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cefadroxil 250 mg/5 ml susp

Out of Stock Manufacturer WEST-WARD/HIKMA 00143976701
Out of Stock

Uses

Pharyngitis and Tonsillitis

Oral cefadroxil is used for the treatment of pharyngitis and tonsillitis caused by Streptococcus pyogenes (group A β-hemolytic streptococci). Although cefadroxil generally is effective in eradicating S. pyogenes from the nasopharynx, efficacy of the drug in prevention of subsequent rheumatic fever has not been established to date.

Selection of an anti-infective for the treatment of S. pyogenes pharyngitis and tonsillitis should be based on the drug's spectrum of activity, bacteriologic and clinical efficacy, potential adverse effects, ease of administration, patient compliance, and cost. No regimen has been found to date that effectively eradicates group A β-hemolytic streptococci in 100% of patients.

Because the drugs have a narrow spectrum of activity, are inexpensive, and generally are effective with a low frequency of adverse effects, the American Academy of Pediatrics (AAP), Infectious Diseases Society of America (IDSA), American Heart Association (AHA), and others recommend a penicillin regimen (i.e., 10 days of oral penicillin V or oral amoxicillin or single dose of IM penicillin G benzathine) as the treatment of choice for S. pyogenes pharyngitis and tonsillitis and prevention of initial attacks (primary prevention) of rheumatic fever. Other anti-infectives (e.g., oral cephalosporins, oral macrolides, oral clindamycin) are recommended as alternatives in penicillin-allergic individuals.

If an oral cephalosporin is used for the treatment of S. pyogenes pharyngitis and tonsillitis, a 10-day regimen of a first generation cephalosporin (cefadroxil, cephalexin) is preferred instead of other cephalosporins with broader spectrums of activity (e.g., cefaclor, cefdinir, cefixime, cefpodoxime, cefuroxime).

Skin and Skin Structure Infections

Oral cefadroxil is used for the treatment of mild to moderate skin and skin structure infections caused by susceptible staphylococci or streptococci.

Urinary Tract Infections

Oral cefadroxil is used for the treatment of mild to moderate urinary tract infections, including acute prostatitis, caused by susceptible Escherichia coli, Klebsiella, or Proteus mirabilis.

Prevention of Bacterial Endocarditis

Oral cefadroxil is used as an alternative for prevention of α-hemolytic (viridans group) streptococcal endocarditis in penicillin-allergic individuals undergoing certain dental or upper respiratory tract procedures who have underlying cardiac conditions that put them at highest risk of adverse outcomes from endocarditis. Cefadroxil should not be used for such prophylaxis in those with a history of immediate-type hypersensitivity to penicillins (e.g., urticaria, angioedema, anaphylaxis).

For information on which cardiac conditions are associated with highest risk of endocarditis and which procedures require prophylaxis, see . When selecting anti-infectives for prophylaxis of bacterial endocarditis, the current recommendations published by the AHA should be consulted.

Dosage and Administration

Reconstitution and Administration

Cefadroxil is administered orally.

Cefadroxil may be administered without regard to meals. Administration with food may minimize adverse GI effects.

Reconstitution

Cefadroxil powder for oral suspension should be reconstituted at the time of dispensing by adding the amount of water specified on the container to provide a suspension containing 125, 250, or 500 mg of cefadroxil per 5 mL. The water should be added in 2 equal portions and the bottle shaken after each addition.

The oral suspension should be shaken well prior to administration of each dose.

Dosage

Adult Dosage

Pharyngitis and Tonsillitis

For the treatment of pharyngitis and tonsillitis caused by Streptococcus pyogenes (group A β-hemolytic streptococci), the usual adult dosage of cefadroxil is 1 g daily given as a single dose or in 2 equally divided doses for 10 days.

Skin and Skin Structure Infections

For the treatment of skin and skin structure infections, the usual adult dosage of cefadroxil is 1 g daily given as a single dose or in 2 equally divided doses.

