CEFADROXIL
| CEFADROXIL (sef-a-drox'ill) Duricef Classifications: antibiotic; first-generation cephalosporin; Therapeutic: antibiotic; cephalosporin Prototype: Cefazolin Pregnancy Category: B |
Availability
500 mg capsules; 1 g tablets; 125 mg/5 mL, 250 mg/5 mL, 500 mg/5 mL suspension
Action
Semisynthetic, first-generation cephalosporin antibiotic. Bactericidal action (similar to that of penicillins): drug penetrates bacterial cell wall, resists beta-lactamases, and inactivates enzymes essential to cell wall synthesis.
Therapeutic Effect
Active against organisms that liberate cephalosporinase and penicillinase (beta-lactamases). Effective in reducing signs and symptoms of urinary tract infections, bone and joint infections, skin and soft tissue infections, and pharyngitis.
Uses
Primarily in treatment of urinary tract infections caused by Escherichia coli, Proteus mirabilis, and Klebsiella sp.; infections of skin and skin structures caused by Staphylococci and Streptococci; and for treatment of group A beta-hemolytic streptococcal pharyngitis and tonsillitis.
Contraindications
Hypersensitivity to cephalosporins and penicillin.
Cautious Use
Sensitivity to penicillins or other drug allergies; impaired renal function, elderly; GI disease, history of colitis, coagulopathy; pregnancy (category B).
Route & Dosage
| Uncomplicated Urinary Tract Infection Adult: PO 1–2 g/d in 1–2 divided doses Child: PO 30 mg/kg/d in 2 divided doses Skin and Skin Structure Infections, Streptococcal Pharyngitis, or Tonsillitis Adult: PO 1 g/d in 1–2 divided doses Child: PO 30 mg/kg/d in 2 divided doses Renal Impairment Clcr <25 mL/min: Adult: PO 1 g q24h Child: PO 15 mg/kg q24h |
Administration
Oral- Give with food or milk to reduce nausea. If nausea persists, termination of therapy may be necessary.
- Follow directions for mixing oral suspension found on drug label. Reconstituted suspension contains 125 mg or 250 mg cefadroxil per 5 mL.
- Shake suspension well before use; discard after 14 d.
- Store in tight container unless otherwise directed. Oral suspensions are stable for 14 d under refrigeration at 2°–8° C (36°–46° F). Avoid freezing. Note expiration date on label.
Adverse Effects (≥1%)
Body as a Whole: Hypersensitivity [rash, swollen eyelids (angioedema), pruritus, chills], superinfections. GI: Nausea, diarrhea, vomiting, heartburn, gastritis, bloating, abdominal cramps.Diagnostic Test Interference
False-positive urine glucose determinations using copper sulfate reduction reagents, such as Clinitest or Benedict's reagent, but not with glucose oxidase tests (e.g., Clinistix, Diastix, TesTape). Cefadroxil-induced positive direct Coombs' test may interfere with cross-matching procedures and hematologic studies.
Interactions
Drug: Probenecid decreases renal excretion of cefadroxil.Pharmacokinetics
Absorption: Acid stable; rapidly absorbed from GI tract. Peak: 1 h. Elimination: 90% unchanged in urine within 8 h; bacterial inhibitory levels persist 20–22 h; crosses placenta; excreted in breast milk. Half-Life: 1–12 h.Nursing Implications
Assessment & Drug Effects
- Determine previous hypersensitivity to cephalosporins, penicillins, and other drug allergies, before therapy is initiated.
- Lab tests: Perform culture and sensitivity testing prior to and periodically during therapy.
- Lab tests: Perform baseline and periodic renal function studies in patients with renal function impairment, and monitor I&O ratio and pattern.
- Monitor for manifestations of drug hypersensitivity (see Signs & Symptoms, Appendix F). Discontinue drug and promptly report them if they appear.
- Monitor for manifestations of superinfection (see Signs & Symptoms, Appendix F). Promptly report their appearance.
Patient & Family Education
- Report promptly the onset of rash, urticaria, pruritus, or fever, as the possibility of an allergic reaction is high, if you are allergic to penicillin.
- Take medication for the full course of therapy as directed by your physician.
- Report promptly S&S of superinfections (see Appendix F).
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug