovial, pericardial,
pleural, and peritoneal fluids; also bile, sputum, and urine; also bone, the
myocardium, gallbladder, skin and soft tissue; crosses the placenta and appears in
breast milk
Protein binding: 20%
Half-life: 1-2 hours; 20-24 hours in renal failure
Time to peak serum concentration: Within 70-90 minutes
Elimination: >90% of dose excreted unchanged in urine within 8 hours
Usual Dosage
Oral:
Adults: 1-2 g/day in 2 divided doses
Prophylaxis against bacterial endocarditis: 2 g 1 hour prior to the procedure
Dosing interval in renal impairment:
Clcr 10-25 mL/minute: Administer every 24 hours
Clcr <10 mL/minute: Administer every 36 hours
Dietary Considerations
Concomitant administration with food, infant formula, or cow's milk does not
significantly affect absorption
Monitoring Parameters
Observe for signs and symptoms of anaphylaxis during first dose
Test Interactions
Positive direct Coombs', false-positive urinary glucose test using cupric sulfate
(Benedict's solution, Clinitest, Fehling's solution), false-positive serum or urine

creatinine with Jaff reaction

Mental Health: Effects on Mental Status
May cause nervousness; case reports of euphoria, delusion, illusions, and
depersonalization with cephalosporins
Mental Health: Effects on Psychiatric Treatment
May rarely cause neutropenia; use caution with clozapine and carbamazepine
Dental Health: Local Anesthetic/Vasoconstrictor Precautions
No information available to require special precautions
Dental Health: Effects on Dental Treatment
No effects or complications reported
Patient Information
Take as directed, at regular intervals around-the-clock (with or without food).
Chilling oral suspension improves flavor (do not freeze). Complete full course of
medication, even if you feel better. Drink 2-3 L fluid/day. If diarrhea occurs,
yogurt or buttermilk may help. May cause false-positive test with Clinitest; use
another form of testing. May interfere with oral contraceptives; additional
contraceptive measures are necessary. Report severe, unresolved diarrhea; vaginal
itching or drainage; sores in mouth; blood, pus, or mucus in stool or urine; easy
bleeding or bruising; unusual fever or chills; rash; or respiratory difficulty. Breastfeeding precautions: Consult prescriber if breast-feeding.
Nursing Implications
Administer around-the-clock to promote less variation in peak and trough serum
levels
Dosage Forms
Capsule, as monohydrate: 500 mg
Suspension, oral, as monohydrate: 125 mg/5 mL, 250 mg/5 mL, 500 mg/5 mL (50
mL, 100 mL)
Tablet, as monohydrate: 1 g
References
"Advisory Statement. Antibiotic Prophylaxis for Dental Patients With Total Joint
Replacements. American Dental Association; American Academy of Orthopedic

Surgeons," J Am Dent Assoc, 1997, 128(7):1004-8.

Cutler RE, Blair AD, and Kelly MR, "Cefadroxil Kinetics in Patients With Renal
Insufficiency," Clin Pharmacol Ther, 1979, 25(5 Pt 1):514-21.
Dajani AS, Taubert KA, Wilson W, et al, "Prevention of Bacterial Endocarditis
Recommendations by the American Heart Association," JAMA, 1997,
277(22):1794-801.
Donowitz GR and Mandell GL, "Beta-Lactam Antibiotics," N Engl J Med, 1988,
318(7):419-26 and 318(8):490-500.
Marshall WF and Blair JE, "The Cephalosporins," Mayo Clin Proc, 1999,
74(2):187-95.
Smith GH, "Oral Cephalosporins in Perspective," DICP, 1990, 24(1):45-51.