Urinary Tract Infections

For the treatment of uncomplicated urinary tract infections (i.e., cystitis), the usual adult dosage of cefadroxil is 1 or 2 g daily given as a single dose or in 2 equally divided doses. The usual adult dosage for the treatment of other urinary tract infections is 2 g daily given in 2 equally divided doses.

Pediatric Dosage

General Pediatric Dosage

The American Academy of Pediatrics (AAP) recommends that pediatric patients beyond the neonatal period receive cefadroxil in a dosage of 30 mg/kg daily in 2 equally divided doses for the treatment of mild or moderate infections. The AAP states that the drug is inappropriate for the treatment of severe infections.

Pharyngitis and Tonsillitis

For the treatment of group A β-hemolytic streptococcal pharyngitis and tonsillitis, the usual pediatric dosage of cefadroxil is 30 mg/kg daily given as a single dose or in 2 equally divided doses for 10 days.

Skin and Skin Structure Infections

For the treatment of impetigo, pediatric patients should receive cefadroxil in a dosage of 30 mg/kg daily given as a single dose or in 2 equally divided doses. For the treatment of other skin and skin structure infections, children should receive 30 mg/kg daily given in divided doses every 12 hours.

Urinary Tract Infections

For the treatment of urinary tract infections, the usual pediatric dosage of cefadroxil is 30 mg/kg daily given in divided doses every 12 hours.

Dosage in Renal Impairment

In patients with creatinine clearances of 50 mL/minute per 1.73 m or lower, doses and/or frequency of administration of cefadroxil must be modified in response to the degree of renal impairment. The manufacturers recommend that adults receive an initial dose of 1 g followed by 500-mg maintenance doses at the following dosage intervals based on the patient's creatinine clearance:(See Table 1.)

Table 1. Adult Dosage of Cefadroxil in Renal Impairment[100 ][120 ][121 ]
Clcr (mL/min per 1.73 m2) Initial Dose Maintenance Dosage
25-50 1 g 500 mg every 12 hours
10-25 1 g 500 mg every 24 hours
0-10 1 g 500 mg every 36 hours

Cautions

Cefadroxil shares the toxic potentials of other cephalosporins, and the usual cautions, precautions, and contraindications associated with cephalosporin therapy should be observed.

Pharmacokinetics

Absorption

Cefadroxil is acid-stable and is rapidly and almost completely absorbed from the GI tract. The rate of absorption and peak serum concentrations of cefadroxil are not affected when the drug is administered with food.

Following oral administration in healthy adults with normal renal function, peak serum cefadroxil concentrations are attained within 1-2 hours and average about 10-18 mcg/mL following a single 500-mg dose and 24-35 mcg/mL following a single 1-g dose.

In a group of children 13 months to 12 years of age with normal renal function, peak serum concentrations of cefadroxil averaged 13.7 mcg/mL and were attained within 1 hour after a single oral dose of 15 mg/kg; serum concentrations of the drug were 0.6-1.8 mcg/mL at 6 hours.

Elimination

The serum half-life of cefadroxil is 1.1-2 hours in adults with normal renal function.

Cefadroxil is excreted unchanged in urine. In adults with normal renal function, from 70 to more than 90% of a single 500-mg or 1-g oral dose of the drug is excreted unchanged in urine within 24 hours, principally within the first 6-9 hours after administration. In adults with normal renal function, peak urine concentrations of cefadroxil of 1.8 mg/mL may be attained following a single 500-mg oral dose.

The serum half-life of cefadroxil is prolonged in patients with impaired renal function. The half-life of cefadroxil is 2.5-8.5 hours in patients with creatinine clearances of 20-50 mL/minute per 1.73 m and 13.3-25.5 hours in patients with creatinine clearances less than 20 mL/minute per 1.73 m. Renal elimination of cefadroxil is substantially reduced in patients with creatinine clearances less than 20 mL/minute per 1.73 m, with about 10-30% of a single oral dose excreted unchanged in urine within 24 hours.

Cefadroxil is removed by hemodialysis.

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