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Product Name
:
CEDROX (dry powder)
Chemical Name
:
Cefadroxil
Therapeutic Category
:
Antimicrobial
Pharmacologic Category
:
Antibiotic, Cephalosporin (First Generation)
Pharmaceutical Form
:
Dry powder
Composition
:
Cefadroxil 125mg / 250mg
Monitoring Parameters
Dosing
 
Dosing: Adult
Susceptible infections: Oral: 1-2 g/day in 2 divided doses
Orofacial infections: Oral: 250-500 mg every 8 hours

Dosing: Pediatric
Susceptible infections: Oral: 30 mg/kg/day divided twice daily up to a maximum of 2 g/day

Dosing: Geriatric
Refer to adult dosing.

Dosing: Renal Impairment
Clcr 10-25 mL/minute: Administer every 24 hours.
Clcr <10 mL/minute: Administer every 36 hours.
Use
 
Treatment of susceptible bacterial infections, including those caused by group A beta-hemolytic Streptococcus
Adverse Reactions
 
1% to 10%: Gastrointestinal: Diarrhea
<1% (Limited to important or life-threatening): Abdominal pain, agranulocytosis, anaphylaxis, angioedema, arthralgia, cholestasis, dyspepsia, erythema multiforme, fever, nausea, neutropenia, pruritus, pseudomembranous colitis, rash (maculopapular and erythematous), serum sickness, Stevens-Johnson syndrome, thrombocytopenia, transaminases increased, urticaria, vaginitis, vomiting
Contraindications
 
Hypersensitivity to cefadroxil, any component of the formulation, or other cephalosporins
Warnings / Precautions Drug
 
Concerns related to adverse effects:
• Penicillin allergy: Use with caution in patients with a history of penicillin allergy, especially IgE-mediated reactions (eg, anaphylaxis, angioedema, urticaria).
• Superinfection: Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea (CDAD) and pseudomembranous colitis; CDAD has been observed >2 months postantibiotic treatment.
Disease-related concerns:
• Renal impairment: Use with caution in patients with renal impairment; modify dosage in severe impairment.
Interactions
 
BCG: Antibiotics may diminish the therapeutic effect of BCG. Risk X: Avoid combination
Probenecid: May increase the serum concentration of Cephalosporins. Risk C: Monitor therapy
Typhoid Vaccine: Antibiotics may diminish the therapeutic effect of Typhoid Vaccine. Only the live attenuated Ty21a strain is affected. Management: Vaccination with live attenuated typhoid vaccine (Ty21a) should be avoided in patients being treated with systemic antibacterial agents. Use of this vaccine should be postponed until at least 24 hours after cessation of antibacterial agents. Risk D: Consider therapy modification
Ethanol/Nutrition/Herb Interactions
Food: Concomitant administration with food, infant formula, or cow's milk does not significantly affect absorption.
Pregnancy
 
B
Pregnancy Implications
Adverse events were not observed in animal reproduction studies; therefore, cefadroxil is classified as pregnancy category B. Cefadroxil crosses the placenta. Limited data is available concerning the use of cefadroxil in pregnancy; however, adverse fetal effects were not noted in a small clinical trial. Adequate and well-controlled studies have been not completed in pregnant women.
Lactation
 
Enters breast milk (small amounts)/use caution (AAP rates “compatible”; AAP 2001 update pending)
Breast-Feeding Considerations
Very small amounts of cefadroxil are excreted in breast milk. The manufacturer recommends that caution be exercised when administering cefadroxil to nursing women. Nondose-related effects could include modification of bowel flora.
Mechanism of Action
 
Inhibits bacterial cell wall synthesis by binding to one or more of the penicillin-binding 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: Rapid and well absorbed
Distribution: Widely throughout the body and reaches therapeutic concentrations in most tissues and body fluids, including synovial, pericardial, pleural, and peritoneal fluids; bile, sputum, and urine; bone, myocardium, gallbladder, skin, and soft tissue
Protein binding: 20%
Half-life elimination: 1-2 hours; Renal failure: 20-24 hours
Time to peak, serum: 70-90 minutes
Excretion: Urine (>90% as unchanged drug)
 
   
 
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